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Orthotic Therapy

Orthotics are external supports designed to fit in to your footwear to support and optimise the mechanics of your lower limbs and foot posture, providing therapeutic relief for acute and chronic pain.

Foot orthoses have been demonstrated to be effective in the management of a range of condtions such as plantar fasciitis, osteoarthritis, chronic conditions (such as diabetes, rheumatoid arthritis, hypermobility syndromes), tendinopathies and neuromas. They can also provide long term benefits toward corns or calluses by reducing high pressure, high friction in footwear.

There are two predominant types of orthotics:

1. Medical Grade Foot Orthotics — these are mass produced and designed to fit a generic foot shape.

2. Custom Foot Orthotics — these are prescribed and designed by your podiatrist for your feet to target and treat your specific needs and are generally the gold standard.

Optimises your lower limb mechanics which will provide a more improved and corrected postural alignment up the body. This will increase your confidence whether you are speaking in a board meeting, playing with your kids or sport activities.

Improves acute and chronic injuries.

Corrects limb length discrepancies that may be causing hip, pelvic and lower back issues.

Prevention for overuse injuries by enhancing foot function position

Prevents postural foot changes and foot collapse in pregnant women.

Guides your child’s foot to grow in a more anatomically aligned position.

Refines proprioceptive sensory input (balance)

This begins with your consultation, where we provide a musculoskeletal and biomechanical assessment including a video gait (walking) analysis. To completely customise your orthotics at Rosewell Clinics we use a structural 3-Dimensional CAD scanner, that curates an impression to the exact dimensions of your foot in its corrected position. This scan along with a detailed prescription form will be sent to our orthotics lab where they will be manufactured.

Dry Needling & Mobilisation

Dry needling (intramuscular stimulation) is a treatment performed by a trained podiatrist, targeting muscle trigger points to reduce pain.

Dry needling is a minimally invasive technique whereby a single-use and sterile filament needle is gently inserted into the muscle trigger point to assist with pain reduction and improve muscle function. The stimulus works by releasing myofascial trigger points (commonly known as knots in the muscle).

When a myofascial trigger point is stimulated and released, two significant clinical phenomena occur: a local twitch response and referred pain.

Myofascial trigger points are localised, hyper-irritable points in tight bands of skeletal muscle or fascia, which, when they are compressed, cause referred pain and tenderness.

https://doi.org/10.3122/jabfm.2010.05.090296 (https://www.jabfm.org/content/ 23/5/640) https://doi-org.ezproxy.uws.edu.au/10.1016/j.ejpain.2008.02.006

The muscle is unable to move frequently, decreasing oxygen and blood flow that ideally flushes out acidic compounds and inflammation (McPartland, 2004; Simons et al., 1999). Muscles continue to tighten to compensate for the pain.

The occurrence of myofascial trigger points, is the body feeding back to us through a protective response to:

– Prolonged posture (e.g standing/sitting at work for long hours)

– Injury — muscles will tighten in an attempt to reduce the intensity of the injury

– Change in muscle loading or regular activity (e.g increased the number of sessions/volume/intensity in any physical activity)

– Quick and unexpected movements (e.g change in direction when walking)

– Nerve impingements — muscles try to protect the nerve by tightening

– Illness

– Nutritional deficiencies and or metabolic/endocrine conditions

Generally, we recommend this procedure to assist with: – Pain management – The release of myofascial trigger points (muscle knots) to restore functional movement

Although dry needling and acupuncture use similar techniques, the methodologies behind each theory differ. Acupuncture treats medical conditions by restoring the flow of energy and balance through the body. Dry needling targets pain reduction in an effort to restore muscular function, by directly releasing myofasical trigger points (muscle knots).

When the fine filament needle gently penetrates the myofasical trigger point, blood flow increases and allows the contracted muscle fibres to relax. Oxygenated blood and nutrients are carried into the muscle fibres, flushing acidic compounds. This physiological response, will result in decompression of local nerve and blood supply.

You may feel a mild sensation as the needle is inserted into the muscle. A short muscle twitch may occur during treatment, this is a positive indication that we have stimulated a myofasical trigger point.

Dry needling is one of our many treatment techniques which may be used as part of your treatment and/or pain management program. Research has indicated that dry needling is often most effective in conjunction with other treatment protocols, depending on what musculoskeletal and biomechnical problems are occurring.

In every form of treating, there is associated risk. Research indicates that adverse effects reported to date, have been mild and not significant. The estimated risk of significant adverse effects can be considered, at worst, rare (doi: 10.1179/2042618613Y.0000000044).

We advise a light walk, o some stretching after treatment, supporting the body in adjusting and continuing blood and oxygen flow. We generally recommend avoiding high impact exercise for at least 24-48 hours after you receive your treatment.

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Injection Therapy (Prolotherapy)

Injection therapy (medically known as prolotherapy) is regenerative therapy (or sclerotherapy) used an alternative treatment for chronic musculoskeletal pain.

Prolotherapy is a procedure where a solution such as dextrose (sugar) or lidocaine (local anaesthetic) is injected into the injured soft tissue. The solution kick starts the body’s restorative response to the injured joints, ligaments and tendons. It is not a surgical treatment, rather a conservative way to manage pain.

Prolotherapy can be supplemented with a co-management plan and can also be a means to delay or possibly eliminate the need for surgery. Prolotherapy has been successfully used in western medicine for over 60 years. Research and systematic reviews show support for the treatment of tendinopathies, ligament dysfunction, bursitis and neuroma’s.

Nail Surgery

Surgery & Ingrown Nails

Painful ingrown toenails, no longer have to keep you from looking and feeling your best.

Ingrown nails (medically referred as onychocryptosis), is a universal issue. An ingrown nail is typically caused when the corner of the nail plate grows into the skin. This allows a portal of entry for bacteria into the area often causing painful infections (look out for signs of infection: red, hot, swollen, pain, discharge). Pain often begins as mild, progressively becoming more severe, to a point that daily tasks, like wearing enclosed footwear and physical exercise, can become painful and limiting.

Causes

There are numerous factors that may cause ingrown nails:

Nails that are: too thick, too wide, or abnormal nail shapes (high curvature)

Improper nail care, such as incorrect cutting technique (talk to us about our wonderful pedicure treatments to avoid this occurrence!)

Poor hygiene Trauma (dropping something on your toe, walking into the bed post for example)

Sports related (especially those that require kicking i.e football, rugby, kickboxing, dancing)

Ill-fitting footwear, causes high external pressure

Hereditary

These risk factors can each affect the growth of the toenail. It is critical that you seek professional advice if you have an ingrown toenail or any other foot-related pain, or simply if you feel concerned. Lack of or mistreatment will almost always cause further pain and damage.

We understand how problematic nail concerns can be, and our Rosewell Clinics Podiatrists will assess the issue and identify the best treatment plan that will work for you and your lifestyle. If the issue is minor, a conservative nail treatment will likely suffice.

The most effective treatment option, in most cases, is a minimally invasive ingrown toe nail surgery, which has a 98% success rate as a permanent solution to your ingrown toe nails.

The most common surgical procedure performed by our expert Podiatrists is a Partial Nail Avulsion (PNA), involving a local anaesthetic injection. Once the section of the offending nail is removed, a chemical called phenol is applied to prevent the regrowth of that section of nail in future. Your podiatrist will then dress the site and provide after care education. Recovery time is approximately 2-5 weeks, during which we ensure a proper recovery with numerous dressing changes and a final checkup.

In more severe cases, if the nail is deformed and causing pain on both sides of the toe, a Total Nail Avulsion (TNA – removal of the entire toe nail) may be necessary to achieve the best therapeutic outcome.

This surgery is a routine, in-clinic treatment, that takes approximately 1- 1.5 hours from entering the clinic to leaving.

At Rosewell, we are about maintaining the appearance of an aesthetically pleasing toenail. We only take part of the nail that is absolutely necessary using the latest, least invasive techniques.

Yes, you can walk immediately after the surgery and you will also be able to wear normal enclosed footwear within 48 – 72 hours.

Follow your nails’ natural curve, cut across your toenails and not down the sides!

Yes, it really does! Footwear needs to fit the shape of your foot, not your foot fitting the shoe. Ill-fitting footwear increases external pressure and will aggravate your ingrown toenails, amongst other foot related issues. Your Rosewell Clinics Podiatrist can advise you on the most appropriate footwear.

Rosewell Clinics Podiatry are registered by the Australian Podiatry Board and the Australian Health Practitioner Agency. We are required to work a minimum standard with meticulous and stringent sterilisation codes. Our podiatrist’s are skilled and trained to treat ingrown toenails, amongst other foot related concerns and conditions.

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Shockwave Therapy

** Only available at Burwood Clinic.

Shockwave therapy was introduced into clinical practice in the 1980’s initially for the management of kidney and urinary stones (1). ESWT was then researched in orthopaedics where it was identified as enhancing the osteogenic response improving fracture healing (3) (4).

Over the last 20 years, shockwave therapy has been used as method of treatment for musculoskeletal conditions and stimulation of bone growth (4).

ESWT is a noninvasive treatment that delivers high frequency shock waves to injured soft tissue to accelerate healing and reduce pain (5). ESWT is often an effective option for patients that have tried rest, ice, medication or other therapies and still present with chronic and unresolved tendinopathies (85% of patients had a 50% pain reduction in hamstring tendinopathy after treattment)

ESWT is frequently practised for the management of common lower limb conditions, including:

Plantar Fasciitis (Plantar fasciopathy) & Heel Pain

– Achilles Tendinopathy – Shin Splints (Medial Tibial Stress Syndrome)

– Jumpers Knee (Patellar Tendinopathy) & Osgood-Schlatter Syndrome

– Proximal Hamstring Tendinopathy

– Hip pain (Trochanteric Bursitis)

– Stress fractures

– Gout

– Calcific Tendonitis

– Morton’s Neuroma

– Cellulite (enquire more here for cellulite treatment with Dr. Jade)

Your skilled Podiatrist will discuss a recommended treatment plan with you at your clinical consult based on your presenting condition and other lifestyle factors. A standard course of treatment usually involves 1 treatment per week for 2 – 5 weeks. Each session takes approximately 10-15 minutes to perform.

To achieve a desired level of symptom relief, we continue treatment as needed. The body continues to go through its own physiological healing cascade, even after the prescribed sessions of shockwave therapy.

Your treatment plan will also include evidence based advice on how to best manage your condition, whether through rehabilitation, strength or mobility to reduce your risk of re-injury.

Book your next appointment today.