Total Care Podiatry

Courtsey of  the The Press Association.

Australia have called up fast bowler Shaun Tait to replace Nathan Hauritz for the remaining three matches in the NatWest Series against England.

Spinner Hauritz has been struggling with a foot injury during the first two games of the series – both of which England have won – and is due to fly home for treatment.

Australia physio Alex Kountouris said: “Nathan Hauritz has developed pain in his left foot during the first two ODI’s against England. While the pain was manageable in the first game, it became more severe during the second game.”

He added: “The pain is likely to be related to a previous foot injury and we have decided the best course of action is to withdraw Nathan from the current tour to allow sufficient time for it to recover.

“His return to training will be determined in the coming weeks.”

Tait’s call-up may be a blessing in disguise with Australia lacking a strike bowler in the two games played so far.

The South Australian, who is already in the United Kingdom due to a county stint with Glamorgan, is Australia’s fastest bowler and will likely form a strong partnership with Doug Bollinger, especially as Ryan Harris is struggling with a groin injury.

Chairman of selectors Andrew Hilditch said: “In view of the injury to Nathan Hauritz and some concerns about the injury to Ryan Harris, the National Selection Panel has made the decision to add Shaun Tait to the ODI squad for the remaining one-day games against England.

“Shaun is still very much in the thoughts of the NSP for the upcoming World Cup and these games present Shaun with a great opportunity to again represent Australia in one-day cricket.”

Harris will continue to be monitored ahead of the third one-day international against England at Old Trafford on Sunday.

Published: Wednesday, June 23, 2010, 12:00 AM     Updated: Wednesday, June 23, 2010, 5:20 PM

Mark McDonald, clinic director of First Choice Rehabilitation in Lower Paxton Twp., relied on more than observational skills to diagnose Moniak’s problem. He used a computer.

In computerized gait analysis, the patient walks or runs with sensors in his or her shoes. The sensors send some 1,000 points of information — about foot pressure, timing, range of motion, strength and foot asymmetry — to the computer and creates diagrams. The therapist and patient can then review them and come up with a treatment plan.

On the computer screen, different colors represent different amounts of pressure. Gait analysis might indicate, for example, that a person puts more pressure on one foot than the other — favoring one because the other hurts.

Whatever the cause, computerized gait analysis can document issues a physical therapist might not see easily — such as leg-length discrepancy or changes in the way the feet hit the ground on each step. The computer can also show patients’ steps in slow motion.

Moniak was diagnosed with plantar fasciitis — a condition partly related to being a runner. When a person strains the ligament connecting the heel bone to the toes, the band becomes weak, swollen or irritated and causes pain to the heel or bottom of the foot.

“It’s pretty nifty to see the problem you’re experiencing firsthand” on the computer, said Moniak, 37, an attorney with Rhoads and Sinon.

McDonald sees patients of all ages, athletic and not. These include children with an “awkward gait” — possibly from developmental delays or structural problems.

Some patients come in with obvious injuries; others complain of chronic pain. Pain means there’s some sort of injury, McDonald pointed out, even if it’s not a broken bone or torn ligament. It could be irritation of the soft tissue; people tend to lose flexibility there with age. Repeated stresses to an area might lead to microtearing at the cellular level. Other patients might have pain because of a structural problem — such as knock-knees. If there is a deformity, physical therapy helps support or accommodate it, perhaps with a brace or orthotic.

Regardless of the source, relearning normal gait is an important goal.

“As you walk, certain things should happen in your muscles and joints, and in the timing,” the therapist said. “If you have pain, you’re not walking with a proper pattern.”

Mike McCormick, who also runs, is back at First Choice Rehabilitation for the second time in three years. Earlier, he was treated for a knee problem — patella-femoral syndrome. More recently the 45-year-old was experiencing pain in his feet, which McDonald diagnosed plantar fasciitis, attributable to “biomechanical improper use.”

Both times the physical therapist used computerized gait analysis. It’s only one “tool” of the physical therapist, but a valuable one, McDonald said.

“It also gives me, the patient, direct feedback, so we can go about fixing the problem,” said McCormick, a developer of senior communities.

McDonald has been using computerized gait analysis for about 15 years. He said the technology can be expensive, and therapists have to invest time to learn to interpret the system. But for him, it’s been worth it, McDonald added.

For one thing, computerized gait analysis lends credibility. “Sometimes, if I tell a patient he or she isn’t walking right, the patient will look at me as if I have two heads,” the therapist said. But with a computerized picture, the message sinks in quickly. “The computer shows patients what’s ‘normal’ and what’s not. It’s patient instructional education.”

The analysis also documents improvement.

“With the use of the technology, we can evaluate if what we’ve been doing is effective, if it’s doing what we want it to to improve the patient’s functioning,” McDonald said.

Thanks to orthotics in his shoes and flexibility exercises, McCormick is getting better.

Exercise is also working for Moniak. “With the studies from six months ago and the studies now, we can see how I’m improving,” he said.

Please note :  Total Care Podiatry has this technology for its patients.

LITH podiatrist: Simplistic sandals are a health hazard

It’s fast and easy to throw on a pair of flip-flops during summertime.

But just like running out without sunscreen, the long-term effects may not be worth it.

That’s what Lake in the Hills podiatrist Jeannie Waschow says.

According to Waschow, flip-flops can cause wounds, sprains, heel pain, and take a toll on joints. It can even contribute to skin cancer.

“Skin cancer of the foot and ankles is the fastest-growing cancer,” Waschow said. “We put SPF everywhere but our feet.”

The lack of shock absorption alone created by flip-flops jars the body and puts immense stress on the heel, causing heel pain known as plantar fasciitis, Waschow said.

But that’s not it. There can be irritation in between the toes, and it can even alter a person’s stride, she said.

“The thong area and the gripping of toes are the only things keeping the flip flop in place,” Waschow said. “It can bring on nerve irritation and altered strides — which are shorter — and it can affect weight-bearing joints. It is now changing how you walk.”

A recent report suggested that women are better off wearing stiletto heels than they are flip-flops, since their shock absorption property is better.

While it’s true that flip-flops carry many health hazards, high heels have their own similar, but separate hazards, Waschow said.

“It’s a true statement in one way, but the reverse is that high heels cause nerve impingements faster,” she said.

There is one benefit of flip-flops, Waschow said. They safeguard someone from contracting germs found in public places.

“They do protect against foreign bodies in pool areas, health clubs and within the house,” Waschow said. “Versus being barefoot, there’s a small ray of sunshine for flip-flops.”

But the negatives certainly outweigh that one positive, she said.

Waschow added that flip-flops aren’t just for teens anymore. They’ve been around long enough to be an attractive option for all generations.

“It’s not necessarily the young at heart,” she said. “It’s really all ages, men and women wearing them.”

The final complaint from the doctor is the lack of stability found in the flip-flop.

“These are unstable things. What secures that shoe on to the foot?” Waschow said. “This is where the foot sprains, ankle sprains and broken bones come from.”

Those with diabetes should avoid them altogether. Any laceration could prove tragic, Waschow said.

“There’s not a lot of coverage, and it opens you up to cuts, scrapes and insect bites,” she said. “For diabetics with impaired circulation and neuropathy, I tell them no sandals. One simple scratch can lead to infection, ulceration and possible amputation.”

For non-diabetics shopping for sandals, Waschow has one simple stability test that the wearer should bear in mind.

“Put a sandal on the foot and shake the foot ferociously. If it doesn’t come off, when you walk, it will go with you,” she said. “It’s OK if you wear them to a barbecue or for short walking distances. Not at Great America.”

By CAROLYN ENTING – The Dominion Post Last updated 05:00 23/06/2010

Towering platform stilettos have overrun the fashion footwear market for the past few seasons and they’re not going away any time soon.  This intelligence makes me both swoon and despair, because like many women, I not only love them, but also have loathed them. Tragic baby steps anyone?  I want to be like Sarah Jessica Parker and stride confidently through the desert in my stilettos the way she does in Sex and the City 2. OK, it’s silly, and she did look ridiculous, and walking in heels in sand is dangerous, but then so is walking around Wellington and I want to do that, too.  It may seem frivolous, but walking in heels is a universal issue. Right now teenage girls are being taught how to walk in high heels in a government-funded college course in Britain.  The six-week Sexy Heels In The City course at London’s South Thames College costs students the equivalent of NZ$320 and also gives lessons on how to carry designer handbags. According to a newspaper report the course claims to prepare young women “for the business world and their social lives”.  British taxpayers’ groups have slammed it as pointless but I wish someone had taught me how to walk in heels. I wonder if the course covers hill descents?  It is undeniable that high heels make your legs look good, and have the power to make you feel sexy. That is until your soles begin to ache like a tooth abscess, or you’re faced with Wellington’s hilly terrain. Assuming a layback position to shuffle limbo-like down an incline is hardly attractive.  Working on Boulcott St (The Dominion Post HQ) is a curse for heel lovers who negotiate the steep footpath as far as the Majestic Centre and ride the escalator to the horizontal planes of Willis St.  The tiled floor of the atrium is a terrifying divide, though still preferable to the uneven steppe that is the wonky footpath outside the General Practitioner. A colleague recently took a tumble in her platforms, fortunately only grazing her hands and knees.  Then there’s riding the bus, which is also treacherous. Disembarking in high heels is a fast track to a hip replacement.  Still, there is some good news; while platform heels might be fashionable right now, so are flats. “You can be sensible and sexy,” says Don Wearing, of Ultra and Mischief Shoes. “It’s like anything  it’s all about moderation. Wearing a heel is not going to kill you unless you are doing it all day and night. It’s about variation.” Ad Feedback  Contrary to popular belief, podiatrists are sympathetic. They recognise the allure of a well turned heel. They won’t tell you to stop wearing them, or judge you.  “If you offered a woman Nike trainers or a pair of Manolos, unless they are about to check into a rest home, they’ll pick the Manolos,” Wellington podiatrist Jason Lubransky says.  “I know podiatrists who wear ridiculous shoes because they look cool. I’ve had heaps of clients say ‘I know you are going to tell me off’ but I don’t. I’m there to help.”  The perils of high heels include (in extreme cases) the shortening of the Achilles tendon; impact shock that passes through the foot to the knee and hip; and bad posture, which can exacerbate lower back pain.  Yet, according to Lubransky, the reality is that many people can wear high heels and never have any problems. It all comes down to biomechanics and bone structure.  Most fashion-footwear-related problems he sees are a result of the shape of the shoe rather than heel height.  “A lot of people come in with shoe-moulded feet, corns and calluses, and they can be caused by flat shoes, too. There is also the classic problem of shoes rubbing the back of the heel bone and causing a pump bump, which in some cases has to be surgically removed,” Lubransky says.  “Probably the worst thing that can happen is breaking your ankle. You hear the odd horror story but how often does it really happen?”  There are preventative measures faithful heel wearers can take, such as regularly swapping heel heights, and stretching.  Yoga can help keep the calves supple and stretchy.  “Walking in heels the calf doesn’t extend or contract like it would when wearing flats and prolonged heel wearing will cause the calf muscle to shorten. If you’re going to wear heels every day you need to counter that with calf stretches,” Om Shanti Yoga instructor Scott Milham says.  A simple stretch he suggests is to place both hands against a wall, one leg forward and one leg back. The back leg is straight, the forward bent. Lean into the pose for one and a half minutes, then swap legs.  The yoga position of downward dog also provides a good calf stretch, and yoga helps core strength, which helps balance.  “Heels change your centre of gravity. In flats, the centre of gravity is the pelvis, in heels that lifts. Depending on how strong your abdominal wall is, will depend on how far you need to push your chest forward to balance,” Mr Milham says.  The higher the heel, the more vulnerable the wearer is to rolling an ankle because the body’s weight is not evenly distributed.  Meanwhile the days of being able to walk comfortably in heels may not too far away. US-based companies Cole Haan and Kenneth Cole have developed footwear which combines the technology of a sports shoe with the looks of a stiletto.  The Kenneth Cole 925 Technology Silver Edition consists of a small range of women’s dress shoes. Locally, Kumfs has brought out an 8.5cm heel crafted to support the heel and minimise sideways twisting.  None are as sexy as a Manolo, but we live in hope.