Ankle sprains occur when the ligaments that help stabilize your ankle become injured. This may occur when the ankle is excessively turned or rotated, overstretching the ligaments. These overstretched ligaments cause the ankle to lose stability, leading to pain and balance issues. Physical therapy can help by restoring joint range of motion, reducing swelling and edema, strengthening to improve stability, and education on ways to avoid re-injury in the future.
Foot drop occurs when you do not have enough strength in your ankle to flex your foot up against gravity, known as dorsiflexion. This can occur from general weakness and range of motion dysfunction, or can occur as a result of compression of the deep peroneal nerve in the leg, the sciatic nerve in the thigh, or nerve roots in the spine. Lack of dorsiflexion can lead to problems and safety concerns when you are walking as you are more likely to drag your foot and trip. Physical therapy can help by reducing compression on the nerve and this is achieved through a variety of manual therapy techniques, nerve mobilization exercises, stabilization exercises, postural re-education, strengthening of the ankle dorsiflexors, and gait training.
A neuroma can be one of the many causes of foot pain. A neuroma is defined as a thickening or enlargement of nerve tissue. A Morton’s neuroma is specific to the foot and occurs when the nerve passing between the 3rd and 4th toes becomes entrapped, irritated and compressed. Symptoms include forefoot pain, burning, tingling, cramping, and numbness of the toes. Common things that may cause nerve compression include wearing tight shoes, shoes with a tapered toe box or extremely high heels. Repetitive stress or irritation to the ball of the feet such as running may also cause a neuroma. Neuromas may be treated through physical therapy interventions such as joint mobilization and stretching and well as icing. Orthotics, activity modification, and shoe modifications may help reduce pressure in the foot giving the nerve time to heal.
Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is a thick band of tissue that runs across the bottom of your foot, connecting your heel bone to your toes. With plantar fasciitis, this connective tissue becomes inflamed and can cause a sharp stabbing pain when putting weight on the foot – particularly when taking your first steps in the morning. Pain can be felt at the heel, along the arch and/or the ball of the foot. Plantar fasciitis is common among runners, people who are overweight and those who wear shoes with minimal support. Faulty foot mechanics, such as being “flat-footed” or having high-arched feet, can also contribute to the development of plantar fasciitis. Here at Cynergy, we use a combination of manual techniques and stretching exercises to decrease pain and improve the flexibility of the ankle, foot and plantar fascia. Individualized strengthening exercises for the ankle and foot are also provided to improve stability of the ankle and foot while standing and walking. Patient education on supportive footwear and/or shoe inserts is also provided by the physical therapist in order to minimize future stress to the plantar fascia.
Postoperative Ankle Fractures
Ankle fractures can occur through a variety of mechanisms and can widely vary in severity. In the most severe cases, surgery may be indicated to repair the fracture and stabilize the ankle. After surgery the goal of physical therapy is to protect the surgical repair, decrease pain, and improve function. This can be achieved through education on how to protect the repair as it is healing, improving your range of motion and improving your strength.
A stress fracture is when a small crack occurs in a bone, usually due to high impact activities, overuse, and poor mechanics during exercise. While stress fractures can occur throughout the body, they are most common in the lower extremities, specifically in the shin, ankle and foot. The first goal of physical therapy is to protect the injury, so it does not turn into a full fracture. Following the protective phase, your therapist will assess and address any range of motion or strength impairments, as well as your mechanics to help prevent the risk of re-injury when returning to your prior activities.