Understanding the Interplay of Physiotherapy Techniques for Foot and Ankle Pain

The foot and ankle are responsible for supporting and balancing the weight of your body when standing and moving. This makes them vulnerable to injury and pain.

Physiotherapists are trained to diagnose and treat the many issues that can cause foot or ankle pain. These include sprained ankles, fractured bones, arthritis, plantar fasciitis and gout.

Stretching

Your feet are some of the hardest working parts of your body. They serve as shock absorbers, supporting up to one million pounds of pressure per day, and are responsible for propelling you forward with every step. And despite this, they are very sensitive. Having 26 bones, 33 joints and over 100 tendons, ligaments and muscles, the foot is especially susceptible to injury.

Using the correct stretching technique, such as those recommended by Physio toowoomba, is essential for reducing pain and inflammation in the foot and ankle. It’s important to note that it is not advisable to perform ballistic stretching, where you bounce into and out of a stretch position, as this doesn’t allow the muscles to properly adjust and relax into the stretched position.

Physiotherapy stretching, such as heel-in heel drops and knee to wall achilles stretches, has been shown to improve symptoms for plantar fascia pain. DiGiovanni et al reported that at an eight week follow up, there was a significant reduction in the pain of plantar fascia pain on first steps and on pain when walking up stairs in the group who were carrying out the specific stretching exercises.

Strengthening

With 26 bones, 33 joints and more than 100 tendons and muscles, it is no wonder the foot and ankle are susceptible to injury. Whether the cause is a sprain, strain or an injury to a muscle or bone spur, pain in the feet and ankle can be debilitating. A physical therapist is trained to create a personalized treatment plan to help reduce your symptoms and increase your ability to move.

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Optimise Health will guide you through a progression of exercises to improve your strength, balance and proprioceptive (joint position sense) awareness. These techniques will help you manage your pain and return to the activities you enjoy. Performing these exercises 3 to 5 times per week will maintain the improvements you have made. This will also help prevent the injury from recurring.

Joint Mobilisation

Joint mobilization, also known as motion palpation assessment technique or movement-based manual therapy, involves the therapist applying pressure at the joints of your feet and ankles that are stiff, swollen or misaligned. This can help improve the mobility of those areas and alleviate pain.

There are a few different types of joint mobilizations but the most common include slow oscillations and fast thrust techniques. The therapist will use a scale to determine which type of mobilization is appropriate, depending on the joint, how well the patient tolerates it and the goals of treatment.

There are a few precautions and contraindications to joint mobilization such as tendon/muscle injury, nerve damage and fracture. However, if performed by a skilled physical therapist, these techniques are generally very safe and effective for most people. They can significantly reduce pain and improve mobility in those with joint dysfunction (hypomobile). The rapid, small amplitude movement creates a “click” sound that is called cavitation.

Manual Therapy

If the tendons or muscles are tight, stiff or not moving correctly then a physical therapist may use manual therapy techniques to break down adhesions and scar tissue. This will help to increase tissue extensibility, reduce pain and inflammation.

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The physical therapist will also use myofascial release, which is a hands on technique that targets the fascia (the connective tissue that wraps all of our muscles and bones) and feels around for tight or stiff spots to manipulate and massage to restore pliability. This is a great way to relieve foot and ankle pain caused by bunions, flat feet or plantar fasciitis.

Chronic foot or ankle pain can significantly interfere with your normal daily life and prevent you from doing the things you love to do. Your physical therapist is trained to find the root cause of your pain and get you back to doing the things you enjoy as soon as possible. Along with exercise progression, the addition of manual therapy can improve your recovery and return you to the activities you love sooner.

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