Ankle and Foot Pain
The human ankle and foot are uniquely designed to support the entire body weight and provide a platform through which propulsive forces are transmitted to the ground beneath.
The foot and ankle complex represent a dynamic, reactive, and force-generating structure containing a complex arrangement of bones held by an array of ligaments, muscles, tendons and nerves.
There are 26 bones, 33 joints and more than 100 ligaments, tendons and muscles in each foot. On average, we walk 10000 steps per day, 1000000 steps per year and 115000 miles in our lifetime. The foot stands 3-4 times body weight during walking and running.
This anatomical complexity, together with the biomechanical demands placed on them, make the foot and ankle particularly susceptible to a variety of injuries.
Common Conditions of the Foot and Ankle
The foot and ankle are among the most common sites for both acute and chronic injuries in athletes and other physically active individuals. Although seldom life-threatening, they often have detrimental effects on sport activity and participation. When an injury to the foot or ankle occurs, athletes are limited in their abilities to run, jump, kick, and change directions in sports like football, rugby, netball and basketball. Dancers are also highly prone to ankle and foot injuries.Thus, the treatment and rehabilitation of these injuries are crucial in returning athletes to full participation at full functioning. The most common injuries seen by the physiotherapist include:
- Ankle sprains
- Plantar heel pain/plantar fasciopathy/plantar fasciitis
- Achilles tendinopathy/tendinitis
- Management of ankle fractures (medial malleolus fracture, lateral malleolus fracture, lateral malleolus fracture), stress fractures, foot fractures
Assessment of the Ankle and Foot
At Praxis Rehab Physiotherapy, we ensure a thorough assessment to rule out any red flags i.e. any signs and symptoms that might indicate a more serious condition. If needed, you will be referred for scans (x-ray, ultrasound and MRI).
A proper history-taking of your problem will help us to identify – the barriers limiting your ability to move at home/work/socially, nature and behaviour of pain, coping strategies, your concerns regarding pain, beliefs and attitudes developed over time to manage the pain, and short & long-term goals.
A detailed assessment will aim to look for any pain, weakness, stiffness, tightness, or instability in the ankle/foot movements, functional movements, work-related and sports-specific activities such as stair-climbing, kneeling, squatting, lunges, running, jumping, landing, sudden stop-start and change of directions. It is also important to consider other factors such as foot type, biomechanics, footwear worn during activity, and external supports such as bracing or taping. The foot is the base of the lower quarter kinetic chain, thus if rehabilitation and treatment is not managed properly, an injury to the foot or ankle can ultimately cause secondary injuries elsewhere up the chain.
Management of Ankle and Foot Pain
Research has shown that exercise therapy is most effective as first-line treatment to improve pain, mobility, strength, function, neuromuscular coordination and balance. Hands-on/manual therapy such as soft tissue massage, joint mobilization, bracing and taping may be integrated as additional therapy to help in the initial treatment phase. We may also advise some shoe inserts for symptom modification. We would like to take you till the end-stage rehab and challenge you with strengthening exercises targeting different muscle groups, plyometrics and agility drills specially if it is a sports-related demand.
At Praxis Rehab Physiotherapy, we aim to derive considerable comfort and results from research that consistently demonstrates improvements in symptoms with a well-structured and graduated exercise program. We will advise you on the type, duration and dosage of exercise, modify activities if painful, calm the load down before reintroducing controlled loading and gradual progression from simple to complex ankle/foot movements.
We put great emphasis on education as an essential component of rehabilitation, and attention to lifestyle factors (smoking cessation, nutrition, stress, and sleep management) to enhance outcomes.