Stuart Mailer Physiotherapy and Sports Medicine
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The Foot and Ankle can present with many injuries that may require, Physiotherapy, Podiatry intervention or even Surgery if required. With the foot having 28 different bones, 33 joints, 19 muscles, and over 100 ligaments a review with a Foot and Ankle specialist should be undertaken to get an accurate assessment and treatment. We will examine your Foot, Toes, Ankle and your Lower limb including the Knee, Hip, and Pelvis assessing Muscular Imbalances, Stability, and Strength. We will assess your ait using video analysis and a range of tests to determine your dysfunctions in your Foot and Ankle. There are many Foot and Ankle injuries that Stuart assesses and treats, an example of some of the most common injuries we see are listed below.
Foot and Ankle Assessment
When you visit your Foot and Ankle Specialist Physio your assessment involves a detailed history of your Foot or Ankle condition, discussion of your goals and an examination. This takes between 30 mins to 60 mins. The examination will consist of looking at your Foot, Ankle the Knee and Hip. Stuart will check your Foot dynamically and passively to determine how your Foot functions. Due to many injuries being contributed from other areas we want to check if there are any Muscular Imbalances or Biomechanical Dysfunctions contributing. Together with your Foot and Ankle Physiotherapist the best course of action will be determined.
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Plantar fasciitis is a common condition that can cause pain under the heel (calcaneum). The Plantar Fascia is a thick band of tissue that connects the heel to the toes on the sole of the foot. This condition affects around 10% of people at some point in their lives and can start as a low-level pain in the morning but left untreated can slowly increase to become more debilitating inhibiting walking. Contributing factors can be changes in activity such as increased walking or running or inadequate footwear. We will assess your lower limb biomechanics such as your gait, stability and test your foot control then provide the best course of treatment for you or referral if required.
Achilles Tendinopathy is a condition that affects the Achilles Tendon itself or the insertional attachment at the heel. Through increased loading overtime the tendon loses its organized structure and has what is known as a "failed healing response". The tendon then becomes weak and painful and can potentially lead to rupture. It is generally accepted that exercise is the most suitable intervention to allow your tendon to accept load and help return you to normal. Unfortunately, this can be a slow process as a tendon does not adapt to load as quickly as a muscle. We will assess your tendon, other contributing muscles, and your lower limb biomechanics then plan the appropriate exercise intervention.
Bunions- Hallux Valgus
Hallux valgus or a "a bunion," is a deformity of the big toe and the metatarsal bone and is common enough to affect more than 20% of adults. A bunion is when the big toe bends towards the smaller toes and a protruding bump develops overtime. The bump can be the soft tissue structures at the joint such as the bursa sac or capsule and the head of the metatarsal bone. A Bunion is a progressive disorder and causes can be contributed from genetic disposition such as foo type, mobility and Footwear such as high heels. Treatment consist of Specific rehabilitation for the toes and foot and orthotic referral if required.
Lateral Ligament Sprain
Lateral ligament sprains are the most common ankle injury seen in sports at approximately 10-15% of all cases. There are three major ligaments that support the outer side of the ankle joint known as the ATFL, CFL and PTFL. The ligaments can be injured when the ankle is twisted inwards (inversion) such as rolling over or through an impact. This causes a stretch to the one or more ligaments that may be a small tear or even a full rupture . Treatment depends on the severity and extent of the injury however after examination we can guide you from PRICE, rehabilitation and return to activity.
Morton's neuroma is a condition that affects one of the interdigital nerves that run in-between the long bones (metatarsals) in the foot. There is a fibrotic thickening of the nerve that then causes pain such as, burning, numbness and tingling under the ball of the foot . Contributing factors can be may be anything that irritates the nerve such as ill fitting shoes or a tapered toe box or high heels, poor foot mechanics or even prolonged landing on the feet. Treatment can consist of strengthening exercises of the foot to helps support and offload the nerve, stretching and orthotic devices if required.
Pes Planus (Flat feet) is a postural deformity relating to the collapse or overpronation or flattening of the medial longitudinal arch. Pes Planus can be a congenital where someone is born with this predisposing condition or acquired by losing active or passive support during loading activates. The foot is controlled dynamically by many muscles and these can be very weak increasing the load on the foot contributing to other injuries. You will be thoroughly examined and given the appropriate rehabilitation to plan increase our arch control and strength. You may be recommended a soft temporary orthotic or advised to be reviewed by a podiatrist for some orthotics.
IN THE PRESS
I was referred to Stuart Mailer after I had bunion surgery following a running injury. Desperate to get back to exercise, I felt he really understood this and kept my goals realistic as well as pushing my recovery exercises as much as possible. His knowledge and experience of working with professional athletes across many disciplines is invaluable to anyone who likes to train more than the average person.
Mrs S Birks , Art Director/Stylist .
I have seen Stuart for many of my sporting injuries such as knee and Ankle sprains from when I was playing football at AFC Wimbledon to now studying to be a PE teacher. Keeping fit is paramount for my work and well-being and Stuarts expertise has always kept me on track. First class physiotherapy service
Mr Owen Roberts. PE Student Teacher , February 2018