Our Director and Principle Podiatry, Kristi Boles knows first hand what it means to live her life with a chronic health condition. Kristi shared her knowledge and personal experience last year at the 2015 Marfan Conference, Melbourne.
I sit down with Kristi and ask her the hard questions about heel pain, what treatments she recommends, what she’s passionate about and what enticed her to podiatry in the first place.
What are the main conditions you see as a podiatrist?
Chronic heel and arch pain. This is not always plantar fasciitis, therefore we need to assess, diagnose the condition and set the right plan of action.
How do you diagnose and assess?
We do a biomechanical assessment to look at the foot posture and how the feet are functioning. This helps us to diagnose what might be causing the pain and whether it is the foot function, the activities being undertaken or the footwear that is being worn. Sometimes pain can be caused by your body being out of alignment, therefore we have Musculoskeletal Therapy, Osteopaths and a traditional Chinese herbalist here to help with some other issues too.
Why do we get such heel and arch pain, especially in the morning or after being sedentary?
There is often pain from inflammation which has occurred from exercise or the incorrect footwear from the day before.
The reason this happens is that metabolites (waste products from the healing process) form when you’ve been sitting or lying down for a period of time, once you start moving again, these toxins move through the inflamed area and cause pain.
As a podiatrist you talk about active inflammation. What is this?
It is where an existing area of inflammation is being re-damaged and over strained by continual use. Where you are still exercising or using those muscles and tissues in a way that is not helping them to rest, recuperate and recover.
What techniques do you use in your practise?
This depends on the longevity of the condition.
Early Stages – we use an anti-inflammatory approach, where we encourage icing the area, massage, foot rolling, footwear changes, strapping and sometimes customised orthotics.
Chronic Stage – is where the brain has become used to the inflammation and quite often doesn’t respond in a healing process anymore, so we need to kick start it all again. This is where we use Radial Shockwave Therapy.
What is Radial Shockwave Therapy?
It is our innovative technology. It is high energy acoustic waves that are transmitted through the surface of the skin and spread into the body. The body responds with increased metabolic activity around the site of the pain and inflammation. This stimulates and accelerates the healing process. It is non-invasive and rapidly decreases the pain over a few weeks. In fact, it has been shown through clinical trials to have an 80% success rate in treating heel pain.
What do you specialise in?
Heel and Arch pain for sure. I have spent the last 15 years developing the Heel Pain Program which tackles this chronic and more often than not, life limiting condition. This is where we treat the inflammation and pain in the short term and address the underlying cause of the problem with ongoing support and rehabilitation of the foot to reduce the risk of it reoccurring in the future. It’s my job, as their podiatrist, to work in partnership with my patients and help them follow their treatment plan.
Is heel and arch pain preventable?
Yes, by choosing the correct footwear for their foot type. Getting professionally fitted can enable this to happen. Choosing shoes the right length, the right width and choosing the correct shoes for the different activities is essential in prevention of pain.
Why did you choose to be a Podiatrist?
I have always enjoyed communicating with people and finding out more about them. I knew I always wanted to work in the health profession but it wasn’t until I did work experience with a podiatrist and saw the diversity of the profession, from working with all of the different ages and many different treatment types. I knew that podiatry could offer a diverse career that I could be passionate about. I really love the fact that I can help people get back on their feet, living life, feeling good and doing the things that they love again.
What are you passionate about?
My passion is in caring about people in a Holistic way. No one condition is only one layer deep. As practitioners we need to consider what the cause is, what other conditions might have been caused by it or have contributed to it. Does the person need emotional support? Is their immune system effected by diet, lifestyle or sleeping habits?
This is why I created our Allied Health (& wellness?) clinics in Berwick and Patterson Lakes. We are able to help our patients care for their whole body, heal themselves and improve their overall health and wellbeing. To make a real difference in enhancing the health of a person, that’s what keeps me doing what I do everyday.
What are your two hot tips?
- If you’re having trouble finding shoes that are comfortable, go to see a podiatrist to get the right advice.
- Don’t rapidly increase activity levels when your body and feet aren’t ready for it.
If you feel like Kristi or the many other amazing practitioners here at Casey Allied Health or Patterson Lakes Allied Health could help you and your health in any way, make sure to call and make an appointment. To keep up to date with all our allied health news, make sure you subscribe to our fortnightly
I have worked as a sports trainer for footy clubs for a few years now and have observed some very strange and even detrimental habits that our beloved athletes have gotten themselves into. As this year’s footy season comes to an end, these are the 10 lessons that can be learned.
The Sports Trainers 10 commandments
- Thou shall not try to super hydrate the day before the game!
- Good hydration is lifestyle! Not something that you do last minute. There is no point in lugging around an extra 3 liters of water that your body hasn’t had time to absorb.
- Thou shall not skip breakfast before a game.
- I don’t care how little appetite you have before a game, high performance vehicles need fuel and you’re no different.
- Thou shall not eat lots of highly concentrated sweets during a game!
- Anything with more than 8% sugar will move slowly through your guts and slow down your fluid absorption. You need water much more than you need sugar.
- Thou shall not eat nutritional supplements (e.g. gel packs) that mostly list numbers as ingredients!
- Most of these are chemical substitutes or artificial sweeteners to make it taste good.
- Also be careful of supplements with ingredients that you can’t pronounce.
- Thou shall not ignore the trainer when they tell you to come off the field!
- Really, if a man over 40 just hauled ass to get to you in the middle of the field some thing’s wrong!
- Thou shall not get taping when you don’t need it!
- Next person to get their wrists taped for no reason gets their mouth taped too.
- Thou shall not get a brand new pair of boots one week before finals start!
- Really….What were you thinking? Do you like blisters?
- Thou shall wear thy mouth guard!
- And don’t get red ones! From a distance it looks like your mouth is full of blood.
- And stop fiddling with it in your mouth! Then it looks like your mouth is bleeding AND coming off your face.
- Thou shall not abandon your gear in the first aid room!
- Unless it’s nice stuff and you don’t mind me wearing it.
- Thou shall not consume alcohol or soft drinks 12 hours before or after a game!
- After a game your body needs water, electrolytes, carbohydrates and proteins in that order. Alcohol and/ or processed sugars are just going to slow your recovery.
- If you’re injured and get drunk after the game then you deserve to be injured.
As dentists, we deal with a variety of medical conditions that can have a bearing on dental procedures. One of the most challenging ones is cancer.
Did you know the best way to treat cancer patients is BEFORE they have had any chemo or radiotherapy?
As healthcare professionals, we all know what these therapies are and what they do to the body, blood and immune system.
It can be potentially dangerous to do dental extractions post head and neck radiotherapy because the risk of osteonecrosis is very high.
In fact, such patients are often referred to specialists adding to financial burden. They may require antibiotics prior to extraction and hyperbaric oxygen therapy.
Please do remember to pass this message on to people who may have been recently diagnosed with cancer to visit their dentist before they start any therapy. A dentist would extract doubtful teeth, fill those that are safe to keep in the long term, remove infection with a scale and clean and provide fluoride treatment to minimize the post therapy complications.
Cancer is a difficult diagnosis and has touched us all in some way either through family, friends or famous people. This information is just to make things a little bit easier during those tough times.
Dr. Mamatha Srinivasaiah
Casey Allied Health
There’s no better time to get healthy and ready for summer than
National Nutrition Week
(13th to 19th of October). National Nutrition Week also coincides with World Food Day and Nude Food Day. So it’s definitely the right time to take that next step towards greater health.
National Nutrition Week raises awareness and supports the community to look at how the food and lifestyle choices we make impact our health. Each year, Nutrition Australia releases a theme for National Nutrition Week, and this year’s theme is Project DinnerTime-Cook, Eat, Enjoy.
The aim of Project DinnerTime is to improve our knowledge, skills and confidence in the kitchen by empowering people to prepare more meals from home. With the abundance of convenience foods and the common belief of healthy cooking being difficult and expensive, home cooking has declined. With the rates of obesity and chronic disease rising, it’s important that we all work on improving the nutritional quality of our diets.
Healthy cooking at home is a great way to improve our diets and health. It gives us control over the ingredients we put into our meals and foods that we feed our bodies. With some easy planning and preparation, cooking at home can be quick and easy. You’ll be amazed at how much money you can save too! Cooking at home is a great way to get the whole family involved in health eating through menu planning, grocery shopping, food preparation and cooking. It’s also a fun and fantastic way to educate children about healthy eating.
As mentioned in the theme, Project DinnerTime addresses the following areas:
Cook: Develop skills and confidence to cook meals from scratch. This includes learning basic food safety principles, following recipes and learning how to identify healthy recipes based on ingredients and preparation methods. There is a strong emphasis on choosing budget conscious meals with a focus on seasonal variety.
Eat: Appreciate the tastes and textures of wholesome foods. Develop a greater depth of knowledge and understanding food labels and making healthy choices in the supermarket.
Enjoy: Experience the celebration and social/emotional connectedness that food brings. This can build and strengthen family relationships around the dinner table.
Let’s all take one step towards better health during National Nutrition Week by getting on-board with Project DinnerTime. Take this as an opportunity to try a new vegetable or that recipe you’ve always wanted to try.
Nutrition Australia have put together a Project DinnerTime Kit to help everyone with health cooking at home. Whether you’re already a fantastic home cook or you’re looking for healthy cooking ideas, The Kit will give you information on cooking on a budget, making healthy food choices, kitchen and pantry basics to make home cooking easy and recipe building blocks which can be modified to suit anyone’s taste. The Kit is free to download on the Nutrition Australia website. For more information and access to the kit, visit www.nutritionaustralia.org
Fibromyalgia is one of those conditions that no practitioner feels comfortable managing. It’s poorly understood by medical science and people who suffer from it are generally very fed-up with seeing dozens of different practitioners and not getting results. As a former sufferer of CFS (Chronic Fatigue Syndrome), Glandular fever and fibromyalgia, I’ve had a lot of time to think about these conditions and here’s my say as an educated professional in how this condition needs to be treated.
To officially diagnose fibromyalgia a doctor must be able to identify at least 11 out of 18 different characteristic painful pressure points on the body. As a practitioner I am dissatisfied with this method of diagnosis. I could take any healthy person off the street and could get a painful response from touching any one of those 18 points because those points are all located on classic trigger point locations on muscles that people very commonly over use. Fibromyalgia is not an idiopathic disease that can be diagnosed by one simple test, is a conglomeration of symptoms all being created by various causes all working together. If your primary focus is to treat symptoms then you’re never going to get anywhere. Focus on the causes.
You can’t treat fibromyalgia or CFS directly; you have to treat all of the problems around it first. It’s like untying a knot; you don’t start in the middle where the knot is at its tightest point. You start where the knot is at its loosest and work your way in. You will find as you loosen up the surrounding problems, the center of the knot becomes looser and more manageable.
Musculoskeletal/mechanical misalignments, neurological inhibition, chemical poisoning, metabolic disorders, mitochondrial dysfunction, emotional strain, there are so many things can become a tangled mess with one another acting just like individual ropes creating our metaphorical knot. A good practitioner will know they can’t treat all of these things by themselves. A team of several professionals will normally be required to untie this knot but it is vitally important that they are all coordinated with each other and can give priority over which ropes need to be untied first and how.
Some knots take a long time to untie, especially when the knot may still be in the process of tangling itself up. They can be extremely complicated and in such a mess that it’s no wonder a lot of practitioners have a very hard time managing patients with fibromyalgia and CFS. The rules to untie this knot however can be simple.
- Some ropes in the knot have to be loosened before others will give way.
- Always start where the knot is at its loosest.
- Educate the patient on how they can help untie their own knot.
- Make sure to coordinate with other practitioners so that all the ropes are being pulled in the right way at the right time.
- Keep your chin up. Untying tough knots tests everyone’s patience; don’t let it wear you down.
You may never be able to fully untie the fibromyalgia knot, it’s big, it’s complicated and some ropes can be so rigid they won’t budge. But Fibromyalgia can be managed and you can enjoy your life with it, you just need to know what the knot looks like.
By: Daniel Carner
Bachelor of Health Science – Musculoskeletal therapy
Casey Allied Health
54 Kangan Drive, Berwick 3806