Ankle Sprain Information Flyer

Posted by on Monday, November 9, 2015 in Blog | Comments Off on Ankle Sprain Information Flyer

We have just published the first (of many) patient information flyers. This flyer gives information regarding acute ankle injuries.
The file is accessible from the link below



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Cumulative Injury Cycle (CIC)

Posted by on Wednesday, November 4, 2015 in Blog | Comments Off on Cumulative Injury Cycle (CIC)

Cumulative Injury Cycle (CIC)

Many chronic conditions arising in the foot and lower limb can be attributed to the CIC, or the CIC can commence as a result of an injury and lead to further injuries developing. The CIC is a cycle in which  one factor can contribute to the development/progression of other factors in the cycle, leading to increased tissue damage, increased pain and delayed recovery times.


In some instances you may have previously tried one treatment (eg: stretches or icing the painful area) and have gained a small amount of relief, however the pain is still present and/or the pain has returned. This may indicate that you are in the Cumulative Injury Cycle and will need a more thorough assessment in order to determine the root cause of your condition so as to commence the most appropriate treatment program for you.



What Does It All Mean?

The CIC is a self-perpetuating cycle that feeds itself and can worsen a biomechanical/musculoskeletal problem. For example; swelling in and around a muscle (which may be caused from injury, poor biomechanics etc…) does not allow for free movement of the muscle/s to occur, due to swelling and/or scar tissue. This in turn increases the friction between muscles and fascia, resulting in decreased ranges of movement (eg: tight muscles and fascia). Tight muscles and/or fascia are more susceptible to injury. Injured tissue results in swelling… and so the cycle continues.

Types of Injuries

1. Acute Injury – Eg: Ankle sprain. This type of injury results in inflammation developing as blood rushes to the area to begin repairing the damaged structures.

2. Repetitive Injury – Occur when repetitive movements are performed with very little rest time in between. This results in overused, fatigued and weak musculature. In relation to podiatry; poor biomechanics/foot function placing repetitive stress on musculature as the muscles are trying to compensate for inefficient joint motions (eg: fallen arches resulting in the leg muscules working harder to stabilise the foot/arch)

3. Constant Pressure / Tension – Occurs as a result of poor posture/biomechanical alignment. Constant pressure/tension on structures decreases blood flow, interferes with nerve input and can inhibit cell repair.



Weak & Tight Structures: If a muscle is constantly under increased tension (ie: tight) it eventually becomes weak, and when a muscle is weakened the body’s response is to tighten the muscle/s up in an attempt to stop the abnormal function.

Friction / Pressure / Tension: If there is an increase in these factors in and around soft tissue structures the structures are not able to freely move throughout their normal ranges of motion.

Decreased Circulation / Oedema (Edema): Increased friction / pressure / tension placed on blood and lymphatic vessels will disrupt the flow of blood and lymph fluid into and out of an area. This means that your body may not be able to clear up any swelling due to the vessels being under pressure, or alternately you may not get adequate blood flow to an area due to pressure on the vessels. These processes can happen simultaneously.

Adhesions/Fibrosis: When the body is attempting to heal injured structures it repairs the areas with more fibrous tissue than what was there originally. Fibrous structures are not as elastic or strong as normal connective tissue, and these tissues adhere to surrounding structures resulting in increased friction/tension and/or decreased range of motion.

Tear or Crush: Some of the types of physical disruption/injury that can occur to the body’s tissues. A tear injury may be an ankle sprain or a torn muscle/tendon.

Inflammation: This results from the tissue injury and begins the ‘healing’ process in which adhesions begin to form, at which point the cycle continues to weaken and tighten the tissues.

As you can see, this is a cycle that will continue to self-perpetuate unless the cycle is broken.



FTSPodiatry utilises a number of therapies and treatment methods in order to combat each aspect of the cycle so as to obtain the best possible treatment outcomes for our patients.



Orthotic Therapy

Lower Limb Soft Tissue Therapy / Manual Therapy

Dry Needling

Sports Taping

Exercise Prescription


The above information is for informative purposes only and should not be used as a diagnostic and/or treatment tool. Undertaking a treatment/rehabilitation program without advice from an experienced health professional may lead to injury. In order to correctly diagnose your condition and commence an appropriate individualised treatment program it is advised the you contact Forster Tuncurry Sports Podiatry for further assessment.

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Achilles Tendinitis/Tendinopathy

Posted by on Thursday, July 16, 2015 in Blog | Comments Off on Achilles Tendinitis/Tendinopathy

Achilles Tendinitis & Tendinopathy/Tendinosis what’s The Difference?


The terms tendinitis and tendinopathy are frequently used interchangeably. The use of these terms interchangeably is incorrect, as there is a large difference between these two conditions.

Tendinitis refers to inflammation of a tendon. Development of tendinitis is frequently associated with an acute overload of the structure. Acute overload refers to increased load on the tendon that is too heavy and/or too sudden.

Tendinopathy/Tendinosis refers to degeneration of a tendon. Tendinopathies are characterised by poor healing responses and an absence of inflammation. Chronic overloading of a tendon is reportedly the most common pathological stimulus. There are two types of Achilles tendinopathy; mid-portion and insertional.

Achilles tendon disorders are among the most commonly reported overuse injuries, with a reported annual incidence in runners between 7% & 9%. Achilles tendinopathy is more common in those participating in recreational and/or competitive sporting activities, however sedentary individuals can also develop the condition.

Conservative management has been shown to be successful in 90% of those suffering mid-portion Achilles tendinopathy. Unfortunately only an estimated 30% of those suffering insertional Achilles tendinopathy respond to conservative treatment. For those who fail to respond to conservative treatment surgical intervention may be recommended.

Overuse, poor vascular (blood) supply, muscle imbalance/weakness, decreased flexibility, ageing and foot biomechanics have been identified as some of the factors that may contribute to an individual developing Achilles Tendinopathy.

A number of effective evidence based treatments are available for Achilles tendinopathy. A treatment regime will commonly vary from patient to patient depending on the results of a biomechanical assessment in which individual underlying factors are identified.
Most therapeutic exercise programs for the treatment of Achilles tendinopathies last approximately 12 weeks.

The symptoms of Achilles tendinopathy can vary. Patients typically report an insidious onset of pain around the lower portion of the Achilles tendon. The severity of pain and disability varies greatly, ranging from minor to severe. Stiffness and discomfort first thing in the morning or at the commencement of exercise is common. As the condition progresses pain frequency, intensity and duration may increase. Localised swelling and tenderness may also develop over the Achilles tendon. Unfortunately Achilles tendinopathies rarely get better on their own.

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Sever’s Disease

Posted by on Tuesday, July 14, 2015 in Blog | Comments Off on Sever’s Disease

Sever’s Diseasesevers2

What is it?

Sever’s Disease is defined as ‘a traction apophysitis of the calcaneus’ (meaning: inflammation of the growth plate of the heel bone, usually due to muscle/fascia restrictions of the calf muscles, intrinsic foot muscles and the plantar fascia) The Achilles tendon attaches itself to the back of the calcaneus (heel bone), and in those children/adolescents who have not reached skeletal maturity a growth plate exists at this tendon insertion point. During physical activities there are increased forces & tension placed on the Achilles tendon, if these forces are excessive inflammation of the growth plate can result.

Who Does it Affect?

Sever’s Disease most commonly affects boys and girls in the 9-12yr age group.


Pain located at the back of, and underneath the heel.
Pain is typically worse during and after activity.
Activities that usually exacerbate the condition are; running, walking up stairs, walking/running up hills.
Children can often present with an intermittent limp &/or toe-walking, in addition to complaining of pain.
Swelling/Inflammation at the back of the heel.
Discomfort on palpation around the heel/Achilles tendon.

Contributing Factors

Poor footwear
Calf tightness/weakness
Biomechanics/Foot Posture
Problems with exercise/training (insufficient warm up, sudden increases in activity, poor technique etc…)
Muscle imbalances (including the core and hip musculature)
Insufficient lower limb strength & stability – Poor proprioception (balance)
Rapid growth spurts


Treatment varies from patient to patient depending upon the contributing factors identified. In most instances addressing footwear, implementing a simple stretch regime and rest may be all that is required to treat the condition. In other instances foot/lower limb biomechanics, muscle imbalances, poor balance etc… will need to be addressed in order to successfully treat the condition.

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2014 Recap

Posted by on Friday, December 19, 2014 in Blog | Comments Off on 2014 Recap

As another year comes to a close we would firstly like to thank everyone for their continued support. Each and every referral and positive feedback we receive is greatly appreciated.

It has been very busy throughout the year both in the clinic and out and about.

Throughout 2014 Forster Tuncurry Sports Podiatry has volunteered time and expertise for a number of information sessions & community events. May this year saw Talysha invited to work in the recovery tent helping injured athletes during the Port Macquarie Ironman. The Gloria Jean’s Fun Run, Forster Women’s Shed, fitness2428 and many others also had Talysha volunteer her time to offer education and advice on all aspects of Podiatry & Sports Podiatry.

Early this year Talysha attended a work shop run by the Podiatric Surgery Centre in Sydney. During this course a number of injection therapy techniques were introduced that are useful in the diagnostic and treatment process. A number of these techniques are frequently used and some of the best results we have seen are in those patients suffering from chronic heel pain/plantar fasciopathy, who have been unresponsive to many other treatments (cortisone, orthotics, exercise therapy, ultrasound therapy etc…)

July saw Talysha head back to Sydney for the annual Australasian College of Podiatric Surgeons clinical insight sessions, and in the same month to attend an extensive workshop run by The Manual Therapy Institute in association with the Podiatry Association (NSW). This workshop involved learning new functional assessment and soft tissue treatment techniques for many lower back, hip, leg , knee and foot complaints.

In September it was off to Canberra for a Gait Rehabilitation & Retraining course run through Exercise & Sports Science Australia (ESSA).

Phew! No wonder we are looking forward to a bit of a relax over the holidays…

2015 is set to be another great year in the area of professional development. Talysha has recently accepted a scholarship to pursue post graduate studies in clinical rehabilitation. This will be done in addition to her current studies in the area of applied movement neurology.

As always we would like to say thank you again to everyone, patients and businesses alike who have continued to support us and very much look forward to working with you all next year.

We wish you all a Merry Christmas and a happy and safe new year.



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Forster Tuncurry Sports Podiatry

Posted by on Monday, June 30, 2014 in Blog | Comments Off on Forster Tuncurry Sports Podiatry

Tarsal Coalition

Tarsal Coalition is a congenital condition (present at birth) that affects the bones of the foot in children and adolescents. A Tarsal Coalition occurs when the bones in the feet fail to separate during fetal development. In the past this condition has been called peroneal spastic flatfoot. Tarsal Coalitions are not uncommon, affecting approximately 1-2% of the population.

The tarsals are the group of bones that make up the rear foot and mid foot. These include the talus, calcaneus, navicular, cuboid and cuneiform bones.

The two most common types of coalitions are the calcaneonavicular coalition and the talocalcaneal coalition. FOOT

A coalition between the two bones can be made of bone, cartilage or fibrous tissue. A coalition involving bone results in a stiff coalition, whereas a fibrous coalition has more flexibility.

The foot is a very complex structure involving 26 bones (28 including the sesamoids) and over 30 joints. All of the bones/joints must move in relation to each other to function correctly. If movement at a joint is abnormal or non-existent the entire foot and lower limb mechanics are disrupted.

The primary symptom that patients present with is PAIN. Usually the pain is located just below the fibula (bone on the outside of the ankle). As the child ages, and the condition becomes more advanced pain may be noticed in other areas. For example; pain on the top of the foot, pain on the outside of the foot, knee pain and/or back pain. Pain can present in the knee and back as a result of altered gait patterns.

How do we diagnose a Tarsal Coalition?

A lot of patients begin to experience symptoms between the ages of 8 – 15 as a result of changes occurring in the foot during growth and development.
A thorough biomechanical assessment involving; History taking, joint range of motion assessments, muscle range of motion assessments, visual and digital gait analysis are all used to help determine the presence of a Tarsal Coalition.
Xray, CT and MRI imaging are excellent for confirming the presence of this condition.

When to seek treatment?

Your child complains of pain
Noticing a change in your child’s gait (walking with a limp etc…)
Interfering with walking/activities
Difficulty fitting shoes
Noticing a change in the appearance of the foot


Non-surgical and surgical treatment options are available. The treatment approach varies from patient to patient.

Surgical Treatments
Podiatric and Orthopaedic surgeons will assess each patient individually and treatment will vary on a case-by-case basis.

Non-Surgical Treatments
– Orthotic therapy
– Soft tissue therapy
– Exercise therapies
– Proprioception/Balance exercises

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