<![CDATA[RURAL HEALTH - BLOG]]>Fri, 21 Feb 2020 15:45:09 +1100Weebly<![CDATA[Running Season, RETURNING to running!]]>Wed, 23 Oct 2019 21:43:12 GMThttp://rhpl.com.au/blog/running-season-returning-to-running
The sun is shining, the birds are chirping and the magpies have settled, it’s time to dust off the runners and get ready for another stellar running season!

Running season for most, typically starts around October and will go through until March. It is during this time, as Podiatrists we see a spike in soft tissue related injuries – WHICH ARE PREVENTABLE!

Soft tissue injuries are typically multifactorial, meaning multiple reasons contribute to why the injury has occurred. As health professionals with extensive training we understand and address the causative factors that relate to your injury, thus helping you in both the short term while also reducing your risk of the same injury recurring in the future.

Here are our top tips for being proactive in reducing your risk of injury this running season.


How old are your runners? Manufacturers will say that the lifespan of a pair of runners is 600-800 km. If you’re unsure – best to update.

​Do your runners suit your biomechanics? Every pair of runners on the market will influence your biomechanics in either a positive or negative way. Barefoot, minimalist, pronation controlling, zero drop, maximalist... are these terms new to you? If so your runners should be fitted by a specialist who understands lower limb biomechanics and how a shoe can influence it.

What shoes do you wear on a daily basis?
Typically we spend 40+ hours in our day-day shoes and comparatively only 3-5 hours in our runners. Poor footwear day-day can lead to excessive fatigue in your lower limb soft tissues, so that when you do go for a run, your muscles are already fatigued to begin with and cannot give 100%. This increases the chance of injuries developing.


Do you have any niggling injuries carrying over from past running seasons? A lot of runners often begin the running season without addressing any niggles from the season before. A rest over winter often doesn’t cure these symptoms and sore muscles are often the sign of weak muscles. See a Health Professional and spring in to your running season niggle free! 


Have you got your training program sorted? Are you incorporating progressive overload and allowing for adaptation time? A proper training program is one of the simplest ways to reduce your risk of injury this season. Many runners believe that they could run 10km ‘easily’ and with 4 months off do the same. Don’t make that mistake. Start off small and build slowly and progressively, seek a Health Professional or running coaches advice for tips and tricks if uncertain.
At Peak Performance Podiatry, our Podiatrist holds additional qualifications in running training and lower limb strength and conditioning, for more information you can book online or please phone 02 5926 3806.
<![CDATA[SKI bootS + SKI orthotics = Happy Feet]]>Wed, 10 Jul 2019 22:33:42 GMThttp://rhpl.com.au/blog/ski-boots-ski-orthotics-stable-happy-feetPicture
Ski orthoses / orthotics, custom foot beds or ski insoles are well established to benefit a skier or boarder in three ways...
  • Even pressure dispersion 
  • Foot alignment and support
  • Cushioning
Ski boots are very firm and rigid supporting the foot on the sides and across the top, so it is vital to support the foot from underneath with an orthotic device. Think of it like filling in the gaps or empty space in your boot. When purchasing new ski or snowboard boots any worthwhile Boot Fitter will suggest you get custom made inserts in your boots. Custom inserts are also always the first place to start to resolve any boot fitting problems, without stabilising the foot any changes made elsewhere in the boot will not fix the problem as the foot remains unstable.​ 

Regular orthoses do not work in ski boots as they are designed for a walking or running gait in which the foot performs greatly contrasting movements to those in a ski boot. Regular orthoses are designed for the foot to go through a full range of movements from heel strike to toe-off and then swing through the air. In contrast in a ski boot your foot is stuck in mid-stance all the time. Ski orthoses are designed to support your foot in optimal neutral position distributing pressure throughout the ski turn. Regular orthoses are generally made from a hard polypropylene material and are designed to correct or change your gait pattern. Ski orthoses are softer, more accommodative and have a higher arch for support and pressure distribution.
  • Pressure dispersion - this will make the foot feel comfortably supported like it's never felt before. It prevents "hot spots" under the foot and an even feeling of control.
  • Holds the foot in a neutral joint position - Holding the foot in a neutral position supports the muscles and ligaments of the foot. The 33 joints are held in the ideal, neutral position allowing the nerves and arteries to run through without being squashed. This prevents cold and numb spots, and fatigue and cramping from muscles overworking. Ever had an arch cramp in a ski boot? Oh yeah, you need ski orthoses. Or if you already have ski orthoses, you need new ones/modifications.
  • Arch support - When turning, the arch will collapse if not supported, causing the ankle to roll in and the tibia to rotate inwards, creating a tendency to 'A-frame' as you move through the turn. Proper support here will prevent the ankle from rolling too much and causing shin rub or painful inner ankle problems on the boot.
  • Improved ski control - A ski orthosis "fills in the gaps" under the foot so your movements are translated to the ski with minimal energy loss from wasted movement.  Improved contact also improves your sense of balance - your head has more information with which to calculate your position in space (proprioception). Better control leads to improved technique from setting the ski on its edge and releasing it faster.
  • Prevents the foot from splaying - Did you know that your foot can measure a size larger if you don't have a well made custom ski orthosis in your ski boot? A boot that's too big will result in sloppiness and unnecessary foot pain. If you require any shell expansions for spots that rub or cause pressure, you need a ski orthosis. Unless you have a ski orthosis stabilising your foot, it will just move into the space created and you will still get the rubbing or squashed feeling in your feet. Black and bruised toes and toenails occur if your foot is not stabilised and is sliding around in the boot.
  • Cushioning - Everyone needs a bit a of cushioning between their foot and the hard plastic shell. Can you imagine the heel bruising without it? Ski boots come with a cushion-y insoles but they compress very quickly once you leave the shop and lack adequate support. Ski orthosis will maintain their cushioning while supporting your feet season after season.

First clipping into skis at Selwyn as a Milo Mini Mite, Podiatrist Evan has since spent many hours both on and off-piste in the Canadian Rockies, New Zealand Canterbury & Otago Alps and Australian NSW & VIC Alps as a snowboarder, alpine and telemark skier. Combining a long-term love for snow sports with his Podiatry degree Evan has a unique understanding of anatomy of the foot and lower limb, biomechanics and the role the equipment plays in the foot's functionality whilst skiing. At your initial consult our Podiatrist will do a full biomechanical assessment, take your history and inspect your ski boots. This is when we find out all about what kind of skiing you like to do, previous boot problems, injuries, biomechanical function and anything else relevant. A 3D scan will then be taken of your feet and a custom prescription will be made for your ski orthotics. At your next consult your ski orthotics will be ready for fit and issue just in time for your next snow trip. All of this is claimable through your private health fund, so don't forget your private health care card!

  • Everyone not only benefits, but NEEDS, ski orthoses.
  • Regular running or walking orthoses must NOT be worn in ski boots.
  • Ski orthoses will make your feet feel all warm and fuzzy all day long.
  • Ski orthoses lead to better control, less fatigue and longer ski days.
  • Make sure you get your ski orthoses made by someone with skill in understanding equipment AND feet and how they all fit together.
  • Ski orthoses made by a Podiatrist are claimable through your private health fund!

At Peak Performance Podiatry, our Podiatrist Evan is experienced in assessment, prescription, modification and fit of ski orthotics. For further information book online or phone 02 5926 3806

<![CDATA[Wart Treatment - FALKNOR’S DRY NEEDLING]]>Wed, 12 Jun 2019 10:41:14 GMThttp://rhpl.com.au/blog/wart-treatment-falknors-dry-needlingPicture
​What is it? Falknor's Dry Needling is a surgical procedure in which the wart (verruca) is punctured with a sterile needle repetitively producing bleeding and stimulation of the body’s immune system to recognise and respond to the Human Papilloma Virus.

Is it painful? This procedure is performed under local anaesthetic blocking pain. Anaesthetic action typically lasts one hour although patients report post operative pain experienced is very low.

What is the advantage of this procedure? There are many wart treatment options although the results are mixed, the treatments are often painful and they often require several consultations. Wart needling is an effective treatment, often working following the first treatment. Protective dressings can be removed  within one-to-three days post procedure permitting return to regular duties. A review consult is held eight weeks post procedure to assess treatment success.

Risks and complications of the procedure? Although carried out with due care the possible complications of this and any procedure involving injections include infection, bleeding, bruising or an unexpected reaction to the anaesthetic. Strict surgical procedure ensuring sterility are undertaken to ensure risk of complication is minimal.

If it does not work, what are my options? The treatment is typically repeated for a second session, on review after the second wart needling session if a positive outcome is not achieved alternate treatments are considered.

Will I need to take a pain killer afterwards? These are generally not necessary and anti-inflammatories should be avoided as this can reduce the body’s immune response and therefore success of the treatment.

How successful is the treatment? Warts are a notorious source of frustration for both practitioners and patients alike, as no single treatment is completely effective for all patients. Studies indicate Falknor's Dry Needling is 70% successful in the treatment of persistent warts and offers a high level of treatment efficacy compared to alternate therapies. 

Our Podiatrist is experienced in the Falknor's Wart Needling procedure in the treatment of persistent warts, for further information book online or phone 02 5926 3806

<![CDATA[warts: types, treatment & prevention.]]>Wed, 12 Jun 2019 10:33:39 GMThttp://rhpl.com.au/blog/warts-types-treatment-preventionPicture
Warts (verrucae) are lumpy growths caused by human papilloma virus infection of the epithelial (skin) cells. Warts seen on the feet are typically mosaic or plantar wart variations which are often resistant to topical Pharmacy preparations. Mosaic warts appear as a group of tightly clustered warts typically affecting the hands and soles of the feet. Plantar warts look like hard bumps and are often misdiagnosed as corns, they may have tiny black dots within them (as pictured) and typically affect the soles of the feet. 

Warts are common, particularly during childhood with studies indicating up to one in five children have warts and that children aged 12 to 16 years are most commonly affected. Anyone can develop warts, factors that increase risk include:
  • Injuries to the skin
  • Frequently getting the feet wet
  • Hands or feet that sweat heavily (hyperhidrosis)
  • Swimming in public swimming pools
  • Direct contact with other people’s warts
  • Scratching or shaving your own warts, which can spread the infection to other areas of your body.

Warts are a notorious source of frustration for both practitioners and patients alike, as no single treatment is completely effective for all patients. At Peak Performance Podiatry we only offer treatments with a strong evidence base indicating high levels treatment efficacy including: Depending on history, wart location and your day-to-day activities such as school, work or sports we subjectively approach treatment to ensure positive outcomes. Our Podiatrist Evan is experienced in the diagnosis and treatment of warts, for further information or tailored treatment book online or phone 02 5926 3806.

CAUTION: If you have diabetes or a weakened immune system (for example, HIV) and have developed plantar warts, speak to your Podiatrist before undertaking any type of treatment. DO NOT attempt to remove a wart yourself by burning, cutting, tearing, picking, or any other method.

<![CDATA[Winter weather, cold feet & chilblains.]]>Tue, 04 Jun 2019 22:52:20 GMThttp://rhpl.com.au/blog/winter-weather-cold-feet-chilblainsPicture
​Every year when the cold hits we see a worrying increase of feet suffering from chilblains particularly on the toes. 
Chilblains are an uncomfortable and often painful skin condition that occur as a reaction to cold temperatures. Symptoms typically include a burning or itching sensation, swelling or colour change from pale pink to red or dark blue in the affected areas. In more severe cases the surface of the skin may break and sores or blisters can develop. Chilblains rarely cause permanent damage but they are uncomfortable and do require treatment to prevent ulcers and/or infection. If you suffer recurrent or chronic chilblains you should discuss this with your Podiatrist or General Practitioner. 
Factors that increase risk of chilblains include:
  • Poor circulation
  • Family history of chilblains
  • Exposure of skin to cold & damp conditions
  • Lack of appropriate warm clothing - not enough layers or wearing cotton 
  • Women are more likely to get chilblains than men
  • Low body weight 
  • Raynaud’s phenomenon - a condition that affects the blood supply to certain parts of the body, usually fingers and toes
  • Autoimmune disease
To prevent chilblains:
  • Dress appropriately for the weather with several layers of woollen or synthetic clothing 
  • Dry shoes between wear
  • Change socks as soon as they get damp 
  • Limit exposure to cold 
  • If your feet get cold warm them slowly under warm water 
At Peak Performance Podiatry, our Podiatrist Evan is experienced in assessment and treatment of Chilblains. For further information book online or phone 02 5926 3806​.

<![CDATA[What is a cam walker/Moon Boot?]]>Mon, 03 Jun 2019 05:50:58 GMThttp://rhpl.com.au/blog/what-is-a-cam-walkermoon-bootPicture
What is a CAM Walker?
A Controlled Ankle Movement (CAM) Walker AKA Moonboot is designed to immobilise and offload the ankle & foot allowing damaged bone or soft-tissues to heal.

Why have I been prescribed a CAM walker?
Whether you have sustained a severe ligament/tendon overstrain, tear or rupture, fractured a foot/ankle bone or have a non-healing chronic wound a CAM walker will prevent excessive loading and movement of the affected tissues supporting healing. CAM Walker wear is typically part of longer term management in conjunction with a subjective rehabilitation plan. Conditions or injuries commonly involving CAM walker immobilisation in treatment include: 
  • Severe ankle sprain involving ligament tear or rupture.
  • Achilles tendinitis/tendinopathy.
  • Achilles tendon rupture.
  • Stress fracture.
  • Sesamoiditis.
  • Post foot surgery.
  • Chronic non healing wounds.
Features including velcro fastening permitting removal for showering, rocker bottom sole enabling crutch-less ambulation and adjustable padding facilitating custom fit are advantageous over alternate methods of immobilisation such as plaster casting.

Potential risks of a CAM Walker?
Due to the thicker CAM Walker sole you may experience a change in gait leading to strain of the knees, hips or lower back, this can be mitigated by wearing a supportive shoe with a similar sole thickness on the opposite foot. Likewise care must be taken on slippery/uneven surfaces or climbing stairs to avoid falls. We additionally advise against driving while wearing your CAM walker. Immobilisation in conjunction with injury can increase the risk of clot formation (Deep vein Thrombosis), if you feel abnormal pain or swelling in your leg additional to existing injury related pains, remove the walker immediately and present to your nearest hospital or GP.

What happens at the end of the wear period?
Before ceasing CAM Walker wear you are required to visit your prescribing practitioner for assessment to determine if adequate healing has occurred and if rehabilitation can then commence. Often an X-ray, diagnostic Ultrasound and/or physical re-examination is required to establish if sufficient healing of the damaged tissues has occurred. 

Where to purchase a CAM walker?
CAM Walkers can be purchased in our Tumut Clinic and should be fitted by a trained practitioner (Podiatrist or Physiotherapist) to ensure appropriate fit and offloading. 

At Peak Performance Podiatry, our Podiatrist Evan is experienced in prescription and fit of CAM Walkers. For further information, injury assessment or CAM Walkers fit and issue book online or phone 02 5926 3806.

<![CDATA[What is Dry Needling?]]>Wed, 15 May 2019 11:40:13 GMThttp://rhpl.com.au/blog/what-is-dry-needlingPicture
What is Dry Needling?
Dry Needling involves multiple advances of an acupuncture-type needle into the ‘trigger point’ of the muscle. The aim is to achieve a twitch in the muscle, which is associated with reduced muscle tension and pain.

What will I experience?
Initially the practitioner administering the treatment will briefly massage the target muscle body searching for taught bands and tender areas aka 'trigger points'. The needle then used is very thin, and you may or may not feel the needle enter your skin. If the muscle being needled is very tight and/or sensitive you will feel a cramping or twitch sensation. This is very short-lasting, and patients quickly learn to recognise this sensation as therapeutic as it is followed by a feeling of pain relief and muscle relaxation.

Are there any side effects?
The most common side effect is temporary muscle soreness after the treatment. This typically lasts for a day or two, and your clinician will instruct you on how to minimise this. There are other less common side effects such as bruising. If you have any questions about side effects, please discuss this with your clinician.

How does Dry Needling help?
Dry Needling helps to reduce pressure on the nerve by releasing muscle shortening. It is now well researched that the ‘twitch’ response in the muscle during dry needling is associated with the muscle relaxing and stopping the pull on adjacent areas.

How often will I need treatment?
Treatments are typically once a week, to allow enough recovery time between treatment sessions. However, this can vary. The number of treatments you will require will depend on many things, such as:
• How long you have had your problem
• The extent of your problem
• How long it takes to address the contributing factors
• How quickly your body can heal

Are there any contraindications to Dry Needling?
Prior to treatment please inform your clinician if you are pregnant, or have any of the following:
• Metal allergies
• Local infection
• Bleeding disorders or use anti-coagulants (eg. aspirin)
• Axillary or inguinal node dissection
• Joint replacements, implants or a pacemaker
• Needle phobia

At Peak Performance Podiatry, our Podiatrist Evan is certified by GEMt in application of Dry Needling within the lower limb. For further information about Dry Needling, how it may help you, or to book a consult with our Podiatrist book online or phone 02 5926 3806​.

<![CDATA[Ankle Sprains, What to do?]]>Wed, 01 May 2019 04:08:58 GMThttp://rhpl.com.au/blog/acute-ankle-sprains-what-to-doPicture
We’ve all stepped awkwardly slightly twisting an ankle at some point and thought that was a bit clumsy! But if you have immediate pain, swelling, bruising, instability or can no longer bear weight you have likely sprained your ankle…
Ankle sprains often happen during rapid changes in direction in multi-directional sports such as netball, soccer or rugby, or when walking on uneven ground. Typically the ankle rolls outwards and the foot turns inwards straining the lateral supporting muscles, tendons and ligaments.
Implications of a lateral ankle sprain vary in severity and may involve aspects of peroneal tendinopathy, anterior talofibular ligament tear [weakest and injured first] calcaneofibular ligament tear [injured in more severe ankle sprains] posterior tibiotalar ligament tear [strongest and rarely injured in isolation] or bone fracture [common in youth and elderly].
If you or someone you know has a suspected ankle sprain it is important during the first 48hrs post injury to rest, ice, compress & elevate the ankle. Use crutches to walk and take an oral anti-inflammatory medication such as Ibuprofen as directed to manage pain and reduce swelling. 1-2 days post injury you should seek specialist assessment from a trusted health professional such as a Podiatrist who will determine the severity of your injury via physical assessment, ultrasound or x-ray scans and then tailor a recovery and rehabilitation program to prevent long term weakness and instability.

​Our individually tailored rehabilitation programs aim to return normal ankle range of motion, strengthen supporting muscles, improve proprioception/balance and return you to functional activities and sport as soon as safely possible while reducing risk of recurrent ankle sprains.
For further information about ankle sprains or to book a consult with our Podiatrist book online or phone 02 5926 3806