Podiatry

Heel Pain in Children

Custom orthotics for severs disease
Custom orthotics for severs disease 600 400 Ace Health Centre

Custom orthotics for severs disease

Custom orthotics are widly used for severs disease. If done right they can have a great effect in help reduce pain in in childrens feet, alowing them to continue doing exercise and walking with less if not no pain.

Severs disease is growing pains in the heel of kids feet. It mostly occurs in in children aged 9-13. Although they will eventually grow out of it, it can be debilitating at times. The pain can make children avoid speding time on their feet, doing sport and activities. Keeping chrildren active, moving and therefore happy is the main objective. Nobody in pain and avoiding the activies they love is happy.

Orthotic prescription

When prescribing orthotics for sever there a a few things that we aim todo.

  1. To start, we are aiming to take pressure away from the heel area. This is done by providing adequate arch support. The more weight we can redistrobute away from the heel the less pain that they will experience.
  2. The next is providing extra cushiong. Hard floors and vibrating increase pain, and so adding extra lawyers of cushing can reduce pain.
  3. Adding a heel lift helps reduce pull of the achillies on the heel. This is done via footwear that have a heel pitch built in. The orthotics under the heel also add a slight heel lift to reduce pain.
  4. Pronation can cause strain on the heel. The foot rolling inward causes the calf muslce to pull on the heel bone. The orthotics can be used to reduce pronations to help reduce pain.
  5. Soft top covers on the orthotics can help further add cushioning.

We commonly use Custom orthotics for severs and found them much more effective than off the shelf ones. This is due to the range of customisation we have to aim the orthotics at the child at hand. Having the right support, the right arch height, the right amount of chsioning to maximises the effects of the orthotics. They are also much more durable than over the counter products.

If your child is experiencing heel pain then give us a call today to see how custom orthotics can help them.

 

Blog written by Mike, Podiatrist

Custom orthotics for hypermobility

Custom orthotics for hypermobility
Custom orthotics for hypermobility 804 750 Ace Health Centre

Custom orthotics for hypermobility

Custom orthotics are widely used for symptomatic hypermobility. This occurs in adults and children. Hypermobility is widely genetic. Passed down from parents to children. There are also other types of hypermobilty which are genetic abnormalities such as marfams, or Ehlers danlos syndrome.

Joint range of motion

Joint have a range of motion that is whithin normal limits. Hypermobilty is when these joints move much further than they should do. For example. The big toe joint is meant to have aprox 45 degess for walking and up to around 60 degress. More than 90 degress is considered abnormal and hypermobile. The are a few different tests that you can do in order to see how flexable you really are. The main tests are done under the beightons scale for hypermobility.

Here are examples of a few test that are used in order to diagnose your level of hypermobiltiy.

  • Bend forward and place your hands flat on the floor without bending your knees.
  • Straighten your elbows past a neutral position (hyperextend) (one point for each elbow).
  • Straighten your knees past a neutral position (hyperextend) (one point for each knee).
  • Bend your pinky (little) fingers back beyond 90 degrees (one point for each finger).
  • Bend your thumbs back to touch your forearms (one point for each thumb).

The Orthotics

The orthotics that this client has been made for has been suffering from aching legs, feet, knees and loweer back. When a joint it hypermobile it becomes very unstable. This instubility requires your muscles to work overtime in order stablise the joint. This results in fatique and aching.

Custom orthotics are commonly used for hypermobilty to help stabalise the feet which can help in reduceing overuse. This in turns helps reduce the aching and fatique.The orthotics are only as good as the shoes that they are put into. This is why it is important for the podiatrist to give footwear recomendations that are suitable to put the orthotics into.

If you think that you are hypermobile and experience aching feet or legs then book in with our podiatrist today.

 

Blog written by Mike, Podiatrist

Ace Health Centre. Podiatry Gold Coast. Best podiatry Cold Coast. Bulk billing podiatry. Flat Feet. Best Orthotics. Low arch.

Orthotics for flat feet
Orthotics for flat feet 1000 667 Ace Health Centre

 

Orthotics for flat feet

When designing orthotics for flat feet there are lots of different modifications you can do. Changes in the arch height, flexibility, rear foot and forefoot angles and more.  In the video, we run through one example of a prescription we have done for a client.

The design

This design is for a client that has been coming for a fair few years now. We have tried a few different prescriptions over time to try and improve the outcomes but it seems the best for this client is to keep it fairly simple. The client has extremely flat feet and has suffered from chronic foot, knee and back pain and other injuries associated with having flat feet. They have a job that requires them to be on their feet all day and so the orthotics have been a massive help for him not only for work but for allowing them to play touch.

The prescription

This custom orthotics prescription has – A 3.5mm thick shell with a 2.5mm thick bar. The bar runs under the arch of the orthotic to help increase stability through this area without having to make the whole of the orthotic too thick. The arch height is exactly 20mm high. The rearfoot has a 6-degree angle tilting outwards, and a 6mm skive in the rearfoot (the flat spot at the heel which tilts the foot outwards even more).

The covers

To provide cushioning on the orthotics we have put a layer of poron under the arch. Poron is a highly durable, soft material that provides extra cushioning in this area. With the foot being so flat and so much force in the arch area, extra cushioning is required for the person to reduce the risk of blisters and callous build-up.

We then have a full-length E-tpu top cover. E-tpu is an extremely durable and bouncy material that’s commonly used as the soles of Adidas shoes. It doesn’t absorb moisture and is generally used for a more sports-based orthotic. This orthotic will be used in combination with a Brooks Beast shoe to provide maximum stability and get the most out of the orthotics.

Always remember that your orthotics are only as good as the shoes you put them into. Your podiatrist will recommend appropriate shoes to make sure you get the maximum benefits from your custom orthotics.

Book today if you need orthotics for your flat feet. 

ACE Custom made Insoles. 3d orthotics

Welcome to your new custom orthotics
Welcome to your new custom orthotics 1000 667 Ace Health Centre

Welcome to your new custom orthotics

Thank you for purchasing your new custom orthotics from Ace Health Centre. Here’s all of the information you will need about them. It details how your custom orthotics are prescribed, designed, manufactured, and what to expect.

Did you know it takes your podiatrist over an hour of extra work after your consult to finish your orthotics?

How your orthotics are prescribed

 

Your orthotics are prescribed from a mix of –

  • your injury
  • your flexibility
  • your posture
  • your alignment in your feet, knees hips and back
  • your weight
  • your shoes
  • your sport or activity
  • your medical history such as being diabetic
  • your blood flow to your feet
  • your nerves and feeling in your feet
  • your balance
  • history of other injuries
  • muscle strength
  • corns or callous
  • and more…

Orthotics prescription and design

When prescribing orthotics there are many different things that a podiatrist can do design-wise. The prescription itself will be determined from the assessment.

Your podiatrist will then have done a 3D scan of your feet. The 3D scan provides a base model of your feet giving them your base arch heights, foot length and widths.

The custom orthotics are then designed via computer software by your podiatrist after the consult. It takes a lot of time and practice to be able to use compete software to design up an orthotic to know how it will end up after being 3D printed. The software helps aid with consistency of the product being produced and is far more accurate than other methods of orthotic manufacture.

Every podiatrist will prescribe slightly different meaning you could go to 10 different podiatrists and get 10 different orthotics designs and prescriptions. The goal though will always be the same. The main difference is that many podiatrists get other companies to do computer design for them. At Ace, we do all of the computer design ourselves. Did you know Mike, our podiatrist does design work for other podiatry clinics around Australia as well in his spare time?

3D printing

Once your orthotics have been designed by computer the file is then sent to a 3D printer. The 3D printer is an industrial-size printer that prints around 30-50 sets of orthotics in one go. It cannot just print singles. It prints by laying down layers of very fine powder in microns and then heats the powder to fuse it in specific places. The printing process takes around 24-36 hours in total. The orthotics are then removed from the printer, sandblasted to remove any excess powder, and then washed. The orthotics are printed using an HP MJF 4200 using PA11 nylon material. This material is also eco-friendly and 3D printing minimises waste material.

Covering

Once the 3D-printed shell has arrived back at the clinic it’s time to cover the orthotics. This is all done via your podiatrist by hand. The covers that your orthotics will is decided by your podiatrist from your consultation. This is determined by factors such as – your activity, the shoes you will wear them in, your weight, your medical history, your injury and more. There are many different materials available. Covers on orthotics can be replaced if you ever want to give your orthotics a little TLC.

Fitting

Once the orthotics have been completed, our reception team will give you a call to arrange a fitting appointment. Your orthotics are always made slightly big for your shoes and require trimming up to ensure a good fit.

It’s important to remember that your orthotics are only as good as the shoes they are being put into. This means that although putting them into flat soft or flexible shoes will be much better than nothing at all, fitting them into a good supportive stable shoe will give much better results. Your podiatrist should have discussed footwear with you in the consult and possibly given you recommendations for shoes that your custom orthotics will work best in.

If you do require new shoes we recommended purchasing them before your fitting appointment. This way your podiatrist can check the fitting of the shoes, make sure the shoe is correct, and fit the orthotics into the shoes.

When fitting an enclosed lace-up shoe we usually recommended fitting them by – putting both shoes on, lacing the shoes up properly, standing up, and having a fingers width between the end of your longest toe and the end of the shoe. We also suggest being able to pick a small amount of fabric across the widest part of your forefoot. This ensures that the orthotics will fit the shoes, and will provide a more comfortable experience. It is always best to go shoe shopping at the end of the day when your feet are maximally swollen and expanded. This will give you a much better idea of fit and comfort.

For people that do spend a lot of time on their feet, it is sometimes beneficial to purchase 2 pairs of shoes and alternate them daily. The foam in the soles of shoes can take 24 – 48 hours to fully recover and expand back out. This means that having that rest day helps them last longer, maintaining more support and cushioning.

Shoes do have a lifespan. If you are in your shoes for 8 hours per day we recommended getting new shoes every 6-8 months. Just because the top looks ok doesn’t mean the foam is. We also recommended replacing shoes after having them for 1.5 years as the foam and glues in the shoes start to degrade. This means the shoes will not provide the same support and cushion as they once did when new.

Your orthotics may not fit every shoe but may be able to fit between shoes that are the same size. Just take out the original insole that is in your shoe and replace it with your custom orthotics

What to expect

Everybody is very different in the way their body reacts to orthotics. The orthotics as often designed to hold/guide your feet in a certain position. This means that different muscles will be used while wearing them. These muscles can take time to adjust. For that reason, we ask you to pay attention to your body. Aches or pains for up to the first 4 weeks are normal. If you experience this we suggest taking the orthotics out, putting the original insoles from the shoes back in, and then starting to use the orthotics again the next day.

Reviews

After the fitting appointment, we book you for a 3-4 week orthotics review. This review session is to see how you are getting on with them. Making sure you are happy, they are comfortable, and they are doing their job. If there are any issues at this stage the orthotics can be modified when needed. Things such as arch heights, cushioning, support, flexibility and more can be changed. Just like anything custom it can be changed and modified as needed. For the first 3 months reviews are done without any out-of-pocket cost.

If you are experiencing issues where you are not able to wear your custom orthotics due to pain we recommended calling up for a review appointment and coming in sooner.

We recommended having your orthotics reviewed every 12 months. This is due to changes within your body that may affect your orthotics prescription. This can be anything from strength, flexibility sensation, blood flow and more. You may also have a new injury or issues that the orthotic needs to be aimed at that may require a change in prescription again. Your orthotic shell may also become more flexible over time meaning it will provide less support. These changes may mean an update in your orthotics prescription.

If you need anything or have any questions please contact us here, or book here. 

 

online exercise prescription

Online exercise prescription
Online exercise prescription 1920 1009 Ace Health Centre

Online exercise prescription

One of the biggest factors to consider regarding patient rehabilitation and positive outcomes is exercise adherence. Patients no matter the condition are likely to get some form of home exercise program to continue progressing at home. It is reported as high as 50% of patients do not complete their exercise prescribed by the therapist thus limiting their rehabilitation. Often barriers to exercise adherence include lack to time, lack of understanding of exercises, forgetting how to complete the exercise or the prescription regarding sets and repetitions.

So what do we do to combat this?

We use an application called Physitrack for our online exercise prescription. Physitrack allows clinicians to prescribe individualised home exercise programs. Physitrack has multiple user-friendly features including demonstration videos with audible cues for the exercise, allowing the therapist to easily alter the repetitions, sets and resistance for each activity as well as a section for the clinician to add any specific notes for cues they want their patient to remember.

During the consult, we sit down with our clients and educate them on how to download pysitrack and view their program. We also print out the program for our patients which documents, the exercises, exercise explanations, the repetitions and more. We can also put individual notes from the physio to make sure you have everything written down and easy to understand. All these features make exercise adherence easier for the patient thus helping the patient stay on track for a speedy recovery.

Our podiatrist also uses this programme in order to give his exercise programmes. Each clinician can log in and view each person’s programme making it easier to work between practitioners and modalities. This communication between practitioners leads to much better client care.

Online consults

The use of this application also means that we can do online telehealth consultations. Over the phone, we can simply email your exercise programme to you, and know that you will have all the details you need to perform it correctly.

Book now to see our physio

Shock Wave therapy

Shock Wave therapy
Shock Wave therapy 750 502 Ace Health Centre

Shock Wave therapy

Shock wave therapy (otherwise known as Extracorporeal Shock Wave Therapy – ESWT) is a modality of treatment whereas a machine passes sound waves through the tissues in the body to promote healing. Similar to ultrasound but at a lower frequency which causes the “shocks to be felt”. This process is a non-invasive technique that is suggested to promote the formation of new blood vessels at the tendon-bone junction, stimulate tendon cells (tenocytes), increase white blood cell count and amplify growth factor and protein synthesis to promote collagen synthesis and tissue remodelling. 

How does Shock Wave feel?

This can be a tender process due to targeting sore areas of the body but the intensity of shock waves can be adjusted by the operator, to the tolerance of the individual. This allows the process to be more enjoyable without much effect to the treatment. 

What is it used for?

Shock wave therapy is primarily used in the treatment of common orthopaedic musculoskeletal conditions. These include;

  • Muscle tendinopathies of the upper or lower limb
  • Plantar fasciitis 
  • Adhesive capsulitis 
  • Non-union of long bone fractures
  • Avascular necrosis of femoral head
  • Shin splints (Medial tibial stress syndrome)
  • Osteoarthritis of the knee 

Most of the time Shock wave is best used in combination with other treatment modalities such as exercise to promote the strengthening of the tissues during the remodelling phase after new blood vessel growth and collagen synthesis. Hands-on physio massage can also help release the tight aggravated muscles to help relieve even more pain. 

So if you have had that niggly or ongoing injury that just won’t go away, then Shock wave might be the treatment for you! Best to book in with our physio or podiatrist today and start the assessment process to determine the best fit for your condition. 

What is arthritis?

Treatment for arthritis
Treatment for arthritis 722 406 Ace Health Centre

Treatment for arthritis

There are many different treatments for arthritis. We run through a few here.

Massage

As stated before massage can be a great way of suppressing pain and stiffness symptoms associated with OA. When arthrits is present the muscles con contract to help protect the joint. This can also increase pain. Relaxing these muscles can help reduce pain and increase mobility in the joint. Unfortunately, this is only short term until the body starts to guard or protect itself again.

Bracing treatment for arthritis

Bracing is a term used for adding support ot the area to reduce movement. As movement can cause pain reducing this help reduce the pain. On the downside, bracing can cause the joint can stiffen as it is not being used as much. This reduced mobility can mean that when it’s not braced it can be more painful. Bracing is good for the short term to help give the joint a break and reduce inflammation but isn’t always the best long-term option.

Custom orthotics

Custom orthotics work extremely well for arthritis. Not just in the feet, but are also very effective for the knees, and hips and can be for the lower back as well. They do this by redistributing pressure, changing ground reaction forces and changing the angles of the legs and feet. They can help reduce movement where needed, open up joint spaces, provide cushioning and more.

Strengthening

Usually, when it comes to people that have OA they are typically older; have had more stress placed on their joints and are also weaker. This means that they will typically need lots of strengthening. We need to target the most important. Physical assessments from physiotherapists allow the best and most specific exercise prescription to occur, thus allowing the most improvements within the shortest period and easy to manage for clients.

Injections

There are many different types of injections available for arthritis. A few include prolotherapy, Synvisc, cortisone, and local anaesthetic. At the clinic, our podiatrists perform local anesthetic injections into arthritis of the big toe and perform mobilisation. This helps free up the joint, increases mobility and breaks down some of the arthritis. This requires a few weekly appointments. Together with orthotics, this is extremely effective in reducing pain and increasing mobility in the joint.

Other treatments may include Surgery, anti-inflammatories, footwear, custom orthotics, mobilisation, heat, pain medication and more

If you are interested in seeing how we can help you contact our clinic today for more information.

What is arthritis?

What is arthritis?
What is arthritis? 722 406 Ace Health Centre

What is arthritis?

Arthritis describes the “wear and tear” joints face throughout their life span. During this process, cartilage get worn away and is replaced with bone to help strengthen the joint. In turn, this causes joint spaces to get too narrow and irritated. There are many types depending on how the wear and tear occurs; either naturally throughout the life span and due to weaknesses or malfunctioning immune responses causing the body to attack its own joints.

Osteoarthritis

Osteoarthritis (OA) is the damage to the joint surfaces as a result of physical load (day-to-day activities). This is usually caused when the load out-weights the strength of the surrounding muscles, thus the joint takes the load. What results is thinning/damage of cartilage (protects joint surfaces) and deposits of bone being placed where the thinning occurs over time. This process can take a while but will create permeant joint changes that are irreversible.

Symptoms of arthritis

Symptoms vary depending on the severity and can also come and go depending on life’s demands. Lot of people can even have arthritis underlying and don’t get symptoms until the joints are placed under demand or an injury occurs in a similar area.

This is due to the body becoming hyperaware and protective of arthritis to prevent further wear and tear. Thus the muscle spasms surrounding ‘worn’ joints to prevent further movement and thus limit further “wear and tear”. This means that massage is a very useful technique when it comes to the treatment OA. Relaxing the surrounding muscles will significantly reduce pain in most cases. 

OA most commonly occurs in the shoulders, lower back hips and knees as these joints are usually placed under the highest loads due to being weight-bearing joints.

There are many different treatments available for arthritis. Contact us today for a consultation to discuss options.

Blog by Christian Monks

What's custom about your custom orthotics?

What’s custom about your custom orthotics?
What’s custom about your custom orthotics? 1920 1001 Ace Health Centre

What’s custom about your custom orthotics?

Many people receive their custom orthotics thinking that they looks like something they could have just purchased for a lot less from the chemist. This is defiantly not the case. The same as glasses from the chest look the same as glasses from the options but both are very different. Each sense is made to each eye, just like orthotics are designed for each foot. Each glass frame is tailored to each persons use for example reading glasses will be different to sports glasses. Orthotics are the same, each is tailored to the activity you want to use them for and the shoes they are going into. If they were that simple podiatrists wouldn’t spend 4 years learning how to to prescribe them.

We thought we would just name a few things that we can tailor but remember that this is only a shorted list of everything that can be done.

The arch height

This is an obvious one. The arch height is tailored to your feet. Depending how much the podiatrists wants your foot to move and how much pressure they want to redistribute to other parts of your foot. This can be based on your injury, your foot flexibility, the shoes that you wear and more.

Custom widths

The widths of the orthotics heel and forefoot will help control your foot. Your foot needs to sit in the heel of your orthotics to  help guide it. If it is too small it will dig into your foot. if its too large you’re foot will roll around on it. We also need to keep in mid of fitting it into the shoe. Too wide and it won’t fit. Your foots width change from non weight bearing to weight bearing. The podiatrist needs to work out how much and what shoe it will go into to decide the widths.

Custom angles

Podiatrists can chose what angles we put your foot at. This means the heel or foot forefoot angle can be tailored. So if your foot collapses inwards an angle is put on to roll it outwards, and if your foot rolls outward an angle may be put on to make it roll inwards. These angle are dependant on your injury, flexibility, structure of your lower limb and more.

Extra padding

If you need extra padding in places the podiatrist can decide where it needs it and what material to use. Usually if something is so you will need padding around the area and not under the area. This is to take pressure away from the sore area. There are lots of different ways todo this and lots of different materials that have different properties to decide from

The material

Orthotics can be made from many different materials. EVA in many different densities, carbon fibre, pa12 nylon, pa11 nylon, poly propylene to name just a few. Each material has different properties and can be altered in many different ways. Podiatrists need to know what to use and when.

The thickness / flexibility

This is one of the most important factors when prescribing orthotics. The thickness of the orthotic will be one of the main properties to determine how flexible the orthotic is. Thing that will factor into this is the persons weight, flexibility, foot arch height, extra additions on the orthotics that affect the flex, the injury, the severity of the injury, the activity its being used for and more. This is usually changed in increments of 0.1mm

These are just the basic points of what can be done to customise your orthotics. The is a lot more you can do to change the design. Most designing is not done via 3d cad cam engineering software. Orthotics are then 3D printed using machines that cost upwards of $700k. These machines have a high accuracy and product a stable, durable product. Cheaper 3D printers do not yet have a material that can produce a product with the same strength and flex charactoristics.

 

If you want to get some new orthotics or have any other questions please contact us today on 0755726222 or book online.

orthotic copy

Copy your old orthotics
Copy your old orthotics 900 483 Ace Health Centre

Copy your old orthotics

Did you know that we can copy your old orthotics? That’s right! With technology moving forward and 3D scanners now available copying your old orthotics has never been easier.

Your design

When going to a podiatrist and you get your custom orthotics it can be quite daunting as to what they will give you. Many people who have had orthotics in the past just simply want a repeat set. They love their current orthotics and would like to continue using them. Maybe their old ones are damaged, maybe they don’t want to have to swap them between shoes, maybe they have just worn out. Every podiatrist you go to may have a different idea of how your orthotics should be. You could see 10 different podiatrists and get 10 different sets of custom orthotics. This means trying to get another repeat set could be difficult.

 

Scan

With 3D scanning copying, your old orthotics is now a lot simpler. That said, its still not easy. We firstly need your old set of orthotics. From there we remove any top covers, glue and anything else that would

change the shape of them. Once this is done we can 3D scan the shell in order to produce a 3D model. From there we model up a new orthotic from the old one trying to create a replica.

 

orthoic scan

orthoic scan

orthotic copy

orthotic copy

 

94ffc075-d16f-4503-a495-0b7436951c3d original orthotics

 

94ffc075-d16f-4503-a495-0b7436951c3d

3D printing

Once the orthotic has been designed it’s sent off to be 3D printed. We 3D print using PA11 material via an HP MJF 3d printer. This material is eco-friendly and super strong. 3D printing also means there is hardly any waste. Old orthotic manufacturing techniques such as milling and Hot pressing both produce a significant amount of waste material. This makes 3D printing the most eco-friendly way of manufacturing custom orthotics.

 

Covering

Once the shell is manufactured we then add the covers. Covering is all done via hand. There are many different materials available for covering custom orthotics. Each orthotic is covered specifically for the person’s prescription. It takes a skilled craftsman to ship in order to be able to do this.

 

If your after somebody to Copy your old orthotics contact us today. We can ship anywhere. 

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