
Services
Your focused heel pain practice in ACT
Diagnosis & Education
The first step is ensuring you have the correct diagnosis which allows the correct treatment plan. Too many times we see heel pain misdiagnosed which can delay recovery time and it is due to this that our patients have exclusive rates and priorities when it comes to imaging needs such as X-rays, ultrasounds and MRI. Our commitment to you is to fully educate you on what your diagnosis is, what is causing it and the best treatment plan to resolve it once and for all.
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Soft Tissue Therapy
Improving strength and flexibility around the muscles, tendons and joints of the heel is imperative to recovery. At CHPI we identify any abnormalities here and in conjunction with the team devise a specific recovery plan to reduce any deficits with handouts and instruction videos. Commonly calf and Achilles related issues need addressing but the smaller muscles within the arch are commonly a neglected issue. When rehabilitation is done correctly it is a very effective and easy way to reduce your heel pain.
Unloading the heel and reducing pain
In the early stages or acute cases conservative measures such as taping and padding are particularly useful if performed correctly as they can unload pressure on the heel immediately. These techniques are very useful in reducing pain quickly and can easily be taught to you to replicate – there are even premade taping kits available for you just to peel and apply! Arch rollers are very useful in managing morning pain and compression socks are great at reducing pain and swelling in the heel after activity and during the night. At CHPI our philosophy is to resolve your pain in the quickest and easiest time frame which is why these types of treatments are so valuable.

Footwear Considerations
There are multiple categories of shoes that effect heel pain on a daily basis. While we don’t normally run in dress/work shoes a lot of us wear them all day and they tend to have a significant impact on heel pain and although a lot of shoes look the same, their internal make up and structure differs greatly. Commonly just a change in footwear improves if not almost resolves acute heel pain and at CPHI we analyse, advise and issue a footwear prescription for every single patient as part of our first line of treatment. We also have excellent working relationships with shoe retailers which ensure proper fit, correct prescription and also give CHPI patients discounted purchases! There are a lot of different brands, categories and types of shoes on the market so which one(s) are right for you? A few tips regarding shoes and their features: Running Shoes Is it best to run in minimalistic shoes, cushioned shoes, neutral shoes, trial shoes, supportive shoes, motion control shoes or maximalistic shoes? A lot of footwear factors can cause or influence heel pain including amount of medial support, support/cushioning ratio, heel pitch on the shoe, bodyweight, distance you are running in the shoe, striking patterns of your feet just to name a few. The two most important things running shoes are: A) The correct shoe for your foot type and B) A high level of comfort (which seems obvious but isn’t always done!). There are 100’s of running shoes at vastly different price points available which makes life for a runner very confusing. As a general rule, high arched feet are normally better suited to cushioned shoes and pronated feet are better suited to supportive shoes but a lot of the time runners choose shoes on brand rather than category. A detailed running assessment at CHPI will guide the podiatrist into prescribing the best shoe for your heel pain. Thongs & Sandals As Australians, we all enjoy wearing thongs and sandals! Wearing thongs has been an age old tradition and we understand that it isn’t going anywhere in the near future which is why we embrace the concept of thongs and sandals but in a different way. At CHPI we have a range of supportive and orthotic based thongs which are remarkable at reducing heel pain which allows you to get around in the convenience of a thong without suffering from heel pain. These are perfect for around the house, down and the beach or just going for a walk with the dogs as they unload the stresses in your heel while you walk – also very good for athlete’s for injury prevention. Football Boots Although there isn’t as much variety in football boots as there are in running shoes, some are better suited for certain foot types. Neutral and high arched feet are a little more flexible with options and more likely to tolerate lightweight options where as flatter, more pronated feet require more support. There is a variety of stiffness’s in the shank and multiple widths, different upper materials, alterations in midsole density and heel position which can influence heel pain dramatically, particularly in growing feet. Having the correct boot is much more important than judging off brand or colour! It is also important to consider what can fit inside the boot (orthotic wise) and at CHPI we are experts at tailoring orthotics/in shoe padding to custom fit football boots. Sport Specific Shoes Ever tried playing court sports in a running shoe and just not quite feel right? Or felt a bit ‘clunky’ doing a gym work out in runners? At CHPI we have an in depth knowledge of sports specific shoes which are best for turf sports like hockey and preseason football, court sports like netball, volleyball and tennis and the vast range of gym and lifting shoes which are best utilised to get the best outcome. Features such as outsole traction, midsole density and heel pitch height are crucial as both heel pain and performance are greatly influenced by footwear and often it is just a small change needed to gain big benefits. It is all about knowing the best option for your sport and your foot type to avoid overloading your heel and spending time on the sidelines due in injury. Walking shoes/hiking boots Walking shoes or hiking boots are great when used for the right activity and are fitted correctly to the foot. If the fit is a little off then pain, blistering and heel slippage are common compensations which can become very annoying! Hiking boots can come in high, mid and low cut in a variety of widths and quite importantly different weights making the correct decision even more important. Although it is generally fine to walk in a running shoe there are some excellent specific made walking shoes with high durability that suit keen walkers a little better than running. Work Shoes/Dress Shoes What a diverse field this is! No doubt males find adequate dress shoes much easier than females but rest assured there are options to suit every person and their heel pain. Gone are the days of having the wear a big, bulky walking shoe instead of a heel as there are plenty of options that are both stylish and functional so they can treat your heel pain and look stylish (and fit orthotics if needed). High heels are regularly an influence on heel pain and there are strategies in reducing heel pain while still spending time wearing heels! Given the amount of time we all spend in work shoes, getting the correct option is crucial at both treating and preventing heel pain. Our podiatrists can talk you through a detailed footwear strategy that actually works for you and your preferences whether you are in corporate, teaching, nursing, office based work or if you just want to be in the right shoe for those nights out!


Injection Therapy
Injection therapy is an option normally reserved for the most chronic or long-term cases of heel pain but some heel conditions respond better than others to injection therapy. There are a range of injections available including cortisone, blood injections (PRP) for enhanced tissue healing, local anaesthetics, glucose, saline or a combination. Generally, this is not the first treatment option and traditionally seen as treating the symptoms and not the underlying cause, injections can be very useful when used as part of the treatment plan particularly when the body isn’t responding as quickly as we would like. PRP Injection (Plasma Rich Platelet): An injection therapy designed to increase growth factors to facilitate and accelerate healing for musculoskeletal injuries. These growth factors are derived from platelets that contain hundreds of protein crucial for the promotion of healing. The exact mechanism of action is still not 100% known but this therapy can be used for pain relief in joint osteoarthritis, ligament sprains/tears and specific heel pain injuries including plantar fasciitis and Achilles tendinopathy. More and more research is coming out regarding PRP therapy but the good news is that it is completely low risk and you can have multiple injections without the risks of cortisone given it is your own blood! To prepare PRP injection, blood is withdrawn from the patient and processed through centrifugation to separate the blood cells and increase the concentration of platelets. Once this process is complete, the rich platelet content is then injected directly to the injured area. The injected site can initially have a little pain and can take a week or so for the beneficial effect to be seen but when used correctly it can have good effect.
Night Splints
These are options that are available for the right patient/condition that can aid in the repair of tissue by putting the foot into a certain position overnight. In some cases of plantar fasciitis and Achilles tendinopathy we may recommend using them to assist in maintaining flexibility in the calf muscles while you sleep. This increases your total treatment time around the clock – think of a night sock as your specific night treatment combined with your other day based treatments!


Shock Wave Therapy (SWT)
Shockwave is the use of single acoustic pressure waves to treat musculoskeletal pathologies. Various mechanisms produced from the shock wave results in short-term and long-term effects and bring pain relief and healing to the musculoskeletal system. Multiple clinical studies with accordance to evidence-based medicine have been carried out and shown positive results. There is ongoing physiological changes that takes place after weeks and months even after the shockwave treatment has ceased. What Specific Heel Pain Conditions does Shock Wave Treat? Shockwave therapy is a treatment gaining some nice momentum given it’s results andShockwave Therapy (SWT) ease of application. It has merit in treating multiple soft tissue injuries of the body but the conditions of the heel it is best utilised are: • Heel Pain • Plantar fasciitis • Achilles Tendon pain • Medial and Plantar Foot Pain • Flexor Foot Muscles • Tight Calf Muscles How does it work? A shock wave is a type of propagating disturbance. It carries energy and can propagate through a medium e.g. solid, gas and liquid. Across the shock there is an extreme rise in temperature, pressure and density of the flow and the shock wave produces acoustic waves which travel through the soft tissue and bone. Mechanism of Actions: • Shockwave Therapy (SWT) • Reduction in sensation of chronic pain. • Blockade of neurogenic inflammation. • Activation of mesenchymal stem cells (bone cells), thereby induction of healing. • Release of growth factors. • Improved blood circulation in the treated tissue. What are the cause and effects? Shock wave therapy is designed to activate C nerve fibers which are responsible for discomfort during and after treatment. With prolong activation, it reduces the release of C nerve fibers and thus, become incapable of producing substance P. This means less substance P is associated with a reduction in pain and neurogenic inflammation. The Shock Wave Process Pain therapy: Locate painful area, Mark, Apply Gel, Apply Shockwave. Duration: 5-10 minutes, varies dependent on number of locations of painful areas. Number of sessions: Minimum 3 sessions to achieve results. For greater results 5-6 sessions are recommended. Length between visits: 7-10 days. Immediate pain relief and can resume back to normal activities! Pain response may vary depending on the severity of your symptoms.
CAM Walkers (commonly known as Moon Boots)
Commonly known as ‘Moon boots’ these are used to completely unload a foot when the injury is either very significant or very painful. The most common heel pain injury this is required for is either a calcaneal fracture/stress fracture or a plantar fascial tear/rupture. This level of injury requires complete unloading to resolve so if you have high level pain or can’t walk properly you should suspect one of these injuries and see one of our podiatrists for immediate treatment. If left untreated fractures and tears don’t improve – they just get worse!


Surgical Options
Although about 90-95% of heel pain cases can recover without the need for surgery there are some chronic conditions that don’t respond to conservative treatments. At CHPI we have the option for surgery if pain persists aggressively but it is without doubt our last option and we try to avoid it if possible (which is most situations). Plantar fasciitis sometimes require a lengthening procedure to relieve chronic tension at the heel, there are cases where heel spurs need to be removed and some decompression of nerves required in tarsal tunnel syndrome. Of course this is only after we exhaust all of the conservative treatments! Have the confidence that at CHPI we have the most comprehensive range of treatment options available including surgery if needed to ensure we fix your heel pain once and for all!
Orthotic Options
Here at Canberra Heel Pain Institute (CHPI),orthotic options our podiatrists are qualified to prescribe a variety of different orthotic devices ranging from prefabricated orthotics to semi-custom devices to fully custom orthotics.
Our focus is to be able to cater for all patients which is why we have the most extensive selection of orthotic options to treat all heel pain conditions (and all budgets), ranging from low volume prefabricated devices to high tech, fully customised orthotics.
Having such a large range means that if you need an orthotic, at least one option can be suited to your shoes and accommodate all circumstances to ensure you get pain relief as quickly as possible (no matter what shoes you are in!).
At CHPI we understand orthotics absolutely need to fulfil three criteria: they need to fit all shoe options, they need to be comfortable under the foot and they need to be functional (to reduce your pain) which is our main priority.
Orthotics requirements are catered specifically to the individual heel pain condition and the type of orthotic device prescribed for each person depends on:
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Age, condition diagnosed, symptoms and intensity of pain.
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The grade and level of foot correction needed.
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Degree of rear foot angle and arch height required.
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Level of performance including distance of running, acceleration/speed based sports and frequency of physical activity.
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Bodyweight and growth potential of the feet.
All orthotics that are prescribed at CHPI utilise modern technology and up to date techniques to maximise the outcome and ensure accuracy with each prescription. No one orthotic fits everyone and for this reason, we offer different types of orthotics whether it is heat moulded, prefabricated, semi-custom or digital 3D laser scanned prescription orthotics.
At our orthotic clinic, we realise that not everyone requires orthotics and our orthotic treatments are 100% focused around reducing your foot pain while also not breaking the bank. Some heel pain sufferers only require a basic orthotic or heel cup where as others require more in-depth orthotics. We identify only what the foot requires to get pain relief and advise accordingly – there is no ‘over prescription’. The table below summarises the comparison:
Orthotic Type | Considerations | Advantages/Benefits | Points of Interest |
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Prescription Orthotic | • Orthotics are sent to professional orthotic lab for manufacture • Lifespan: 3-5 years • Need time to adjust and adapt | • Firm/moderate/soft density available • Full and advanced customisation – multitude of features modifiable. • High tech and accurate – 3D scanned • Specifically tailored to fit shoes • High accuracy and optimal comfort and results | • Designed for shock absorption • Dual density – great for general stability and cushioning • Great for kids |
Semi-Custom Orthotic | • Medical graded supportive insole • Lifespan: 2 years • Need time to adjust and adapt | • Firm supportive device • Greater customisation – more specific to foot • Resilient, quick and low cost • No waiting time | • Designed more so for flat feet and are similar to custom devices • Supportive, functionally alters biomechanics and greater fitting ability to shoes |
Prefabricated Orthotic | • Medical graded standard insole • Lifespan: 1 year • Prone to fast wear | • Soft mouldable device • Basic customisation • Quick and low cost • No waiting time | • Designed for all heel pain conditions e.g. plantar fasciitis, Sever’s, heel spur, arch pain • Supportive and functionally alters biomechanics, focuses on maximal stability and facilitation of movement. • Aim is to provide ongoing support, comfort, versality and long-term wear. • Available in carbon fibre for lightweight and better fit Best option for rapid pain relief |