- 67-year-old retiree
- Works at community charity op-shop
- Ongoing heel pain
- Previous hip replacement surgery
- Has arthritis
Breanna is an optimistic and active retiree that enjoys volunteering at her local charity op-shop. Unfortunately, over the last 3 months, she has been unable to stay on her feet for long periods because of severe heel pain in her left heel.
Breanna tried changing her shoes to ones with better support and found that this has slightly helped to reduce some of her pain. Unfortunately, overall her pain is still at a severe level, so Breanna’s GP referred her to us to see if shockwave treatment could help.
We conducted a comprehensive biomechanical examination on Breanna and found that her heel pain symptoms were consistent with plantar fasciitis.
We also found that Breanna:
- Was rolling in (pronating)
- Appeared to have a leg length difference
- Had tight calf muscles that were pulling on the back of her heel
We investigated the potential leg length difference further and confirmed with a CT scanogram that there was a 15mm difference between the lengths of both legs. This is a significant difference that has the potential to have many consequences on the body.
How does a leg length difference occur?
In Breanna’s case, it is highly likely that her hip replacement surgery resulted in one leg being shorter than the other. During a hip replacement, the prosthetic hip joint will ideally be the same size and perform the same as the original hip joint. However, due to natural variations in anatomy, this isn’t always the case and can result in one leg being shorter than the other.
The potential for a leg length difference had never been investigated or checked following her surgery.
We discussed and implemented a number of therapies to achieve the best results for Breanna:
Shockwave – to treat the heel pain (plantar fasciitis), we performed five sessions of shockwave therapy. Shockwave helps to kick start the body’s reparative response to help heal the plantar fascia faster.
Footwear – we ensured that Breanna switched to supportive footwear to help stabilise and control the way her foot moves. This will help relieve tension away from the damaged plantar fascia to help it heal.
Heel raise – we helped manage Breanna’s leg length difference with the addition of a heel raise in her shoe beneath the shorter leg. Ideally, this raise will be incorporated into an orthotic to provide permanent correction when Breanna is wearing the orthotics.
Stretching & strengthening program – we prescribed a stretching and strengthening program for Breanna to help with her tight calves and help restore strength to the muscles around her feet and leg.
After completing the five shockwave sessions spaced one week apart, and consistently wearing her supportive footwear and heel raise, Breanna has been able to return to her volunteer work.
She is now able to stay pain-free on her feet throughout the day and continues to enjoy her retirement.