Foot and ankle pain is a frequent complaint in people of all ages and activity levels. It makes sense why it is such a common complaint as we use our feet constantly! There are of course traumatic injuries, such as sprained ankles or broken bones, which require obvious medical attention and appropriate rehab. However, many people experience pain on a daily basis that is not related to trauma or a one-time injury.

Common diagnoses for foot and ankle pain are plantar fasciitis, tendinitis, metatarsalgia, heel or arch pain, achilles tendinitis, neuroma and shin splints. Many people who suffer with foot and ankle pain are unaware of the unique benefits that are available through physical therapy.

Categories of Foot and Ankle Pain

Injuries to the feet from walking and running are often categorized as “overuse” injuries. “Overuse” implies that the injury develops gradually as a result of changes in intensity or duration of activity. Simply put, when you hear the term “overuse” in conjunction with foot and ankle pain, you know that the body is rejecting the level of stress acting upon it. Wearing the right shoe is more important than most people think; the key to finding the right shoe is to know more about your feet.

The three basic foot types are:

1. Pronated – the “flat foot” in which the arch is collapsed down
2. Supinated – the “high arched” foot which is very stiff and rigid
3. Neutral – the more ideal foot, with normal arch height

Once you have a basic idea of your foot type, you can begin to understand the role that your shoes should play in supporting you and your activities. A simple biomechanical explanation of these three foot types are as follows: The pronated foot is too loose and mobile and is in need of extra stability or support. The supinated foot is too rigid and lacks mobility, and thus it needs more shock absorption. The neutral foot, as the name implies, does not need extra support or extra shock absorption built into the shoe.

Tips for Healthier Feet

• A critical component to avoiding an overuse injury is to find and wear the right shoe. Buy shoes based on function, not simply fashion. Going for the cheapest, or most stylish pair of shoes leads to trouble. Take the time to find good quality shoes that meet the demands your work and activities require. This can be challenging at first because the correct shoe must fit the shape of your foot, provide control for abnormal motion your foot makes, and support your foot type.

• Utilize running shoes for more than just running. Around home, running errands or when traveling, consider using your running shoes for those long periods of walking and standing. Correctly fit running shoes can decrease the compressive forces on your feet and also take stress off the knees, hips and back.

• Get the correct type of shoe for your activity or sport. Avoid using a generic sneaker for your daily walks or a sport they are not intended for. Running shoes may be fine for running and walking, but are not appropriate for use with court sports and other activities which require more side to side stability.

• Give your feet the exercise they deserve. Unlike some other joints and muscles in the body, your feet are working hard to support you even when you are simply standing still doing simple daily functions. Take the time to learn some basic stretches and exercises which can diminish the stress that your feet acquire every day.

• Perform a little “TLC Rollout”. After a long day on your feet, sit down and place a small ball (the size of a golf ball, but preferably softer) under your foot. Gently roll your foot back and forth over the ball to massage various areas. Curl your toes down, up and apart periodically as you roll out some of the day’s stress.

• Always remember the joints and muscles above. While your feet are your foundation, they are also reactive to your body’s constantly changing center of gravity. Imbalances at the hips, pelvis and spine often cause unbalanced forces to act on your feet and can be the cause for many foot and ankle problems.

• Don’t be afraid to consult with professionals who are foot/ankle specialists. The mechanics of the foot and ankle are incredibly complex. When seeking help, find a medical professional or therapist who is qualified to accurately diagnose your problem and develop a customized plan for recovery.


Treatment

Physical therapists understand the dynamic mechanics and cooperation that must occur between the 26 bones, 33 joints, and more than 100 muscles, ligaments and nerves in the foot and ankle to perform two key functions. These two functions are: to provide shock absorption for body weight under the forces of gravity, and to propel the body forward. Achieving these two functions requires the feet to become mobile and adaptable while transforming into stabile levers to push off from during walking. Most foot and ankle injuries and painful conditions can be traced to an inability of the body to perform or transition between these two key functions of shock absorption, and stable lever.

Playing “detective”, a physical therapist finds both obvious and subtle clues contributing to the abnormal forces acting on your feet. A critical aspect unique to physical therapy is that therapists assess not only feet and ankles, but also look for other problems higher up in the knees, hips, pelvis, and the opposite side of the body. Patients are typically surprised, but relieved, when all of the clues add up and finally make sense to them.

Implementing treatment strategies for foot pain can involve immediate pain-relieving techniques to calm down inflammation or swelling. In some cases, simply making small changes in the shoes or insoles helps the feet perform their duties more efficiently. There can also be a need for stretching, strengthening, and movement retraining. Since the human body is the master at compensation, retraining a normal walking gait becomes a necessary part of preventing long-term problems and recurrences.

Therapists at Avante Physical Therapy are skilled in empowering the patient in the healing process through education and the development of an individualized wellness plan.