Compression Stockings

Our foot specialist, Lada Milos Lee is proud to offer Ofa Bamberg line of compression therapy. Compression therapy is achieved using gradient compression, which has the greatest pressure at the base, and reduces pressure as the compression garment goes up the leg. This helps encourage the movement of fluids, including blood circulation and the lymph fluid circulation. The gentle pressure helps blood vessels and lymph  vessels absorb fluids more easily, providing relief for tissues. This helps to relieve pain  by reducing swelling and preventing accumulation of fluid buildup. Venous disorders are very common and it is estimated that 20% of men and 30% of women suffer from some form of venous disorder.

  • Do you suffer from tired, aching legs at the end of your day?
  • Do you suffer from spider or varicose veins?
  • Do you travel long distances frequently?
  • Do you sit or stand for prolonged periods of time?
  • Are you pregnant?
  • Do you struggle with some excess weight?

If you answers “YES” to any of these questions, compression stockings may be helpful in alleviating pain, reducing swelling and preventing chronic venous disorders.

Prevention of Varicose Veins

When the valves of the veins are damaged or do not function properly, blood pools and the increased volume causes pressure within the wall of the veins. This can then cause veins to bulge and distend. Over time, the veins loose their ability to bounce back, causing “spider” veins ( in the small superficial veins), and “varicose” veins ( in the larger veins). Compression therapy is effective in preventing the veins from becoming damaged and noticeable.

Sports

Studies have shown that wearing compression stockings during exercise helps reduce muscle soreness.

Travel

Long-distance travel wether by car, train or airplane, can be associated with the leg discomfort and increased risk of DVT (deep vein thrombosis). Lack of leg movement due to prolonged sitting and cramped spaces gives way to swelling of the feet and legs. The swelling contributes to leg fatigue, discomfit, and a heavy sensation in the leg. Studies have shown that a traveler not wearing a graduated compression stockings is 12.5 times more likely to develop DVT.

Wearing gradient compression stockings appeared to be effective in reducing the risk of DVT and prevent overall swelling during frequent or long travel.

Pregnancy

As the baby grows, the enlarged uterus applies pressure on the vena cava, which returns blood to the heart. The pressure can cause stasis and valve damage, which results in swelling, leg discomfort, and even varicose veins. On average 23% of pregnant women will have venous disorders as early as their first pregnancy, and this number rises to 31 % by their fourth pregnancy. Compression hosiery helps to relieve leg fatigue and discomfort by helping to prevent the superficial veins from becoming distended with blood. It also helps to reduce pressure in the tissue underneath the skin.

Are You Covered?

Compression stockings with a pressure of 20-30, or 30-40 mmHg are covered by most insurance plans on an annual basis. A physician prescription is required.

Consultation

A 20-min initial consultation is required. The appointment should be scheduled at the beginning of the day to ensure the best measurements. Styles and materials will also be discussed to determine the best product for your needs.

Plantar Fasciitis

It’s morning, and the alarm clock has just told you it’s time to get out of bed. Another few minutes won’t hurt. You check your emails, social media sites, and you even ring your mom to see how the dog slept last night… basically anything to delay putting your feet on the ground and taking those first steps to get the day started. And it’s because of this pain you’ve been getting on the bottom of your heel every morning for the last few weeks. And it’s getting worse… Time to see your osteopath!

There are a few things that can cause pain on the bottom of the heel, but the most common cause is a condition named plantar fasciitis (also known as plantar fasciopathy).

 

What is plantar fasciitis?

Plantar fasciitis is an overuse condition affecting the plantar fascia. The plantar fascia is a layer of soft tissue that stretches along the bottom of the foot, from the heel bone to the metatarsal bones in the front of the foot. It helps to provide stability to the arch of the foot and is similar in make-up to a tendon (the things that attach muscle to bone). If too much stress is placed on this structure, over time the tissue can degenerate, weaken, and start to give you pain. The pain is commonly felt where the plantar fascia attaches into the heel bone.

 

Risk factors

Scientific research suggests there are a few groups of people who are more prone to developing plantar fasciitis. These include:

  • Runners
  • People who are over-weight and lead a sedentary lifestyle and/or spend long periods standing for work (e.g. a factory worker)

Important things to consider with these at-risk groups include:

  • Foot alignment and arch height: Having a very low or high arch or having excessive or not enough movement in the foot joints can lead to the development of this problem.
  • Amount of training: Increased levels of training can place greater stress on the plantar fascia more regularly.
  • Footwear: Wearing certain types of footwear when training can lead to an increased risk of plantar fasciitis (i.e. wearing athletics spikes, or the wrong footwear for your foot type).
  • Muscle strength and flexibility: Decreased strength in the muscles that control toe movement, as well as weakened and tight calf, hamstring and gluteal muscles are all associated with higher rates of plantar fasciitis.

 

Signs and symptoms

The signs and symptoms of plantar fasciitis include:

  • Pain at the bottom of the heel
  • Pain that appears as a gradual onset
  • Pain felt first thing in the morning (i.e. taking those first steps out of bed in the morning is classic!)
  • Pain that decreases with activity, but increases again afterwards (early stages)
  • Pain that increases with activity and pain felt at night (latter stages)
  • Pain felt after periods of prolonged rest during the day (i.e. being sat at your desk for 2-3 hours and then getting up again)
  • Tight calf, hamstring and gluteal muscles
  • Weak muscles that help to support the arch of the foot
  • Stiff or over-flexible foot and ankle joints

 

Diagnosis and treatment

First things first, if you have heel pain that sounds similar to the picture we have painted above, make an appointment with us now (you know what to do call us on (416) 546-4887). Once we have asked the relevant questions, performed the necessary tests, and are convinced that the issue stems from the plantar fascia, we will formulate a plan with you with short and long-term goals to reach within a set time.

 

Initial hands-on treatment will include a combination of massage, joint mobilisation and manipulation, and dry needling of the lower limb muscles with the aim of correcting any mechanical issues that are playing a role in this issue. Depending on the presentation, we may also use tape around the foot and ankle to provide support and reduce the stress being placed on the tissues. Other treatment will include advice on weight loss (if required), training regimen, footwear, and exercise prescription that helps to lengthen and strengthen tight and weak muscles. Some cases of plantar fasciitis may require a foot orthotic or in-sole to provide extra support to the foot whilst wearing shoes. This would be best recommended and assessed by our Chiropodist (foot specialist) at Beachealth.

 

Plantar fasciitis is a tricky condition to treat which may require ongoing treatment for several months. We will endeavour to get you pain-free in the shortest time possible, so we recommend following all advice to a T, which may include a reduction in the amount of training you are doing at present. When you start to hit goals and we see improvements being made, we’ll have you back up to your full training program before you can say “plantar fasciitis”.

 

Imaging?

 

People regularly ask if they need imaging for such an issue, but the majority of cases of plantar fasciitis can be diagnosed with a thorough case history and physical assessment. This is where we excel! Imaging is there for cases that do not respond to treatment and for those instances where we need to rule out a more serious problem.

If you need help with heel pain, please call us today on (416) 546-4887 to book your appointment. Let’s have you putting your best foot forward, ASAP! 👌

 

 

References
1. Thompson, JV. et al. 2014. Diagnosis and management of plantar fasciitis. Journal of American Osteopathic Association. 114 (12). Available from: https://jaoa.org/aoa/content_public/journal/jaoa/933660/900.pdf
2. Brukner, P. et al. 2017. Clinical Sports Medicine. 5th ed. Australia: McGraw Hill Education
3. Harvard Health Publishing. 2007. Easing the pain of plantar fasciitis. [Online]. Available from: https://www.health.harvard.edu/newsletter_article/Easing_the_pain_of_plantar_fasciitis. [Accessed 15 Jul 2020]
4. Orthoinfo. 2010. Plantar fasciitis and bone spurs. [Online]. Available from: https://orthoinfo.aaos.org/en/diseases–conditions/plantar-fasciitis-and-bone-spurs. [Accessed 15 Jul 2020]

Orthotics

Do I need orthotics? What kind?

Many people come to the clinic complaining of foot pain from conditions such as bunions, hammertoes, a pinched nerve (neuroma), or heel pain (plantar fasciitis). I perform a thorough evaluation and examination, and together we review the origin, mechanics, and treatment plan for the specific problem.The patient usually asks if they need and orthotic and, if so, which type would be best.

I recommend a foot orthotic if muscles, tendons, ligaments, joints, or bones are not in an optimal functional position and are causing pain, discomfit, and fatigue. Foot orthotics can be made from different materials, and may be rigid, semirigid, semi flexible, or accommodative, depending o your diagnosis ad specific needs.

  Different types of orthotics

There are few types of foot orthotics: over-the-counter/off-the-shelf (OTC) orthotics; “kiosk-generated” orthotics; and professional custom orthotics. OTC orthotics are widely available and can be chosen based on shoe size and problem. Kiosk orthotics are based on the scan of your feet. A particular style or size of orthotics is recommended for you based on a foot  scan and the type of foot problem you are experiencing.

For custom prescription orthotics, a health professional performs a thorough health history, including an assessment of your height, weight, level of activity, and any medical conditions. A diagnosis and determination of the best materials and level of rigidity/flexibility of the orthotics is made, followed by casting mold of your feet. This mold is then used to create an orthotic specifically for you. The difference between OTC/ kiosk and custom made orthotics may be likened to the difference between over-the-counter and prescription reading glasses.

  Which type of orthotic is right for you?

A person of average weight, height, and foot type and with a generic problem such as heel pain, usually does well with OTC or kiosk orthotic. They are less expensive, however you may have to replace them more often. Someone with a specific need, or a problem such as severely flat foot, may benefit from custom prescription orthotics. These also last longer.

Another important fact is that your foot specialist will be able to educate you about proper footwear. You may be surprised to learn that many people have not had their feet professionally measured in years. As we age our foot length and width changes, and sizing may not be consistent between brands.

In my experience, certain groups of people benefit from an examination performed by foot specialist, and prescription for custom orthotics. These may include people with diabetes who have lost a feeling in their feet, people with poor circulation, and people with severe foot deformities caused by different foot misalignments and medical conditions.