The foot is made up of 26 bones, 33 joints, 107 ligaments, and 19 muscles. There are entire specialties within healthcare, such as podiatry, that dedicate years of education and experience to understanding this region of the body. Because of the complexity of the foot and ankle, I am going to focus on a few of the most commonly injured areas, how it happens, how to recover, and ways to prevent future injury.
3 common injuries:
1) Ankle Sprains
Ankle sprains are the most common injury to the lower extremity. It usually happens when you step on an object, like someone else’s foot, and your foot rolls inward. This injures your talofibular ligament on the outside of your ankle. Swelling and bruising is usually expected with an ankle sprain. In most cases, the more swelling and bruising, the more severe the injury.
When you sprain your ankle, implement PRICE in the beginning (Protect, Rest, Ice, Compress, Elevate). For most ankle sprains, you do not want to completely immobilize your ankle, so a mild to moderate ankle wrap will provide enough support and compression. Overall, the movement is good for your ankle to help push the inflammation out of the ankle and back to the heart. Within the first 3-5 days you should be able to handle walking around on it with minimal pain and discomfort.
Rehab exercises are the best way to decrease your odds of spraining your ankle over and over. In the early stages of the injury, you can spell out the ABC’s with your foot in uppercase and lowercase. Be sure to do the motions slowly while trying to make the ankle movements as big as possible. It will help restore your range of motion and improve the fine motor skills that your foot and ankle do throughout the day.
Another rehab option involves using a resistance band that resembles a large rubber band. Anchor one end of the band to the leg of a table or chair and then attach the other end to the front of your foot. From there roll your foot so that the outer edge is raised (eversion). This is the reverse motion of how you originally sprained it. This band exercise will help rebuild the strength of your ankle.
2) Achilles Tendonitis
The Achilles tendon is where the calves connect to your heel. There are high amounts of stress placed on the Achilles tendon with activities that require a lot of running and jumping. As more stress is placed on the tendon, it can become inflamed (-itis means inflammation). When the Achilles gets inflamed it will hurt to walk, run, and jump. Even pinching it with your fingers can be especially painful.
There are a couple things you can do to control how inflamed your tendon gets. The first is to thoroughly warm up and stretch your legs and calves before exercising. Second, do not do too much too soon. Make sure you are gradually increasing your workout intensity. As you implement these things, your tendons will be able to adapt and handle the extra stress you place on them with time.
How do you treat it if you already have it? At first, rolling out your calves, resting and icing can help control the pain. Trigger point therapy or sports massage on the calves can take pressure off the Achilles, allowing it to heal.
When it comes to rehab, the most effective option is to do eccentric contractions with your calves. You can do this with resistance machines at the gym or by doing calf raises on a step. The eccentric contraction is the downward motion. You should spend about 3-5 seconds gradually lowering your heel towards the ground. Start with 2-3 sets of 10 twice a day. If your pain does not get worse, then gradually increase it until you are doing 2 sets of 15 twice a day. Eccentric contractions are also helpful with muscle cramps, spasms, and some strains.
3) Plantar Fasciitis
Plantar Fasciitis is the most common cause of heel pain. The plantar fascia helps to make up the arch of your foot. Think of your arch as the trampoline that absorbs the forces when you strike the ground and spring forward. The pain is usually felt on your heel where it attaches. The pain often feels like a nail is stabbing the front edge of your heel. You may also notice that the pain is worse in the morning for the first few minutes after you wake up and start walking around.
There are a few things you can do at home to help when you first notice heel and arch pain. Stretching your calves, feet, and toes is a good place to start. In addition to this, you can gently roll out with a golf ball along the arch of your foot for a few minutes each day. These options can alleviate the mild to moderate symptoms. If this is not changing your symptoms, trigger point therapy or sports massage to your feet and calves can help.
There are two basic rehab exercises you can do at home. The first one is the marble pickup exercise. Place 10-20 marbles on the ground. Using your toes, pick up each marble and place it into a bowl.
The other exercise is the towel curl. Place a hand towel on the floor. Using your toes and the front of your foot, pull the towel under your foot. Be sure to keep your heel planted on the ground while you are curling your toes. You should also notice the middle of your foot coming off the ground in the process, creating an arch. Both of these exercises will help strengthen the muscles of your toes and foot.
Have you ever been walking around and you step on a crack or small rock causing your ankle to start to roll and then suddenly the muscles around your ankle kick in and stops you from completely rolling your ankle? This is your body’s proprioception at work. Proprioception is your body’s ability to recognize where your joint is in space.
Just like any other part of your body, the more you train it, the more efficient it becomes. Balance and coordination play a large role in improving your proprioception. Here are three ways to improve your proprioception:
1) Single foot stand
Balancing on one foot is a common functional test. You should be able to stand on one foot for at least 20 seconds. If you cannot, then try taking time during the day to practice standing on one foot. It becomes more difficult if you do activities while on one foot such as brushing your teeth or doing the dishes. You can further mix it up by testing your balance with your eyes closed.
2) Uneven surfaces
Walking or running on uneven surfaces such as sandy or rocky terrain can help your foot and ankle adapt to unknow variables. Eventually, your reaction time, foot strength, and ankle strength will improve.
3) Wobble board
A wobble board is a common piece of rehabilitation equipment for the entire lower extremity. Simply standing on it can improve your balance and coordination. To improve even more try doing lunges or squats with one leg on it. You can also have a partner bump you from random directions to improve your reaction time.
Ankle sprains, Achilles tendonitis, and plantar fasciitis can be successfully treated with rehabilitation exercises, stretches, and different muscle work techniques. None of these injuries are a “life sentence”. A sports chiropractor or physical therapist can help speed up recovery and give you addition tools to help your specific situation. Strengthen the injured areas, improve your proprioception, and loosen up the tight muscles to recover and prevent re-injury.
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