Case Study August 2017 – An Interstate Patient Pays a Visit to the Podiatrist in Sydney

Initial Consultation with Podiatrist in Sydney

A 55-year-old female from Queensland presents to the podiatrist in Sydney while on holidays, with excruciating pain in the base of her heel. She reports that she is on a 4 week holiday and has been walking around the city most days. She has a podiatrist back home in Brisbane who was treating her for plantar fasciitis. The podiatrist was using a shockwave therapy machine to treat her condition, and was applying sports tape to both feet on a weekly basis. The podiatrist was made aware of the patient’s travel plans, and advised her to seek the help of a podiatrist in Sydney if her foot pain increased. The patient informs the podiatrist that the rigid sports tape makes a huge difference and she feels much less pain while walking. The shockwave therapy has also been beneficial and she has received three sessions. Due to the increased amount of walking around the city, she began to feel pain in her calf muscles and an increase in pain around both heels. She wakes each morning and while walking around the hotel bathroom she has been hobbling due to the pain from the plantar fasciitis. The patient attempted to re-apply the rigid sports tape to no avail. She would apply ice packs as much as possible and would apply Voltaren gel. In order to avoid having to visit a podiatrist in Sydney, the patient also packed prescription medication to reduce pain and inflammation. She also committed to using functional walking shoes. Unfortunately, the above-mentioned was insufficient and she decided to search for a podiatrist in Sydney.

This lady is 12 kilos overweight and is pre-diabetic. She takes no medication and aside from the pre-diabetic signs, has all round good health. Aside from this recent episode of plantar fasciitis she boasts good foot health. She presents to the podiatrist in Sydney, Karl Lockett, feeling very frustrated and in lots of pain. She has a further two weeks left of her holiday and she is keen to continue walking around Sydney. She calls the Martin Place clinic requesting shockwave therapy.

Transfer of Medical Records to the Podiatrist in Sydney

The podiatry practice in Brisbane were contacted and were very helpful, agreeing to forward the patient’s medical records to the podiatrist in Sydney. Karl Lockett was able to see that the patient had received three sessions of shockwave therapy at a maximum pressure of 2.4 bar and 8 Hz. She had been instructed to perform calf stretches and was advised to wear functional walking shoes. The podiatrist in Brisbane had also been applying rigid sports tape, using a simple and reproducible technique. While this patient had not expected to see a podiatrist in Sydney, she was very grateful for the opportunity to receive further shockwave therapy.

Physical Assessment by Podiatrist, Sydney

The podiatrist in Sydney, Karl Lockett, palpated the plantar fascia which elicited pain in the medial and plantar heel area, consistent with the treatment notes that came from the podiatrist in Brisbane. He confirmed that the pain that she was feeling was a result of plantar fasciitis. To this end he agreed to apply shockwave therapy to the affected area and to use rigid sports tape to unload the foot.  The patient agreed and consented to treatment.

Shockwave Therapy Treatment by Podiatrist, Sydney

The patients received 2000 reps of shockwave therapy starting at 1.5 bar and increasing to 2.5 bar. Treatment was well tolerated and the patient felt an immediate reduction in pain. Rigid sports tape was then applied to both feet which the patient was comfortable with and able to walk freely. The pain level with the rigid sports tape in place dropped significantly and the patient was able to walk without limping. The podiatrist assessed the patient’s walking shoes and confirmed they were functional and supportive. She was advised to continue using the shoes as much as possible. The podiatrist in Brisbane had recommended that she avoid walking without shoes or in soft sandals / thongs. The podiatrist in Sydney agreed with this advice and encouraged the patient to stay in supportive shoes as much as possible. The stretching technique was also revisited and the patient demonstrated good technique. She did admit that her calf muscles felt much tighter since her visit to Sydney.

1 Week Follow Up Appointment with Podiatrist, Sydney

The patient returned to see the podiatrist in Sydney a week later for a review of her plantar fasciitis. She reported “a good week” with a lot less pain. She had been able to walk a lot more than she had prior to treatment and no longer felt throbbing while seated. Her jump response to firm pressure was less than before. She had been compliant with ice packs and calf stretching and had been using her functional walking shoes everyday. The patient requested another session of shockwave therapy due to the fact that she had another 5 days here in Sydney. The podiatrist agreed and the patient received a further 2000 reps of shockwave therapy at a maximum of 2.5 bar of pressure. Rigid sports tape was once again applied to both feet for extra support.  Treatment was well tolerated and the patient was able to walk freely around the consultation room.

Transfer of Patient Records from Podiatrist, Sydney to Podiatrist, Brisbane

The podiatrist in Sydney printed the Medical records for the patient to take back to the podiatrist in Brisbane. The patient was advised to continue using functional shoes and perform calf stretches on a daily basis. The application of cold ice packs was also recommended. The patient was advised to apply the cold packs each evening before bed for approximately 30 minutes. She was advised to return to her regular podiatrist in Brisbane once she returned home, for further treatment. She was informed that her podiatrist in Brisbane could contact the podiatrist in Sydney at any time should there be anything further to discuss.

She was advised that plantar fasciitis can take 6 or 8 weeks to recover once treatment commences. She would need to be compliant with stretching and the application of ice packs until the condition had fully resolved.

Please note that the information contained in this case study is specific to one particular patient and should not be taken as general advice. If you have foot pain or plantar fasciitis and you are a Sydney based patient you should seek the help of a podiatrist in Sydney for a professional opinion.