<![CDATA[RURAL HEALTH - News & Updates]]>Fri, 16 Jul 2021 14:31:37 +1000Weebly<![CDATA[Diabetes and Your Feet]]>Sun, 01 Aug 2021 14:00:00 GMThttp://rhpl.com.au/blog/diabetes-and-your-feetDiabetes, if present long term or if glucose levels are poorly controlled can have significant negative implications on the health of your feet. Two of the most common effects include nerve damage and reduced blood supply to the feet. 
Nerve damage can present in the feet and legs in several ways, including:
  • Numbness
  • Coldness 
  • Tingling
  • Pins and needles
  • Burning
  • Altered sensations

Nerve damage can result in loss of sensation which protects the feet from accidental damage occurring when you can’t feel pain. Without detection, a minor injury can develop into an ulcer, which could eventually penetrate to bone. This significantly increases the risk of bone infection and may require amputation to prevent blood poisoning.

Reduced blood supply to the feet and legs is another common risk of poorly controlled glucose levels with diabetes. Poor blood flow increases the risk of infection following any injury that breaks the skin. Signs of reduced bloody flow can be leg cramps after walking short distances, cold feet, reddish-blue coloured skin in the feet and legs, and cuts or skin abrasions that are slow to heal. Reduced blood flow also makes it difficult for the body to fight infection should it occur.

Your Podiatrist will perform assessments to check the health of your nerve supply and bloody flow and provide assistance in managing these risk factors if they are prevalent.

Diabetes Australia advises a yearly diabetic foot check to ensure early identification of any negative changes.

For further information or to book a Diabetic foot assessment with a Podiatrist, phone 02 5926 3806.
<![CDATA[Exercising: Warm ups - what, why & when!]]>Tue, 06 Jul 2021 02:00:00 GMThttp://rhpl.com.au/blog/exercising-warm-ups-what-why-whenPicture
Warm-ups: we all know we’re meant to do them, but who really wants to waste that valuable time when you could get stuck straight in to your training or game. Especially as the temperature drops, winter sets in and everyone wants to be back indoors as quickly as possible!

You might think of a warm-up as running a couple of low-intensity laps around the oval before a training session, or jumping on the bike or rower for 5 minutes before a gym session - basically anything to get the heart pumping a bit faster and the body feeling a bit warmer, but you should think about a warm-up as much more than that!

​Let’s look at what a warm-up can really offer you…

Why should I warm up?

Studies Racinais and Oksa (2010) found that a variation in muscle temperature of just one degree Celsius can modify performance by 2-5%.

To put that into perspective - an average vertical jump height for a male is around 45cm. Adding 5% increases the jump to 47.25cm, this may not seem like much, but 2.5cm in the basketball world could be the difference between a block or a basket.

Effective implementation of a warm-up strategies also reduces the likelihood of musculoskeletal injury by loosening up your joints and improving blood flow to your muscles you are significantly reducing risk of soft tissue rips and tears, or joints twisting in a harmful way.

So what actually happens?

For us to move, our muscles contract and relax to bend our joints. As we move, heat is produced by friction from sliding filaments during muscle contractions. More blood flows to our working muscles, our blood vessels expand to help the blood flow through easily, and the viscosity (thickness) of our tissues reduces - this makes our muscles and joints less stiff. 

Like when you’re chewing gum, or playing with play dough, or preparing to roll out your famous homemade pizza dough. It can be a tough job to start with, but as you apply pressure it starts to become easier and easier to move and shape, until suddenly you’re the master of the gum/dough and it can be moulded however you want. We want to be the master of our muscles.

Elevating tissue temperatures also results in nerve impulses travelling more rapidly, meaning our rate of muscle contractions and reaction time will be faster.

So what's wrong with the 2 minute jog?

Warm-ups that include specific drills like movement preparation, muscle activation, dynamic stretching and mobility work have shown to have the most benefits to both performance (Fradkin et al. 2010), and injury prevention. So if we want to be able to sprint faster, or lift heavier, then we need to make sure we’re focusing on the right movements in our warm-ups.

​But not only from a physical perspective - when our warm-ups involve skill-specific movements it gives us the chance to visualise our goals, mentally prepare for the game or session at hand, and connect with teammates, coaches and our surrounding environment.

Then how should I warm-up?

Depending on what your session involves, each warm-up will be different:
  • Any sports involving sprinting movements need some prepared glute, hamstring, and calf muscles. 
  • Need to be jumping higher during your game? Then don’t forget to actually jump before you get on the court.
  • Planning on hitting your squat PB? Chances are much lower if your ankles aren’t going to let you get down that low, if all the muscles that make up your glutes aren’t ready to go, or your back and the small muscles around your spine aren’t able to get into the positions they need to be.
  • ​Tackling a frosty 6am run? Let’s think about what we’re wearing, and how that temperature is going to affect us.
​Not sure whether you’re getting the most out of your warm-up? Accredited Exercise Physiologist Brodie can help you find that extra 5%, for more information or bookings phone 02 5926 3806.
<![CDATA[Cortisone injections]]>Sun, 06 Jun 2021 14:00:00 GMThttp://rhpl.com.au/blog/cortisone-injectionsPicture
Are you experiencing pain in your foot and/or ankle that isn't responding well to conservative treatment?

​A cortisone injection may be an adjunct treatment option for you consider...

What is a cortisone injection? A cortisone injection is a type of corticosteroid which mimics your bodies natural anti-inflammatory hormones reducing inflammation, pain and swelling at the site of administration. ​ Cortisone injection may provide you short-to-medium pain relief for a wide range of inflammatory foot and ankle complaints such as:
  • Plantar Fasciitis
  • Morton’s Neuroma
  • Bursitis
  • Sesamoiditis
  • Synovitis
  • Capsulitis
  • Plantar Plate Tears
  • Sinus Tarsi Syndrome
  • Achilles tendinopathy
  • Tarsal tunnel syndrome
  • Posterior tibial tendonitis

What does a cortisone injection do?
There are different types of cortisone which have varied durations of action. Your GP will make a prescription appropriate to your presenting condition which can then be then administered by your Podiatrist. Typically a long-duration cortisone will be prescribed which will take effect within several weeks and last between 1-9 months, depending on your condition and the severity of it. During the period of cortisone effect it is important to continue your rehabilitation program to prevent reoccurrence of pain as cortisone effect progressively fades.

What happens during a cortisone injection?
Your Podiatrist will review the painful areas, GP prescription and any correspondence, if you have any concerns these will be discussed. Local anesthetic will be administered prior or with the cortisone to provide immediate pain relief. You may feel some pressure during administration which typically fades quickly as local anesthetic takes effect. 

How many injections are required?
Your Podiatrist will discuss with you the most beneficial treatment plan based on your injury. Often it will be guided by your response to the first injection and your injury or condition. Sometimes one injection is enough while other times multiple injections spaced weeks or months apart can be appropriate. Typically you will see your Podiatrist 2 weeks after cortisone injection to review progress and plan further care.

Risk of a cortisone injection?
Every procedure has associated risks. Potential side effects of cortisone injection include infection, bruising or reaction to the substance (eg. anaesthetic, corticosteroid). To reduce risk of complications we take great care by using sterile equipment, aseptic technique and injecting well below your safe maximum dose of local anaesthetic.

Where and how can I get a foot or ankle cortisone injection?
For further information regarding cortisone injections, our Podiatrist (Evan) and your GP can discuss which option will best suit you, for further information phone 02 5926 3806
<![CDATA[Wart treatment - curettage]]>Sun, 09 May 2021 23:30:09 GMThttp://rhpl.com.au/blog/wart-treatment-curettagePicture
What is it? Curettage is a procedure performed under local anaesthesia​ in which your Podiatrist will surgically remove the affected wart tissue and cauterise the site to prevent reoccurrence.

Not sure if this treatment is appropriate for you? Read on to find out more... 

What is the advantage of this treatment? 
Curettage is a relatively quick in consult surgical procedure, once local anesthetic is administered procedural pain is significantly reduced. Warts are difficult to treat and curettage is typically considered if topical treatments have failed. Studies report a success rates of 65% to 85% making curettage a viable treatment option.

Is it painful?
To lessen pain during procedure local anaesthetic is administered prior too commencing. There may be some moderate pain during local anesthetic administration although this will typically pass quickly as local anesthetic takes affect. Depending on the location of the wart your foot will typically be anaesthetized at the level of the ankle, your foot and the surgical site will typically be numb for 1 hour after the procedure. 

Risks and complications of the procedure?  Possible complications of this treatment include infection, reoccurrence, ulcer formation and scarring. Scarring and/or wart recurrence are reported to  occur in up to 30% of patients. As this procedure involves local anesthetic administration you will need to arrange for transportation to and from our rooms on the day of surgery. During the procedure our  Podiatrists take care to not go deeper than the epidermal/dermal layer which reduces risk of scarring and you will be provided strict post procedure care instructions to reduce risk of complications.

You must not use this treatment if:
  • You have poor circulation
  • Are living with diabetes
  • Experience needle phobia
  • Take anti-coagulants

If it does not work, what are my options? Healing of the site typically takes 7-14 days, at 2 weeks post procedure you will return for review. Wart curettage has a high success rate eradicating warts. However, there is always a chance for resistant warts to return especially when you are on immunosuppressive drugs and have diminished immune system, in case of reoccurrence further treatment options can be discussed.

Our Podiatrists are experienced in the treatment of persistent warts and can discuss which option will best suit you, for further information phone 02 5926 3806
<![CDATA[Active Ageing - Ella's work placement experience!]]>Sun, 04 Apr 2021 23:30:00 GMThttp://rhpl.com.au/blog/active-ageingPicture
Over the past months Ella Bradshaw, Year 10 work experience student has helped Brodie Palmer (Accredited Exercise Physiologist) deliver our group exercise sessions and has learnt about the considerable benefits of exercise for over 65's.

​Read on to hear from Ella the what, why and when on Active Ageing...

What are the benefits of exercise for people over 65 years of age?
Studies have shown that maintaining a regular exercise regime when you are over the age of 65 will decrease the likelihood of acquiring certain diseases. It can improve your mental health, by staying regularly active and putting it in your routine it can make your day a whole lot better. Another great thing is that it can decrease the risk of falls, by staying healthy the likelihood of having falls is less than the normal rate. 

What type of exercise is the best?
Water aerobics is the best exercise for people over 65. It can give you a range of motion that you can’t have out of the water. The water takes off some pressure that makes it easier for your body to be able to move better, it gives you a certain motion that you may no longer be able to use on land. Another great one is walking, it doesn’t have to be to extreme levels just as long as you are moving at least every day. There are some beautiful walking areas around our town that makes it so much better.
Pain or health issues making it hard to exercise?
Seeing an Exercise Physiologist (EP) about health or joint issues would be your best bet, seeing an EP comes with many great things such as: 
  • Giving you an exercise program to follow
  • Weekly check ins 
  • Friendly advice 
  • Group sessions for added social benefits 
  • Getting you fitter and stronger 
  • Helping you with rehabilitation 
This is why you should come and join our group sessions which happen every week.

Like the sound of that?
Accredited Exercise Physiologist (Brodie) with my help (Ella) will be running weekly Active Ageing groups for those over the age of 65 throughout the year.

​A short assessment is required before joining the groups. Call us on 02 5926 3806 a call to find out more and book your assessment. 

Look forward to seeing you there!
<![CDATA[RuralStrong Groups!]]>Sun, 21 Mar 2021 13:00:00 GMThttp://rhpl.com.au/blog/ruralstrong​What is it all about? Picture
RuralStrong is an exercise group that we run weekly. It incorporates strength, balance and flexibility activities to help improve mobility, function and independence.

Every week we move together in a safe and supervised environment while enjoying the social aspect of exercising in a group!

Why exercise?

There’s lots of benefits to participating in regular exercise. Not only does exercise help improve your heart and lung health, it keeps your bones and muscles strong, and you feel pretty good afterwards!

For older adults, exercise can have even more benefits. This includes things like:

Falls prevention:
Exercise prevents falls in older people, by address key risk factors:
  • Muscular strength
  • Balance
  • Flexibility
  • Balance confidence
  • Walking speed

Weight training can help to:
  • Protect brain cells
  • Preserve cognitive function
  • Exercise can also be used to manage dementia by:
  • Slowing progression
  • Improving physical and mental function
  • Slowing or reversing muscle wasting
  • Improving mood and depression
  • Lessening behavioural problems 

Exercise can help to:
  • Reduce pain
  • Increase muscle strength
  • Improve movement range
  • Improve balance
  • Prevent muscle wasting
  • Improve physical function
  • Improve wellbeing 

Exercise helps:
  • Develop stronger and better bones
  • Protect bones from injury
  • Increase bone mass
  • Prevent age-related bone loss
  • Increase muscle strength
  • Improve balance
  • Reduce falls risk

Can I join?

In partnership with Sport Aus and Exercise and Sports Science Australia, Rural Health is proud to run Active Ageing groups - which provide clinical exercise groups at a reduced rate. To be able to access the reduced rate, you’ll need to fit the following criteria
  1. Aged over 65 years (or over 55 years if you are an Aboriginal or Torres Straight Islander)
  2. Not currently meeting recommended physical activity guidelines (half an hour of moderate exercise every day)​

How much will it cost?

If eligible, you’ll come in for an initial meet and greet - this costs $5.50 - we will discuss your health history, any injuries or surgeries, your goals, and look at what your fitness and strength is like at the moment.

​Following this, you can join in on a weekly group - costing $8 per class.

If you’re not eligible, you can still join the groups - they will cost $15 each week.


Come and join our Accredited Exercise Physiologist, Brodie, for some movement and plenty of laughs  weekly at Rural Health!​
Contact us on 02 5926 3806 to register your interest, or pop in and see us at 27 Russell Street, Tumut.
<![CDATA[Leg length differences - Heel lifts & sole lifts]]>Thu, 04 Feb 2021 13:00:00 GMThttp://rhpl.com.au/blog/leg-length-differences-heel-lifts-sole-liftsPicture
Having one leg a little longer than the other is very common, differences of up to 5mm typically will not cause problems, although when differences are more significant (>5mm) this can lead to complications.

​Significant leg length discrepancies can cause poor posture and balance which can then cause other degenerative joint problems, stress fractures, soft tissue overuse injuries in the foot and ankle as well as increasing risk of falls and tripping.

Your Podiatrist can
 accomodate leg length differences by fitting a custom heel lift in your shoe and/or modify the sole of appropriate shoes increasing the sole thickness.

When would you need a lift?
  • An obvious observance of one leg being longer than the other
  • Affected posture (uneven loading between legs, scoliosis)
  • Problems with gait (tripping, scuffing one foot, hitching hip for each step)
  • Pain in the lower back, hip, ankle or knee

What is it? Heel and sole lifts involve your Podiatrist building up the shorter limb to regain symmetry, improve your gait and posture. Heel lifts and sole lifts have individual pros and cons...

Advantages of intrinsic heel lifts? 
Intrinsic heel lifts are relatively quick to fit in consult and can be added to existing orthotics or under the innersole that comes within the shoe, additionally heel lifts can be a useful tool to plantar-flex the ankle joint relieving achilles tendon/heel pressure.
Advantages of extrinsic sole lifts? 
Extrinsic sole lifts involve permanent modification of appropriate shoes. Once a careful biomechanical assessment has been performed and lift height has been determined our Podiatrist will keep the shoes overnight and replace the shoe sole while building in lift. Sole lifts can be shaped with a rocker to make walking easier and they also won't take up space within the shoe ensuring a perfect fit!
Our Podiatrists are experienced in the prescription of intrinsic heel lifts and the addition of extrinsic heel & sole lifts. To discuss which option may best suit you, phone 02 5926 3806.
<![CDATA[Return to sport injuries - Achilles/Calf Injury]]>Sun, 03 Jan 2021 13:00:00 GMThttp://rhpl.com.au/blog/achillescalfinjuryPicture
​After an extended break in regular training over the holiday period and a sudden return to sports our Podiatrists always see an increase in achilles tendon and calf muscle complaints. 

Do you want to avoid becoming another injury statistic? 

Here is our top 5 preventative tips to prevent Achilles Tendinopathy​!

​What is Achilles Tendinopathy?

An overstrain injury of the thick Achilles tendon, which connects the calf muscle to the heel bone. Similar to a rope fraying, the Achilles tendon can tear or rupture if load rapidly or continuously exceeds capacity.

Symptoms can vary but may include:
  • Heel pain
  • Achilles tenderness or burning
  • Swelling
  • Pain aggravated by running/sports

​Who is at risk:
Achilles pain can affect everyone but is most common in runners, those returning to sport after an extended break and middle-aged people who play sports only on the weekends.

How to prevent Achilles tendon and calf muscle pain...

  1. Structured pre-season training to ensure readiness to play.
  2. Warming up before training & sport sessions.
  3. Stretching after training & sport sessions.
  4. Wearing appropriate footwear that is well fitted and provides adequate support and traction for the playing surface.
  5. Staying hydrated before, during and after play.
Sometimes with regular training and prevention injury may still occur.... If you suspect achilles tendon or calf muscle injury you should see your Podiatrist for assessment and rehabilitation before returning to activity.

​For more information or to book an appointment with our experienced Podiatrists phone 02 5926 3806.
<![CDATA[Wart treatment - Cryotherapy]]>Fri, 31 Jul 2020 14:00:00 GMThttp://rhpl.com.au/blog/wart-treatment-cryotherapyPicture
What is it? Cryotherapy involves Podiatrist application of a liquid cryogen too wart tissue. The resultant freeze/thaw cycle causes the infected cells to rupture. This release is then recognised by your bodies immune system with a positive response seeing your body fight the human papillomavirus virus and the affected tissue blistering away.

Not sure if this treatment is appropriate for you? Read on to find out more... 

What is the advantage of this treatment? 
Cryotherapy is a relatively quick in consult treatment, studies indicate a cure rate of 75%.

Is it painful? There may be some moderate pain during the treatment and post treatment as the site beings to thaw, pain management options can be discussed with your Podiatrist prior to treatment.

Risks and complications of the procedure?  Possible complications of this treatment include skin irritation, pain,  ulceration, blistering, altered pigmentation and scarring. To prevent complications our Podiatrists will apply protection to the surrounding skin pre-treatment and give strict post treatment care instructions.

You must not use this treatment if:
  • You've had a previous adverse reaction to cryotherapy
  • Have poor circulation
  • Have diabetes
  • Have dark skin

If it does not work, what are my options? Healing of the site typically takes 7-14 days, at 2 weeks post procedure you will return for review where further freezing will be performed if required. If treatment has failed after several sessions alternate therapies include Falknor's Needling or Topicals should be considered

Our Podiatrists are experienced in the treatment of persistent warts and can discuss which option will best suit you, for further information phone 02 5926 3806
<![CDATA[Custom orthotics - Richie brace]]>Sun, 05 Jul 2020 14:00:00 GMThttp://rhpl.com.au/blog/custom-orthotics-richie-brace​Are you living with foot drop, chronic ankle instability, posterior tibial tendon dysfunction, or even complex neurological conditions such as cerebral palsy or post stoke neurological change?

​At Rural Health we have a lightweight and comfortable solution that will fit within your everyday footwear, aiding in restoring mobility!
More than just your every day ankle brace or foot orthotic, the Richie Brace is a custom option for difficult to treat foot and ankle conditions. It is normally prescribed for problems such as foot drop, chronic ankle instability and posterior tibial tendon dysfunction, and even complex neurological conditions such as cerebral palsy or post stroke neurological damage. 

The Richie Brace is a revolutionary treatment option available through our Podiatry service here at Rural Health. Designed to be lightweight, comfortable and fit easily into everyday footwear, it is a much more discrete yet functional brace for everyday wear. Challenging pathologies which historically would be referred on for surgery can now often be managed through a conservative option, avoiding the need for invasive surgery.

The slogan associated with the Richie Brace, “Restoring Mobility”, could not be more accurate. With trademark components including a custom moulded foot bed and the patient specific hinge joint designed to support the ankle joint.

When getting assessed and fitted for a Richie Brace your Podiatrist will take plaster moulds of your feet and ankles, while carefully measuring the ankle structures to allow creation of a brace that is perfectly tailored to suit you. This is not an over the counter, one size fits all - and as everyone is different this is what we love about it! We can essentially create a brace that performs the job of your ankle for you, allowing chronic injuries the chance to heal while allowing you to get on with daily life as normal as possible. 
Over time once injuries have healed and have been adequately rehabilitated many patients are able to discontinue use of the Richie Brace. However, in the case of more complex conditions that are unlikely to resolve, the Richie Brace is a perfect aid to maintaining close to normal function. We believe this is imperative in maintaining our patient’s independence which is always a high priority in our treatment goals.

If you or someone you know has a foot or ankle problem they have been struggling to find a solution for, the Richie Brace may just be the solution!

​For all enquires regarding the Richie Brace call Rural Health on (02) 5926 3806 and book a consult with one of our experienced Podiatrists.