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State Health and Fitness News

Informing you of the latest health and fitness news in South Australia.

Adrenal Fatigue and You

NATUROPATHIC NEWS & REVIEW:

By Columnist Trudy Cadoo – Senior Naturopath:

Managing stress reduces adrenal fatigue

Photo Credit: Bottled Void, 2008 – Stress

Do you feel burnt out? If so, then it may be time to look at how you’re living your life.  Having a double espresso to get you moving in the morning and a bottle of wine to wind down at night, may not be ideal.

Do you find it difficult switching off at night?

Do you wake in the morning rarely feeling refreshed from your sleep?

Do you need a cup of coffee to switch on in the morning?

Do you often feel overwhelmed with what life is presenting?

Do you wonder when it’s all going to slow down?

Do you feel unmotivated?

Do you suffer headaches regularly?

High Stress Levels and You

If any of these questions sound familiar, then your body may be under stress. High stress is something many people are living with day in day out, and most don’t even recognise it.  Our lives have become significantly busier over the past decade.  The impact stress is having on us is becoming more evident in our health and wellbeing.  Understanding where you are at, what you need and putting a few simple techniques into play, can go a long way to calm the stress in your day, regain your vitality and lead you back to living life with passion as you once did.

Are you experiencing any of the following?

  • Constant fatigue.
  • Difficulty waking in the morning.
  • Craving for salty food.
  • Lethargy.
  • Low motivation.
  • Low libido.
  • Low-stress tolerance.
  • Mild depression.
  • Mentally fatigued.
  • Poor memory.
  • Afternoon slumps.
  • Headaches.
  • Increased PMS.

Do your symptoms become worse when meals are missed?

You may be looking for answers as to why you are feeling this way and you may be becoming increasingly frustrated as nothing is coming up in your blood tests. On paper, you look like a healthy person. If you are feeling any of these symptoms, then you may be experiencing Adrenal Fatigue.

What is Adrenal Fatigue?

Adrenal Fatigue is a modern condition that is usually associated with high stress levels and it is characterised by the adrenals not functioning properly.  This is not to be confused with Addison’s disease. Addison’s is a rare endocrine disorder that occurs when the adrenal glands cannot produce sufficient hormones (corticosteroids), which is thought to be caused by an autoimmune disorder. This disorder is called Cushing’s Syndrome (hypercortisolism),  which is a collection of hormonal disorders characterised by high levels of the hormone cortisol which may include tumours of the pituitary and adrenal glands.

Adrenal Fatigue, although not recognised by many main stream Doctors, is estimated to affect around 80 percent of people in the world. According to James Wilson (author of “Adrenal Fatigue: The 21st Century Stress Syndrome“).

What Causes Adrenal Fatigue?

The primary role of your adrenal glands is to produce and regulate the stress hormone cortisol. Altered levels of cortisol are indicative of acute or chronic mental and, or physical stress.

Cortisol has been called the “stress” hormone because it’s what your body produces to get you out of danger.  The bodies stress response system is usually self-limiting. Once it perceived threat has passed, hormone levels return to normal. But when stresses are always present and you constantly feel under attack, that fight or flight reaction keeps hormones turned on. The problem today is a lot of people are under a permanent state of extreme stress.

Lifestyle, physical and psychological stresses can have an impact on the adrenal glands.

Factors that contribute to Adrenal Fatigue include:

  • Poor sleep patterns.
  • Poor diet.
  • Use of stimulants – coffee, energy drinks, sugar.
  • Constant demand and pressures.
  • Perfectionism.
  • Insufficient rest and relaxation.
  • Taking on too much.
  • Chronic emotional load.
  • Physical trauma and illness.

Life events

  • Work stress.
  • Home stress.
  • Emotional trauma.
  • Death of a loved one.
  • Major surgery.
  • Infection.
  • Financial changes.
  • Head trauma.
  • Moving house.
  • Chemical exposure (including drug and alcohol).

Lifestyle

  • University.
  • Parenting.
  • Unhappy marriage.
  • Unhappy/stressful work place.
  • Self-employment.
  • Drug and alcohol abuse.
  • Shift work.
  • Long work hours.
  • FIFO (fly in, fly out).

Can My Cortisol Levels Be Tested?

Testing for the stress hormone Cortisol can be done, and if you find blood tests to be stressful, let me put your mind at ease.  The Adrenocortex hormone profile is a non-invasive saliva test that serves as a reliable marker of stress response and a critical tool for revealing adrenal imbalances.  Lifestyle stresses put a constant demand on the adrenal glands, and we can assume that most individuals today would be under some level of stress.  If the adrenal glands become depleted adrenal fatigue or insufficiency may be experienced.  Saliva samples are taken over the day to give an accurate indicator of your cortisol levels.

Treatments for Adrenal Fatigue

The best way to treat adrenal exhaustion is to address the underlying cause: stress.

  • Diet – consume a balanced wholefood diet, avoiding any food intolerances.
  • Drinks – Avoid stimulants such as coffee, and energy drinks, as well as alcohol.
  • Balance blood sugar levels with regular meals – eat protein rich foods throughout the day and enjoy a well balance whole food diet.
  • Exercise – regular exercise, avoid over exercise.
  • Relaxation techniques – meditation, warm bath, acupuncture and massage.
  • Good quality sleep – getting to bed by 10pm, avoid taking your computer into the bedroom.

Supplementation

  • B group vitamins.
  • Magnesium.
  • Adaptogenic herbs.

If you feel that stress is taking hold of you, it may be time to talk to a qualified Naturopath and get some balance back in your life.

About Our Naturopathic News and Review ColumnistTrudy Cadoo - Logo

Trudy CadooTrudy Cadoo is a Senior Naturopath at Brisbane Livewell Clinic, Wavell Heights. She believes that health is more than the absence of disease. It is the balance of many factors including mental, emotional and physical well-being. Trudy uses a wide range of diagnostic tools to identify and treat presenting problems.  Trudy specialises in helping busy professional women gain more energy, increase their immune system and feel more vital and in control of their health.

Disclaimer: The information published in this column is the author’s own professional and personal knowledge, and opinion. This information and opinion are not intended to be a substitute for professional medical advice, diagnosis or treatment of any manner. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding any medical condition and consult a qualified medical professional before beginning any nutritional program or exercise program. Never disregard professional medical advice or delay in seeking it because of something you have read on InShape News.

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What is SIBO and How Can it Affect You?

NATUROPATHIC NEWS & REVIEW:

By Columnist Trudy Cadoo – Senior Naturopath:

Beneficial gut bacteria

Photo Credit: National Human Genome Research Institute – Healthy Gut Bacteria

Small intestinal bacterial overgrowth — ‘SIBO’ for short — is exactly as its name suggests: an increased amount of bacteria in your gut. It can also refer to changes in the types of gut bacteria. SIBO causes hydrogen, methane and or hydrogen sulphide gas production causing Irritable Bowel Syndrome (IBS) type symptoms and can also damage to the intestinal wall. So, you ask, how does SIBO sneak its way into your body?

What are the Causes of SIBO?

The leading causes of SIBO are:

Post-infection gastroenteritis – think back to when travelling (Bali Belly) or a tummy bug that went around the office? It’s something that you may rather choose to forget, although it may be something that isn’t going to forget you.

A diet high in refined carbohydrates and sugars – This includes white bread and pasta, as well as ‘sometimes foods’ like cake and potato chips is a draw card. Certain bacteria thrive off these refined carbohydrates, metabolising the refined carbohydrates and causing gas and bloating.

A number of medications – Certain medications can result in SIBO, these are – antibiotics, proton pump inhibitors, morphine and other opiates, narcotics, possibly beta agonists and calcium channel blockers.

What are the Symptoms of SIBO?

Symptoms of SIBO can include:
• Constipation
• Diarrhoea
• Irritable bowel syndrome (IBS)
• Abdominal pain and cramping
• Nausea
• Heartburn
• Bloating
• Food sensitivities
• Skin rashes
• GORD / acid reflux
• Joint pain
• Respiratory symptoms
• Iron and B12 deficiency

SIBO may prevent your body from digesting and absorbing the nutrients contained in your food. It can also damage the lining of the small bowel. This damage may lead to leaky gut syndrome. This ‘bad’ bacteria — currently residing in your gut —will impact how you absorb nutrients such as vitamin B12, iron and folate, which, in turn, has an impact on your energy levels, immune system and nervous system.

Do I Have SIBO?

SIBO is quite common in people with gluten, lactose or fructose intolerance. It is highly likely you may not even know you have one of these intolerances — you can rule it out by being tested.

If you suffer from IBS, you might also be experiencing bacterial overgrowth in your gut. Eighty percent of IBS suffers are believed to have SIBO.

To rule SIBO out of the equation, or confirm possible treatment options it is strongly advised to have an SIBO test. Testing for SIBO is a non-invasive breath test. Bacterial overgrowth can cause a rise in gases which are not produced by humans. These gases are hydrogen and methane, which diffuse from the small intestine into the blood and transported to the lungs where exhaled. By capturing the breath after a specific prep diet, assessment of hydrogen and methane gases take place. Best of all, the test is conveniently done at home.

Treatment for SIBO

If SIBO is present in your system, the treatment plan is a change in diet. The SIBO friendly diet is gluten and dairy free, low in grains, carbs and sugar. Nutritional supplementation and herbal remedies are prescribed alongside the dietary guidelines to assist treatment of SIBO.

Treating SIBO isn’t always easy and does involve many changes in your diet and lifestyle. However, under the right supervision, you can regain vitality and health.

About Our Naturopathic News and Review ColumnistTrudy Cadoo - Logo

Trudy CadooTrudy Cadoo is a Senior Naturopath at Brisbane Livewell Clinic, Wavell Heights. She believes that health is more than the absence of disease. It is the balance of many factors including mental, emotional and physical well-being. Trudy uses a wide range of diagnostic tools to identify and treat presenting problems.  Trudy specialises in helping busy professional women gain more energy, increase their immune system and feel more vital and in control of their health.

Disclaimer: The information published in this column is the author’s own professional and personal knowledge, and opinion. This information and opinion are not intended to be a substitute for professional medical advice, diagnosis or treatment of any manner. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding any medical condition and consult a qualified medical professional before beginning any nutritional program or exercise program. Never disregard professional medical advice or delay in seeking it because of something you have read on InShape News.

The Ins and Outs of Warts

PODIATRY NEWS & REVIEW:

By Columnist Andrea Castello – Biomechanical, Sports and Paediatric Podiatrist:

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Photo Credit: Jenny Lee Silver 2006 – Plantar Wart:

 

Rainy and windy days, short days and long nights, heaters and red wine, this is winter to me.  As a podiatrist though, winter also signals the onslaught of wart cases into the clinic.  Whether it is a child who is doing swimming lessons at indoor locations or gym junkies taking their training indoors because of the cold weather, winter seems to be the season of warts.

How are Warts Caused?

Warts, otherwise known as verrucae, are due to a viral infection.  The virus in question is the human papillomavirus (HPV-1), and this infection causes lesions to form on the skin and quite commonly on the skin.

Warts are most common in children but can present at any age, especially for people with finer skin that is more easily damaged and those that are run down or immunosuppressed (think pregnant women or emotionally stressed individuals).

How Do You Get Warts?

Warts spread in public areas such as swimming pools, change rooms and public bathrooms. They are usually spread by scratching them or being in direct contact with other people who have warts.

Some warts go away on their own without treatment but quite often, without medical care, they can increase in size and depth and can multiply and spread. They can also become painful if left untreated. Generally speaking, the longer warts are left untreated, the more stubborn they can be to remove.  One rule I’ve heard about over my time about how long it takes to resolve a wart is “take the time you have had the wart and double it.”

Where are Warts Found?

Warts are found on the soles of the feet. They are usually small hard bumps that can have black dots in them. Often warts are misdiagnosed as corns (and vice versa) and therefore should be properly diagnosed by a medical professional. Some simple differences between warts and corns include:

  • Warts are painful to squeeze, and corns are painful to apply direct pressure to
  • Warts often have small black dots in the centre of them
  • A wart can be found anywhere on the foot, and corns occur only in pressure areas or over bony prominences

In many instances, the papillomavirus lays dormant in the body without any sign of a wart. In this way, it behaves similarly to the herpes virus (think a cold sore). Warts are infectious, however for infection to occur in someone who doesn’t have the virus there generally needs to be a break in the skin to facilitate entry.

How are Warts Treated?

In our clinic, we have several different treatment options that we use to remove warts, many of which do not cause any discomfort.

These treatment options may include:

  • Natural therapies such as Thuja,
  • Cryotherapy or freezing such as Histofreezer or Liquid Nitrogen,
  • Chemical or acid based treatments like salicylic acid and silver nitrate.

Other options include cautery or burning and surgical removal.

As with all health issues, if unsure, consultation with a podiatrist or medical professional will enable you to decide whether the wart requires treatment and what the most appropriate option is for you.

About Our Podiatry News and Review Columnist

AC Podiatry (19 of 20)Andrea Castello graduated from the University of South Australia in 1999 and has worked in the public and private sectors in both the country and the city. After completing a Masters Degree in Health Services Management in 2006, Andrea decided it was time to put his education to work and start his own practice, which culminated in the inception of AC Podiatry in late 2007. Since then it has grown to include 8 clinics employing 11 podiatrists.

As a podiatrist, Andrea has spent much of his professional career refining his skills with particular attention given to biomechanical, sports and paediatric podiatry. In addition to standard podiatric skills, Andrea has also completed numerous workshops in Dry Needling and Mobilisation. He is a member of Sports Medicine Australia, the Australasian Academy of Podiatric Sports Medicine, a Mentor to final year students and new graduates, and is currently the podiatrist for the Central District Football Club in the South Australian National Football League.

Disclaimer: The information published in this column is the author’s own professional and personal knowledge, and opinion. This information and opinion are not intended to be a substitute for professional medical advice, diagnosis or treatment of any manner. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding any medical condition and consult a qualified medical professional before beginning any nutritional program or exercise program. Never disregard professional medical advice or delay in seeking it because of something you have read on InShape News.

 

Could How You’re Feeling Be a Symptom of a Food Intolerance?

NATUROPATHIC NEWS & REVIEW:

By Columnist Trudy Cadoo – Senior Naturopath:

8710818155_0d8f60851a_k

Photo Credit: ELT Pics 2013 Gluten-Free Cake –

Although a food intolerance is usually not life threatening. It can be downright embarrassing and debilitating…

What is a Food Intolerance?

People commonly confuse a food intolerance with a food allergy. However, there is a distinct difference between the two.  A food allergy occurs when the immune system reacts to an otherwise harmless food. This reaction can be severe, and an anaphylactic shock can occur causing a life-threatening situation. An allergy typically occurs soon after ingesting the food responsible, and it can present itself in a variety of ways. Some of the most common side effects of a food allergy include diarrhoea, breathing difficulty, itching, swelling, skin rashes and vomiting.

How Does a Food Intolerance Effect You?

A food intolerance is a chemical reaction that can present with similar symptoms to a food allergy. However, the symptoms of a food intolerance will never reach a life-threatening level. Food intolerance can also be hard to detect as while some symptoms occur immediately; others may not develop for up to 24 hours. Common side effects of a food intolerance include gas, cramps, constipation, diarrhoea, headaches, rashes, eczema, sinus, sweating, fatigue and heartburn.

How to Determine if You Have a Food Intolerance

When trying to determine if your symptoms are from a food allergy or food intolerance, it is important to identify the possible food suspects that you have consumed in the past 24 hours. Figuring out if the reactions you are experiencing are due to a food intolerance can prove to be quite difficult as it can depend on the amount of that particular food you have consumed. Most people with a food intolerance learn that they have a threshold for a particular food before they start experiencing symptoms. Luckily with a food intolerance, there are some very likely suspects that are more common than others, i.e. dairy products, wheat, eggs, yeast and certain fruits.

No longer do we have to rely solely on the Food Rotation and Elimination Diet to get answers, testing for a food intolerance is a simple, safe, accurate and fast, with results given as quickly as within the week.  Once you have defined which symptoms are related to a food intolerance, you can learn how to live with it. Eliminating the foods that cause the intolerance is often the easiest way to ensure you don’t endure the undesirable reactions. Speak with a professional to see if this option is best for you.

While eliminating certain foods can be disheartening, it is important to remember that there are many other foods you can substitute into your diet to provide you with the nutrition and sustenance your body needs. Knowing what to look out for is the key to making a food intolerance liveable and minimising its impact on your life.

If you find that you or your child are experiencing any of the symptoms mentioned in this article, it is important that you seek help. It is also recommended that you undertake a food intolerance test. This test will allow you to take the next steps so you can continue on with more important things in life!

About Our Naturopathic News and Review ColumnistTrudy Cadoo - Logo

Trudy CadooTrudy Cadoo is a Senior Naturopath at Brisbane Livewell Clinic, Wavell Heights. She believes that health is more than the absence of disease. It is the balance of many factors including mental, emotional and physical well-being. Trudy uses a wide range of diagnostic tools to identify and treat presenting problems.  Trudy specialises in helping busy professional women gain more energy, increase their immune system and feel more vital and in control of their health.

Disclaimer: The information published in this column is the author’s own professional and personal knowledge, and opinion. This information and opinion are not intended to be a substitute for professional medical advice, diagnosis or treatment of any manner. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition and consult a qualified medical professional before beginning any nutritional program or exercise program. Never disregard professional medical advice or delay in seeking it because of something you have read on InShape News.

Glutes and Gait

PODIATRY NEWS & REVIEW:

By Columnist Andrea Castello – Biomechanical, Sports and Paediatric Podiatrist:

9534574686_1256373701_bPhoto credit: Firing the Glutes Reduces Injury via photopin (license)

As a podiatrist, I find that most patients present with a range of foot and lower leg issues – heel pain, Achilles Tendinopathy, Medial Tibial Stress Syndrome, Shin Splints and Patellofemoral Joint Pain are all common presentations to my clinic.  Given these injuries and issues affect the foot and lower leg, both referrers and patients alike assume that the cause of these issues are located primarily in the foot.  This assumption is simply not true.  Of those people experiencing the injuries mentioned above the vast majority have issues at the hip and pelvis level, and the glutes.

What Role do the Glutes Play in Movement?

The gluteal complex is a highly important group of muscles. These are the muscles that not only drive you forward when walking, running and jumping, but they are also incredibly important in stabilising the pelvis when the athlete is supporting the entire body weight on one leg, otherwise known as single support phase in running or midstance when walking.

When we run, the glutes hold our pelvis level and steady, extend our hip, propel us forward, and keep our legs, pelvis, and torso aligned.  It then follows that if there is substantial weakness, or poor recruitment and inhibition of the glutes, the knock-on effect to the entire kinetic chain is significant and potentially a real source of injury. An example of this concerns your knee.  Your glutes prevent your femur (thigh) from rotating inwards.  If this doesn’t occur it will result in an increase in both the valgus (knock-knee) and rotational forces through the knee joint, increasing the risk of injury.

Another potential effect on the leg of gluteal inhibition is reduced ankle joint motion.  If the gluteals can’t extend the hip due to inhibition the brain will act to limit hip extension.  One way to restrict hip extension is to reduce ankle motion, which, if present, can contribute to lower limb injuries.  There are numerous studies linking glute weakness/inhibition to pathologies such as Achilles tendinopathy, shin pain, patellofemoral pain, plantar heel pain and iliotibial band syndrome.

The Gluteal Complex Issue

The gluteal complex is a bit of a problem group for most athletes – recreational or otherwise – but particularly runners and walkers, because while this group of muscles stabilise the pelvis, they do not get a strengthing workout during a run. This issue can make your hamstrings, quadriceps, and calves disproportionately stronger. Another issue is that most strength-training routines don’t isolate the glutes. If an exercise requires several muscles to perform the movement, the majority of the work will be done by the strongest of those muscles. Finally, tight muscles, specifically the hip flexors, can inhibit the glutes and prevent their muscle fibres from firing.

The upshot of all of this is to include the glutes as part of a training program; to do this, start with a simple activation program and progress as you get better.  If you are unsure of what you should be doing, seek professional advice.  It will ultimately reduce your risk of injury and as a bonus will cater to improved performance.

About Our Podiatry News and Review Columnist

AC Podiatry (19 of 20)Andrea Castello graduated from the University of South Australia in 1999 and has worked in the public and private sectors in both the country and the city. After completing a Masters Degree in Health Services Management in 2006, Andrea decided it was time to put his education to work and start his own practice, which culminated in the inception of AC Podiatry in late 2007. Since then it has grown to include 8 clinics employing 11 podiatrists.

As a podiatrist, Andrea has spent much of his professional career refining his skills with particular attention given to biomechanical, sports and paediatric podiatry. In addition to standard podiatric skills, Andrea has also completed numerous workshops in Dry Needling and Mobilisation. He is a member of Sports Medicine Australia, the Australasian Academy of Podiatric Sports Medicine, a Mentor to final year students and new graduates, and is currently the podiatrist for the Central District Football Club in the South Australian National Football League.

Disclaimer: The information published in this column is the author’s own professional and personal knowledge, and opinion. This information and opinion are not intended to be a substitute for professional medical advice, diagnosis or treatment of any manner. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding any medical condition and consult a qualified medical professional before beginning any nutritional program or exercise program. Never disregard professional medical advice or delay in seeking it because of something you have read on InShape News.

Considerations on Choosing Your Athletic Shoe

PODIATRY NEWS & REVIEW:

By Columnist Andrea Castello – Biomechanical, Sports and Paediatric Podiatrist:

14044227865_ba59f50ed1_bPhoto credit: Keep running – Nike Women’s Half Marathon DC via photopin (license) –

The June long weekend generally provides us with the opportunity to get out and do those things we usually don’t get time to do.  My wife and I chose to spend some time with friends, sharing an Osso Buco and a cheeky glass of red or two while catching up on everything that has gone on since we last got together.  It was during this lovely afternoon that the number one question I get asked as a podiatrist was thrown to me.  My mate Simon, who is an AFL nut and is keen about fitness, turns to me, glass of wine in hand and asks:

“So Andrea, what’s the best shoe for me to run in?”

As a sports podiatrist, getting asked this question is like being asked, “How long is a piece of string?”

The reality is there isn’t one shoe (or brand for that matter) that is right for every person.  There are so many variables that one must take into account when purchasing an athletic shoe, that to answer this question in any other way would be simply disingenuous.

It is important, however, that people are at least aware of what to look for and what to consider when purchasing athletic footwear.  Below is a list of some of the considerations that you should take into account when looking to buy athletic footwear:

  1. Comfort and Fit:
  • The MOST important consideration, irrespective of foot type or footwear engineering.
  • While we understand that comfort is a subjective measure and difficult to quantify, evidence released last year linked improved comfort to as much as a 13% reduction in the frequency of injury in a running cohort.
  1. Activity to be Performed:
  • All premier footwear brands spend vast amounts of money designing shoes for specific activities.
  • I regularly see sports-related injuries where a shoe designed for running has not been used for its intended purpose.  An example would be a sport requiring sudden changes of direction and side to side movement (e.g. Netball).
  • This may mean you need to buy two pairs of shoes, one for running and one for your other activity.
  1. Type of Injury
  • Different shoes will have an impact on different parts of the lower leg anatomy.
  • High drop/offset shoes will load the knee and offload the ankle and Achilles.
  • Low drop/offset shoes will load the ankle and Achilles and offload the knee.
  • Posted shoes (both medial and lateral) will affect the knee in different ways.  If in doubt go for a stable “neutral” shoe or, even better, seek professional advice.
  1. Biomechanical Profile
  • This does not relate to whether your foot is flat or not.  The evidence surrounding footwear engineering concerning foot type and reduced injury is very weak and not something I personally subscribe.
  • What is important though is how an individual moves taking into account all parts of the kinetic chain including hip, knee and foot function.
  • Considerations in footwear affected by one’s biomechanical profile include, but are not limited to, the weight of the shoe, midsole posting/density and offset.

As I finished my monologue espousing everything I know about footwear, explaining the complexities and how they pertain to him, Simon placed his empty glass on the table, looked at me with a mixture of surprise and disbelief and exclaimed, “Wow, I didn’t realise there was that much to it Andrea.”

I smiled and replied,“You’re not alone mate.  Now how about we refill that glass of yours?”

About Our Podiatry News and Review Columnist

AC Podiatry (19 of 20)Andrea Castello graduated from the University of South Australia in 1999 and has worked in the public and private sectors in both the country and the city. After completing a Masters Degree in Health Services Management in 2006, Andrea decided it was time to put his education to work and start his own practice, which culminated in the inception of AC Podiatry in late 2007. Since then it has grown to include 8 clinics employing 11 podiatrists.

As a podiatrist, Andrea has spent much of his professional career refining his skills with particular attention given to biomechanical, sports and paediatric podiatry. In addition to standard podiatric skills, Andrea has also completed numerous workshops in Dry Needling and Mobilisation. He is a member of Sports Medicine Australia, the Australasian Academy of Podiatric Sports Medicine, a Mentor to final year students and new graduates, and is currently the podiatrist for the Central District Football Club in the South Australian National Football League.

Disclaimer: The information published in this column are based on the author’s own professional and personal knowledge, and opinion. This information and opinion are not intended to be a substitute for professional medical advice, diagnosis or treatment of any manner. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding any medical condition and consult a qualified medical professional before beginning any nutritional program or exercise program. Never disregard professional medical advice or delay in seeking it because of something you have read on InShape News.

Post Tib Tendinopathy

PODIATRY NEWS & REVIEW:

By Columnist Andrea Castello – Biomechanical, Sports and Paediatric Podiatrist:

shutterstock_148343729

The tibialis posterior is a muscle that originates from the posterior and medial side of the tibia (shin) and travels via its tendon behind the medial malleolus (inside ankle bone) before attaching to a bone on the inside of the foot called the navicular. The tibialis posterior acts primarily to roll the foot out, and also controls the rate at which the foot rolls in when it contacts the ground.

Injuries of this muscle and tendon complex occur in and around the tibialis posterior tendon rather than the muscle itself.  The tendon of tibialis posterior is progressively loaded as the foot makes contact with the ground and the foot rolls inward.  In those people who have very poorly functioning feet resulting in significant amounts of arch collapse, the tendon may be compressed (squashed) between the ground/shoe and the navicular.  Running sports in particular place increased strain and compression on the tendon, which increases the risk of injury.

Factors that Cause Tibialis Injury

Many contributing factors have been identified as playing a role in tibialis posterior tendon injury.  These factors include:

•    Malalignment (poor foot posture).
•    Hypermobility (increased joint movement).
•    Ligamentous Laxity (overly elastic ligaments).
•    Local trauma.
•    Changes in training technique and intensity.
•    Changes in playing surfaces.
•    Systemic illnesses such as Diabetes.
•    Increased BMI.
•    Poor Footwear.

All of these factors may contribute to acute inflammation in the tibialis posterior tendon.

Inflammation of the Tibialis Tendon

If left untreated, the acute inflammation of the tibialis posterior tendon can develop into chronic inflammation.  This inflammation may result in degeneration of the tendon leading to tendinosis (a breaking down of the collagen within the tendon). In some instances, we may see tears occurring in the tendon.  These are called intrasubstance tears.

The onset of symptoms of tibialis posterior tenosynovitis is usually gradual and affects those between 30 and 40 years of age. The pain is typically not debilitating initially but rapidly worsens with prolonged walking or standing.  In the athletic cohort, it can ultimately affect push off and drive.

In the clinic, pain may be reproduced on palpation over the tendon as it courses behind the medial malleolus. Swelling is often present, being most pronounced in the part of the tendon around its insertion on the navicular.  Pain on toe standing or heel walking is positive for a posterior tibialis injury.

Management of Tibialis Tendinopathy

The management of tibialis posterior tendinopathy includes the following:
•    Reduce activity.
•    Non-steroidal anti-inflammatory drugs.
•    Careful attention to training modification. Stretching and warm up are critical in the acute phase of the injury.
•    Strengthening exercises.
•    Functional foot orthotic devices are also necessary to help improve function and influence the collapse of the foot – in effect reducing the load on the tendon.
•    Footwear changes to more supportive options.

Ultimately tibialis posterior tendinopathy can result in significant disability and long-term loss of function, especially if it is left untreated and associated issues arise such as the rupture of the spring ligament.  If unsure, please make contact with your nearest podiatrist and have your foot assessed.

About Our Podiatry News and Review Columnist

AC Podiatry (19 of 20)Andrea Castello graduated from the University of South Australia in 1999 and has worked in the public and private sectors in both the country and the city. After completing a Masters Degree in Health Services Management in 2006, Andrea decided it was time to put his education to work and start his own practice, which culminated in the inception of AC Podiatry in late 2007. Since then it has grown to include 8 clinics employing 11 podiatrists.

As a podiatrist, Andrea has spent much of his professional career refining his skills with particular attention given to biomechanical, sports and paediatric podiatry. In addition to standard podiatric skills, Andrea has also completed numerous workshops in Dry Needling and Mobilisation. He is a member of Sports Medicine Australia, the Australasian Academy of Podiatric Sports Medicine, a Mentor to final year students and new graduates, and is currently the podiatrist for the Central District Football Club in the South Australian National Football League.

Disclaimer: The information published in this column are based on the author’s own professional and personal knowledge, and opinion. This information and opinion is not intended to be a substitute for professional medical advice, diagnosis or treatment of any manner. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition and consult a qualified medical professional before beginning any nutritional program or exercise program. Never disregard professional medical advice or delay in seeking it because of something you have read on InShape News.

Plantar Heel Pain Management and Treatment

PODIATRY NEWS & REVIEW:

By Columnist Andrea Castello – Biomechanical, Sports and Paediatric Podiatrist:

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Plantar heel pain, commonly referred to as “plantar fasciitis”, is defined as pain or discomfort in the bottom of the heel. It is generally characterised in its early stages by pain or discomfort when rising from rest, especially if a lot of time has been spent on the heel during the day. In the case of morning pain, it will generally occur if a big day was had the day before.

Symptoms of Plantar Heel Pain

In its infancy this discomfort seems to settle after a couple of minutes of walking around. However if the problem is left to worsen, it can get to a stage where any type of weight bearing activity is painful. I have seen cases where patients have had to resort to the use of crutches and moonboots just to perform basic daily tasks.

Plantar heel pain can be caused by many different risk factors. The main factors I see are a sudden change in activities, such as increased walking, running, jumping, employment that requires more standing, and changes in footwear. Some people are predisposed to plantar heel pain because of biomechanics – poor foot function or poor proximal hip stability – or systemic factors – age, menopause, elevated cholesterol, increased susceptibility to pain, weight. Predisposed people may develop plantar heel pain with even subtle changes in their activity.

Treatment for Plantar Heel Pain

When treating the plantar heel pain, my primary aims are to address two main issues. The first is to reduce compressive load -squashing-up against the bottom of the calcaneus or heel bone – and the second is to reduce shear forces around the heel generally increased by foot function or footwear.

I feel it is important to address plantar heel pain as soon as possible and to be aggressive with treatment. Generally speaking, the longer a patient has this problem, then the longer it will take to resolve.

My general treatment plan for Plantar Heel Pain is as follows:

  • Taping in the first instance. In particular to support the fat pad under the heel so it can act as a “cushion” and reduce the compressive load on the heel.
  • Footwear change. This does depend on the foot type we are treating, however the main aims are to reduce the compressive and shear forces on the heel.
  • Strengthening program for the small muscles of the foot.
  • Calf muscle stretching.
  • Manual Therapy to increase the ankle’s range of motion.
  • Dry Needling of the intrinsic muscles to treat painful trigger points.
  • Orthoses. We now have evidence that custom foot orthoses provide for much better outcome at 12-weeks than exercises and footwear changes alone and in my experience can resolve 95% of cases.

If these interventions fail, which may be the case if the problem is long standing, then other interventions include the following:

Plantar heel pain is a health issue that left without treatment can become debilitating. My advice is if you are suffering with this or something similar, please don’t hesitate in seeking assistance. The sooner it is addressed the sooner you can get back to doing what you love doing, pain free.

About Our Podiatry News and Review Columnist

AC Podiatry (19 of 20)Andrea Castello graduated from the University of South Australia in 1999 and has worked in the public and private sectors in both the country and the city. After completing a Masters Degree in Health Services Management in 2006, Andrea decided it was time to put his education to work and start his own practice, which culminated in the inception of AC Podiatry in late 2007. Since then it has grown to include 8 clinics employing 11 podiatrists.

As a podiatrist, Andrea has spent much of his professional career refining his skills with particular attention given to biomechanical, sports and paediatric podiatry. In addition to standard podiatric skills, Andrea has also completed numerous workshops in Dry Needling and Mobilisation. He is a member of Sports Medicine Australia, the Australasian Academy of Podiatric Sports Medicine, a Mentor to final year students and new graduates, and is currently the podiatrist for the Central District Football Club in the South Australian National Football League.

Disclaimer: The information published in this column are based on the author’s own professional and personal knowledge, and opinion. This information and opinion is not intended to be a substitute for professional medical advice, diagnosis or treatment of any manner. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition and consult a qualified medical professional before beginning any nutritional program or exercise program. Never disregard professional medical advice or delay in seeking it because of something you have read on InShape News.

Talking Achilles Tendinopathy

PODIATRY NEWS & REVIEW:

By Columnist Andrea Castello – Biomechanical, Sports and Paediatric Podiatrist:

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Everybody knows somebody who has had a problem with their Achilles Tendon (AT).  This structure is one of the most injured in runners and this injury is seen very often in the more recreational athlete.

It is important to understand that there are two major types of Achilles Tendinopathy.

  1. Mid-Portion:
    • This is the more common form.
    • This affects the tendon about 2.5-3cm above the insertion on the heel.
    • Generally caused by a sudden increase/change in load on the tendon.
  2. Insertional:
    • This is less common but can be more painful.
    • This is felt on the back of the heel bone itself, where the Achilles attaches.
    • Generally caused by a compression (squashing) of the tendon against the heel bone as the foot is brought back towards the shin (dorsiflexion)

Insertional Tendinopathy is much harder to “cure” and I would strongly encourage you seek professional advice if you have this problem.

In a nutshell, management of Achilles Tendinopathy is about two things.  The first is pain management the second is load management.  It is important to understand that, as a rule, the AT only begins to hurt when the demands placed on it are greater than its capacity to perform said demands.  This is why the AT doesn’t hurt when you don’t do anything.

My Tips on Managing Achilles Tendinopathy are:

Don’t Rest

Yes, you heard me correctly.  Rest is the worst thing for any tendon problem.  If you don’t load a tendon its capacity will diminish making it easier to aggravate when you need to use it.  Rather than resting, you should look to modify your activity.  I am a big fan of simple strength work in the early stages of Achilles Tendinopathy to build capacity.  Isometric calf raises are a fantastic way of building strength and reducing pain in a symptomatic AT.  Any quality healthcare professional will help you devise a suitable program.

Footwear/Heel Lift

Change to a shoe that has a higher stack/drop or place a heel lift inside your shoes.  The greater the fall/drop from the back of the shoe to the front, the less eccentric load (lengthening load) is placed on the AT.  Reducing this load on the tendon will reduce pain levels.

Training Environment

Get off hard ground and playing surfaces.  This aggravates Achilles problems.

Running Technique/Training Intensity

If you are a forefoot/midfoot striker or do a lot of high intensity work outs, it may be worth looking to change to a heel strike pattern, go for longer runs or move to low intensity workouts to reduce the load on the AT until you build capacity.

Seek Professional Help

If managed early, Achilles Tendinopathy can be resolved reasonably quickly.  If left, however, it can become a chronic problem which may take months to resolve.  A quality healthcare professional will guide you through the rehab process and get you back doing what you love, fast!

About Our Podiatry News and Review Columnist

AC Podiatry (19 of 20)Andrea Castello graduated from the University of South Australia in 1999 and has worked in the public and private sectors in both the country and the city. After completing a Masters Degree in Health Services Management in 2006, Andrea decided it was time to put his education to work and start his own practice, which culminated in the inception of AC Podiatry in late 2007. Since then it has grown to include 8 clinics employing 11 podiatrists.

As a podiatrist, Andrea has spent much of his professional career refining his skills with particular attention given to biomechanical, sports and paediatric podiatry. In addition to standard podiatric skills, Andrea has also completed numerous workshops in Dry Needling and Mobilisation. He is a member of Sports Medicine Australia, the Australasian Academy of Podiatric Sports Medicine, a Mentor to final year students and new graduates, and is currently the podiatrist for the Central District Football Club in the South Australian National Football League.

Disclaimer: The information published in this column are based on the author’s own professional and personal knowledge, and opinion. This information and opinion is not intended to be a substitute for professional medical advice, diagnosis or treatment of any manner. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition and consult a qualified medical professional before beginning any nutritional program or exercise program. Never disregard professional medical advice or delay in seeking it because of something you have read on InShape News.

 

How To Choose The Right Podiatrist For YOU?

PODIATRY NEWS & REVIEW:

By Columnist Andrea Castello – Biomechanical, Sports and Paediatric Podiatrist:

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Photo credit: The 3 of Us via photopin (license)

We all know how it starts. You have a foot problem and talk to your friends, family or perhaps a health professional about it and you get the response, “Maybe you should see a Podiatrist?” Then you think to yourself, that’s great advice, but how do I pick a podiatrist that is right for me? What differentiates a good podiatrist from an average podiatrist?

Rather than you running around in circles trying to find the right podiatrist, I have devised the 3T Model for choosing the right podiatrist for you.

What is the 3T Model?

The 3T model is a simple paradigm that you can use to ensure the podiatrist you want to see, or the podiatrist you currently see is the correct one for you. It will allow for you to ask those questions which will ultimately maximise your health outcomes.

The First T: Training

All podiatrists in Australia have completed a Bachelor Degree from a major university. However, this basic training does not make podiatrists all the same. It is important to understand that there are podiatrists that have special training and skills in different areas, such as sports podiatry, high -risk management, paediatrics and surgery. You need to ask, when you make contact with the podiatrist, what extra training, skills or experience they have with regard to your problem, this will ensure the best outcomes for you.

The Second T: Techniques

Put simply, the more techniques at a podiatrist’s disposal the greater the chance they have of fixing your problem. The reality is no two people are the same and not everyone responds to the same treatment regime. The more strings a podiatrist has in their treatment bow, the better it is for you. My advice, do your research and ensure that the podiatrist has at least a couple of options for treating your problem.

The Final T: Total

By this I mean your podiatrist takes a ‘Total Approach’. You are not just a foot and leg, but a whole person. Your podiatrist needs to understand you and the pressures that you may have in your life such as family or work, and ensure that your treatment plan fits you. In addition, there are many foot and leg issues that have drivers higher up the body that also need to be addressed. If your podiatrist doesn’t understand this, and have a strong referral network to ensure you get these other drivers addressed, you won’t maximise your health outcomes.

About Our Podiatry News and Review Columnist

AC Podiatry (19 of 20)Andrea Castello graduated from the University of South Australia in 1999 and has worked in the public and private sectors in both the country and the city. After completing a Masters Degree in Health Services Management in 2006, Andrea decided it was time to put his education to work and start his own practice, which culminated in the inception of AC Podiatry in late 2007. Since then it has grown to include 8 clinics employing 11 podiatrists.

As a podiatrist, Andrea has spent much of his professional career refining his skills with particular attention given to biomechanical, sports and paediatric podiatry. In addition to standard podiatric skills, Andrea has also completed numerous workshops in Dry Needling and Mobilisation. He is a member of Sports Medicine Australia, the Australasian Academy of Podiatric Sports Medicine, a Mentor to final year students and new graduates, and is currently the podiatrist for the Central District Football Club in the South Australian National Football League.

Disclaimer: The information published in this column are based on the author’s own professional and personal knowledge, and opinion. This information and opinion is not intended to be a substitute for professional medical advice, diagnosis or treatment of any manner. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition and consult a qualified medical professional before beginning any nutritional program or exercise program. Never disregard professional medical advice or delay in seeking it because of something you have read on InShape News.

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