Frequently Asked Questions

There are many injuries that we treat at Orthosport, below is a description of some of the more common injuries

Injuries of the Feet

Plantar Fasciitis/ Heel Spur
Plantar Fasciitis is an inflammation to the plantar fascia, a structure that connects the heel to the toes and stops the arch of the foot collapsing during normal gait. Due to biomechanical misalignments the foot flattens too much during the gait cycle and can cause this structure to become stretched. Micro tears appear at the point of origin at the heel and cause pain during walking and running. When the condition is more severe, pain is felt when first putting the foot down in the morning or after periods of rest.

Mortons Neuroma
During the propulsive stage of the gait cycle. A lack of rigidity of the forefoot enables the Metatarsals to come together and pinch the nerve that runs between them. Inflammation and a build up of fibrous tissue around the nerve cause discomfort and over time with the build up of more tissue the pain becomes more severe. If left for too long surgical intervention is the only answer, if caught early enough orthotics can be used to separate the metatarsals and provide a more stable foot during propulsion.

Bunions
Bunions tend to be associated with older people but can affect people at a much younger age. Prevention is the key to halting the progression of bunions, if the Big toe starts to deviate towards the 2nd and 3rd or there is a bump forming at the base, it is wise to consider using a support to redistribute pressure correctly over the forefoot and to prevent any unwanted movement. An orthotic device can considerably slow down the progression of a bunion. Where a bunion has already developed an orthotic can be used to alleviate the pain that is sometimes present.

Blackened Toe Nails
This condition is very common in runners and is often due to ill-fitting shoes. When running the foot impacts the ground this causes it to elongate and toes can be forced into contact with the end of the shoe. It is advisable to check that you have a thumbs width between the end of your toes and the shoe to prevent this from occurring. Even with well fitted shoes blackened nails can be caused by an unstable forefoot or a heavily pronated foot. The muscles within the foot and leg will fire at the incorrect time to try and stabilize the foot to make it more rigid to push the body forward. As a result the toes will claw at the ground, pressure is put through the tips of the toes and the nails over time will become thickened and warped.

Sesamoiditis
The seasamoids are small bones below the big toe, pain can occur if there is too much force being place through the inside border of the foot. The area can become inflamed and in some cases the sesamoids can fracture. This is more common in active people especially with those participating in sports that require jumping and twisting movements.

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Ankle and Lower Leg Injuries

Tibialis Posterior Syndrome
This structure is located behind the tibia and runs down to the inside of the foot around the boney prominence (medial malleolus) on the inside of the ankle. The injury is characterised with pain behind the medial malleolus and down to where the tendon inserts into the foot. Patients with a pronated foot type are more prone to developing this injury.

Achillies Tendonitis
This is one of the most common injuries seen at the clinic. The Achilles inserts into the heel bone and forms the end part of the calf muscle complex (Gastrocnemius and soleus). It is one of the main muscles used to push the body forward. It can become injured when overused or when training is increased too rapidly. It occurs very commonly in pronated foot types. Some patients may find that there are lumps within the tendon and can experience stiffness in the morning and pain when going up stairs. This injury is easily treated when seen early but if left it can quickly become a chronic injury and become much more difficult to heal.

Shin Splints
Shin Splints are a common injury especially in patients new to running it can be caused by poor shock absorption as well as in the pronated foot type. It is often occurs when the outer covering of the tibia (periostium) becomes inflamed as a result of too much stress being put upon it. Characterized with lumps and/or tenderness on the inner part of the shin, it will often resolve after periods of rest only to flare up again on return to training.

Anterior Compartment Syndrome
This occurs when a muscle becomes too big for the compartment that contains it, pain is experienced on the outer border of the shin. This occurs when the muscle has to compensate for a biomechanical abnormality. The extra work placed on the structure can cause an overdevelopment and increase the size of the structure. Rest and biomechanical control is needed to prevent the muscle from working too hard.

Severs Disease
This is inflammation at the point of insertion of the Achilles tendon into the heel bone (calcaneus). It presents in children between the ages of 8 -16 and usually follows a recent growth spurt. As the bones increase in length the muscles become tighter. Pain is often felt when walking or running and it is often tender when the heel is squeezed, there may be a slight swelling or bump in the area. The use of heel lifts can give temporary relief to the symptoms but more support may be needed if the patient is an overpronator. (Severs is a similar condition to Osgood Schlatters disease see below).

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The Knee

Patellofemoral syndrome
Patellofemoral syndrome is pain around or under the knee cap, often described as runner's knee and is a common injury among active people. There are a number of causes such as over pronation, knocked knees, muscle imbalance or an impact in the area. Pain is often present when going down hills and stairs, bending of the knee, squatting and sitting in the same position for long periods.

Illio-tibial Band (ITB) Syndrome
This condition can also be referred to as runner's knee, with this condition however pain is usually felt on the outside edge of the knee, just above the point of insertion of the ITB. It occurs when the ITB flicks across the boney prominence know as the lateral epicondyle. This constant rub damages the structure and causes inflammation and pain. It is especially common in runners due to the repetitive nature of the running movement but can also occur when cycling and rowing. This structure is often neglected during stretching regimes which causes increased tension along the length of the structure and therefore more of a rub.

Osgood Schlatters disease
Osgood Schlatters disease is a fairly common condition seen in young athletes, it is more common in boys and will usually occur during a growth spurt. Pain is located over the Tibial tuberosity (boney prominence just below the base of the knee cap) where the patella tendon inserts. It occurs when the bones grow over a short period of time and as a result the tendons and muscles become tighter. It is a self limiting disease but in patients where biomechanics are poor more help may be required to support and correct any misalignments.

Osteoarthritis of the Knee
This is degeneration of the articulating surfaces of the knee joint, areas of cartilage wear over time, these areas can become thinner and can sometimes wear away completely. It is caused by a number of factors, previous injury, being overweight, overuse, misalignment of the joint to name a few.
Pain is often felt during or after exercise and may be accompanied by clicking or grating sensation, patients will often complain of stiffness within the joint first thing in the morning or if the joint has maintained the same position for any length of time. Once there is excessive wear it can be difficult to do anything to correct the joint and a knee replacement may be the only answer. It is therefore important to correct the problem before it becomes unmanageable and slow down the progression of the disease.

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Other Common Injuries

Piriformis Syndrome
The Piriformis is a muscle that adducts (externally rotates) the leg. It is positioned at the hip joint deep to the gluteal muscles. The Sciatic nerve runs very close and sometimes through this structure. If it becomes enlarged due to overwork or if inflammation is present the sciatic nerve can become impinged which results in pain radiating from the hip down the leg.

Tight Hamstrings
Tight muscles are far more common in men and are usually a result of over training with little to no stretching. Genetics can play a part in muscle length and some people may be naturally less flexible than most. If tight muscle groups are found then a comprehensive stretching regime is needed, tight muscles will limit athletic performance, are more likely to tear and cause joints to become misaligned.

Lower Back Pain
This is a very common problem seen at the clinic. People will often put up with it and believe it to be due to the stress' and strains of everyday life, which to an extent it is but a large number of cases can be solved by using simple exercises and/or orthotics. Patients with tight hamstrings or gluteals can experience lower back pain, a few minutes of stretching exercises a day can lengthen the muscles and relive this pain. Many people have a difference in the length of their legs, this in turn misaligns the pelvis and gives rise to back pain, correcting the difference can improve or resolve the symptoms. There are many causes and only with detailed analysis can the cause be found and treated.

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