Suggest Treatment For Severe Cough And Pain

Hello, 1. Concerning the fat herniations in your heels, what you are likely feeling are fat pad displacements or fat pad atrophy, which can occur with: • The arch is high - which increases pressure on the heel edges • Weight is higher than the soft tissues can support • The mechanics of the foot are altered (supination) • There has been long-term micro-trauma from walking and standing These “white ball” bumps rising under pressure fit with fat pad bulging through weakened connective tissue. They are not warts. 2. Why your lateral heel is collapsing and shifting? This mostly happens when the little stabilizing muscles around the ankle are overworked and tired. With high arches, the weight naturally rolls outward, and if the muscles cannot counterbalance it, the heel fat shifts. Orthotics help only partly when the problem is not just alignment but also soft tissue weakness. Because the foot is not stable, everything above it tries to compensate. That s why your hips, ribs, and even shoulder feel twisted. It s a classic kinetic-chain overload pattern. 3. The coughing and rib pain - Your bronchial issues, combined with a severe cough, can most definitely cause rib strain. When the core muscles are already struggling because of posture imbalance, even normal coughing feels magnified. So your rib discomfort is probably a combination of respiratory irritation and muscular fatigue. 4. Is there one single reason for all this? Honestly, it never is just one cause. In your case, it s a combination of: • High arches (structural) • weight pressing the heel edges more. • Use outer-ankle stabilisers more lightly • Lack of foot core strength • Long sitting time, desk job, • Chronic chest problems rendering the intercostals and abdominal muscles fatigued. Together, these create the “foundation collapse” feeling you described. From what you have described, your physiotherapist focusing on retraining how you walk is actually quite an appropriate approach. No brace or orthotic alone can fix a chain reaction when the foundation is unstable; you need muscle retraining. I would suggest: • Continuing physiotherapy with emphasis on foot intrinsic strengthening • Targeting hip mobility and glute strength (to take pressure off the foot) • Aggressively treating the cough with your doctor to allow your ribs to cool down • Re-evaluate your orthotics if they are not stopping the heel shift. If your cough is severe enough to pop ribs out, you should also have your lungs checked in person to rule out asthma flare or bronchitis needing treatment. My candid view is your symptoms are related, but the fundamental root appears to be foot mechanics + weight load + weak stabilizers, and the flare from respiration is tipping an already fatigued body over the edge. None of this points to a dangerous disease, but it absolutely needs a structured in-person rehab approach. Take care. Hope I have answered your question. If you have any further query I will be happy to help. Wish you good health. Regards, Dr. Usaid Yousuf, General and Family Physician