Shand Podiatry

17/12/2025

Chronic heel pain? We have you covered!! From diagnostic ultrasound to treatments including injection therapy and shockwave

Don't suffer, book now

www.theshandpractice.com

About plantar fasciopathy .....

Plantar fasciopathy (often still called plantar fasciitis) is a common cause of heel and arch pain caused by degeneration and overload of the plantar fascia rather than active inflammation.

The plantar fascia is a thick band of tissue running from the heel bone to the toes. Repeated stress can cause micro-damage and tissue degeneration, leading to pain—especially near the heel.

Typical symptoms

Sharp or aching heel pain, often on the bottom/inside of the heel
Pain worst with first steps in the morning or after rest
Improves with movement, but returns after prolonged standing or walking
Tenderness when pressing on the heel

Common risk factors

Sudden increase in walking, running, or standing
Tight calf muscles or Achilles tendon
Flat feet or high arches
Poor footwear or worn-out shoes
Excess body weight
Long periods on hard surfaces

Evidence-based management (most cases improve without surgery)
1. Load management
Reduce aggravating activities temporarily (running, long standing)
Avoid barefoot walking on hard floors
2. Stretching (very important)
Plantar fascia stretch (especially before first steps in the morning)
Calf stretching (gastrocnemius + soleus)
3. Strengthening
Intrinsic foot muscles (toe curls, short-foot exercise)
Calf strengthening (slow heel raises)
4. Footwear & supports
Supportive shoes with cushioning
Heel cups or arch supports/orthotics
5. Pain relief
Ice massage (5–10 min)
Short-term use of NSAIDs if appropriate
Night splints for morning pain (in selected cases)

Treatments used for persistent cases
Shockwave therapy (good evidence)
Guided steroid injections
Multidisciplinary rehab programs
Surgery is rarely needed.

Prognosis
80–90% improve within 6–12 months with consistent rehab
Recovery is slower if loading and footwear issues are not addressed

17/12/2025

That's a wrap for 2025. Thank you to all our patients for your business and it's been a pleasure to look after your foot and ankle needs

To book in for January 2026, please visit our website and select the foot and ankle pain tab.

www.theshandpractice.com

Have a merry xmas and a prosperous new year.

06/10/2025

Job Ad: Aberdeen:Scotland:Podiatrist:Full or Part Time # comejoinus

08/08/2025

26/06/2025

Pain around your inside ankle bone that travels to the sole of your foot?

Read about Tarsal Tunnel Syndrome ...

Tarsal Tunnel Syndrome (TTS) is a condition caused by compression of the posterior tibial nerve as it passes through the tarsal tunnel, a narrow space on the inside of the ankle near the medial malleolus (the bony bump on the inner side of the ankle).

📌 Anatomy
The tarsal tunnel is bounded by:

Medially: Flexor retinaculum (a thick ligament)
Laterally: The underlying bones (talus and calcaneus)
Contents of the tarsal tunnel (from anterior to posterior, mnemonic: "Tom, Dick, And Very Nervous Harry"):

Tibialis posterior tendon
Digitorum longus tendon
Artery (posterior tibial)
Vein (posterior tibial)
Nerve (posterior tibial nerve)
Hallucis longus tendon

🔍 Causes of Tarsal Tunnel Syndrome

Flat feet or fallen arches
Varicose veins or ganglion cysts
Trauma (e.g. ankle sprain)
Diabetes (due to nerve vulnerability)
Tenosynovitis (inflammation of the tendon sheath)
Masses (e.g., lipoma, tumor)

⚠️ Symptoms

Tingling, burning, or numbness on the sole of the foot
Pain that radiates from the ankle into the arch, heel, or toes
Symptoms worsen with activity and improve with rest
Positive Tinel’s sign over the tarsal tunnel

🧪 Diagnosis

Clinical examination: Tinel’s sign, sensory testing
Imaging:
MRI or ultrasound (to detect space-occupying lesions)
Nerve conduction studies (to assess nerve compression)

💊 Treatment Options

Conservative:

Rest and activity modification
NSAIDs
Orthotics or arch supports
Physical therapy
Corticosteroid injections

Surgical:

Tarsal tunnel release surgery (decompression of the nerve) if conservative measures fail

📝 Prognosis
Good with early diagnosis and treatment
Delayed treatment may result in permanent nerve damage

Diagnosis and management of Tarsal Tunnel Syndrome is available at our clinic in Aberdeen

14/06/2025

😩We all get stressed sometimes😩...and so to do our bones.

Too much stress on a bone or tissue can lead to pain and dysfunction.

One of the most common complaints that we see as podiatrists specialising in running injuries is Medial tibial stress syndrome..... Also known as shin splints ....Read on for info and advice ...



Medial Tibial Stress Syndrome (MTSS), commonly known as shin splints, refers to pain and inflammation along the inner part of the shinbone (tibia) due to overuse or repetitive stress. It’s often seen in athletes, particularly those involved in running, jumping, or activities that involve repetitive impact on hard surfaces. Here’s a breakdown of the condition:

Causes of MTSS:
🚨Overuse/Overtraining: Rapid increase in physical activity, such as sudden changes in intensity, frequency, or duration of exercise, often leads to MTSS.
🚨Poor Biomechanics: Abnormalities in foot structure (like flat feet or high arches), improper running form, or incorrect footwear can put extra stress on the shin area.
🚨Hard or Uneven Surfaces: Running on hard, slanted, or uneven surfaces increases the risk of developing MTSS.
🚨Weakness or Imbalance in Muscles: Weakness in the calf muscles, hip muscles, or core can contribute to the overload on the shin.
🚨Inadequate Rest: Not allowing enough recovery time between training sessions can lead to repetitive stress.

Symptoms:

🚨Pain: A dull, aching pain on the inner part of the shin. The pain usually develops gradually and may worsen during or after exercise.
🚨Tenderness: The area along the inner side of the lower leg may be tender to the touch.
🚨Swelling: Mild swelling may occur in some cases.
🚨Pain with Activity: The pain typically becomes more intense with activities like running or jumping and might improve with rest.

Treatment:

🤞Rest: Avoid high-impact activities to allow the inflammation to subside.
🤞Ice: Apply ice to the affected area to reduce inflammation and pain.
🤞Compression: Use compression sleeves or bandages to help reduce swelling.
🤞Elevation: Elevate the leg to help reduce swelling.
🤞Stretching & Strengthening: Stretch and strengthen the calf muscles, hamstrings, quadriceps, and hip muscles.
🤞Proper footwear or orthotics may also help with alignment and biomechanics.
🤞Gradual Return to Activity: Once the pain has subsided, return to activity gradually to avoid reinjury.
🤞Cross-training with low-impact exercises like swimming or cycling can help maintain fitness during recovery.

Prevention:

👏Warm-up properly before exercise.
Gradually increase exercise intensity or duration.
👏Use appropriate footwear for the activity.
👏Incorporate strengthening and flexibility exercises for the legs and core.
👏Avoid hard, uneven surfaces when running

❤️👍Shand Podiatry's Gait analysis service aims to highlight possible mechanical problems causing your leg pain. Book in to see our podiatrist by visiting our website, www.theshandpractice.com and selecting MSK Consultation from the options.

12/06/2025

Got what it takes? We'd love to hear from you

enquiries@theshandpractice.com

07/06/2025

Gone over your ankle??

A lateral ankle sprain is one of the most common injuries, particularly in sports or activities involving running, jumping, or rapid changes in direction. It typically occurs when the foot rolls inward (inversion), stretching or tearing the ligaments on the outside (lateral) part of the ankle.

🔍 Key Ligaments Involved
The primary ligaments affected are:

Anterior talofibular ligament (ATFL) – most commonly injured.
Calcaneofibular ligament (CFL)
Posterior talofibular ligament (PTFL) – rarely injured unless it's a severe sprain.

📊 Grades of Sprain
Grade I (Mild):
Stretching or slight tear of ligaments
Mild tenderness and swelling
Minimal functional loss
Grade II (Moderate):
Partial ligament tear
Moderate swelling, bruising, and pain
Some instability and trouble bearing weight
Grade III (Severe):
Complete ligament tear
Severe pain, swelling, and bruising
Significant instability and inability to bear weight

🩺 Diagnosis
History and physical exam: Checking for tenderness, swelling, bruising, and instability.
Ottawa Ankle Rules: Help decide if X-rays are needed to rule out fractures.

Imaging:
X-ray: Rule out fractures.
MRI or ultrasound (if severe or not improving): Assess soft tissue damage.

🩹 Treatment: R.I.C.E. + Functional Rehab
Early Phase (First 72 hours):

Rest (avoid weight-bearing)
Ice (20 minutes every 2–3 hours)
Compression (elastic bandage or ankle brace)
Elevation (above heart level)

Subacute Phase:

Mobility & gentle stretching (e.g., ankle circles)
Weight-bearing as tolerated
Physical therapy to restore strength and proprioception

Late Phase:

Balance and proprioception training
Sport-specific exercises before return to play
⏱️ Recovery Time
Grade I: 1–2 weeks
Grade II: 2–6 weeks
Grade III: 6–12+ weeks, possibly longer with severe instability

⚠️ When to Seek Medical Help
Inability to bear weight immediately after injury
Severe swelling or deformity
Symptoms persisting beyond a few weeks

Shand Podiatry are experienced in the diagnosis and management of ankle sprains. Visit our website : www.theshandpractice.com and select MSK Consultation from our online booking platform.

04/06/2025

Peroneal Tendinopathy is a condition that affects the peroneal tendons, which run along the outside of the lower leg and behind the outer ankle bone (fibula). These tendons — the peroneus longus and peroneus brevis — help stabilize the ankle and foot, particularly during walking, running, and side-to-side movements.

Causes:

Peroneal tendinopathy usually develops due to:

Overuse (especially in runners or athletes with repetitive ankle motion)
Ankle instability or recurrent sprains
High foot arches (pes cavus), which place more stress on the tendons
Sudden increase in physical activity
Improper footwear

Symptoms:

Pain and swelling along the outside of the ankle or foot
Pain that worsens with activity and eases with rest
Tenderness when pressing on the tendons behind the fibula
Ankle weakness or instability
Occasional snapping or clicking around the ankle

Diagnosis:

Typically involves:

Clinical evaluation (patient history + physical exam)
Imaging, if needed:
MRI: shows tendon thickening, inflammation, or tears
Ultrasound: can detect tendon motion, inflammation, or rupture

Treatment:

Conservative (first line)

Rest and activity modification
Ice therapy
NSAIDs (ibuprofen, naproxen) for pain and inflammation
Physical therapy:
Eccentric strengthening
Balance/proprioception training
Manual therapy if necessary
Orthotics with valgus correction if needed
Ankle bracing or taping to reduce stress

Other Options:

Immobilization in a boot if severe
Corticosteroid injection (rare; used cautiously due to risk of tendon rupture)
Surgery (only if conservative measures fail over several months or if there is a tendon tear or subluxation)

Prognosis:

With early and proper treatment, most people recover well within a few weeks to a few months. Chronic cases or those with tendon damage may take longer or require surgical intervention

29/05/2025

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