Foot or ankle pain is a common cause for concern among the Utah population. We work hard, we are on our feet all day being active, helping kids, co-workers, starting our own businesses and much more.
Pain and injury to your feet can put a stop to all of that and what you love most. So I’ve put together a short educational article of common foot and ankle injuries. What they are, what to expect from them, and what you can do about it.
Plantar Fasciitis
What it is: Inflammation on the bottom of your foot and pinpoint pain on your heel. This pain is worse in the morning and gets better as you walk on it.
Misconception: Pain on the bottom of your foot is always because of the plantar fascia. Oftentimes this pain gets mis-diagnosed for plantar fasciitis, but could be because of some nerve pain in the foot itself or some nerve irritation between your foot and your lower back.
How to Treat it: Making sure to clear any nerve irritation before treating the Plantar fascia is key. Roll a LAX along the bottom of your foot to help the tightness along that fascia. Strengthening the deep inner muscles of the foot is important. This will help take some stress off the plantar fascia and direct it more on the muscles, where the stress belongs. Adjustments to the small joints of the foot and ankle will also help put your foot in a more favorable position to heal and work as it’s supposed to.
Ankle Sprain
What is it: Rapid stretch of the ligaments to the ankle. Usually from falling, stepping on a curb or on someone’s foot. Sometimes a fractured ankle or foot bone can happen, so we have to make sure to clear that up as well.
What to do: Maintain ankle mobility as much as possible. Rest, Ice, Compress, Elevate Is a thing of the past. For many years this has been the thought to treat early ankle sprains. But research shows that this doesn’t speed that healing process but might actually slow the process down in the long run. Best alternative to “RICE” is to protect the ankle, then optimally load the joint with a range of motion exercises in a mild pain range. Move the ankle by writing your name with your foot. Walk on it to your tolerance. Treat the ankle with massage and taping to the area.
Shin splints
What it is: Shin splints could be many different things. It could be a stress fracture to the lower leg bone, strain to the tibialis muscle (front or back), or chronic compartment syndrome (lack of blood flow to the lower leg muscles). These usually come with a dramatic increase in mileage that you are physically not ready for.
How to Treat it: Myofascial release with IASTM, Active Release, Cupping, KT Tape or RockTape is key because it’s a strain or compartment syndrome of the muscle. Adjustments to the ankle and foot have also shown to be beneficial. Rest is also needed in the early stages to allow yourself some time to heal. A slight increase in mileage is what you need to get back to running healthy.
Stress fracture
What it is: Dramatic increase in mileage or constantly running on hard services can lead to small stress fractures. In the foot, this can appear in the heel bone or the long bones of the foot.
How to Treat it: Hate to say it to a runner, but the best thing to do, is to rest. I know that telling a runner to rest and not run is like death, but you do have to give the bone some time to heal.
Achellies tendonopathy
What is it: Increased load and stress to the achilles tendon causing pain and sometimes inflammation. Pain above the back of the heel, often is worse with running or walking up stairs.
How to Treat it: Correct the muscle imbalances. Myofascial release (massage, Instrument assisted soft tissue manipulation (IASTM, aka. scraping), trigger point therapy, fascial stretch, Active Release Technique (ART)) to detect trigger points and fascial tightness from your calf, hamstring, and foot. Regularly adjusting your lumbar spine, pelvis, hips, knee, ankle/foot where needed has also been shown to reduce knee pain over 4-6 weeks. Strengthening/rehab exercises to your core, hips, knee, ankle/foot will help the treatment that you receive to last and you can continue to move forward with treatment.
Chronic compartment syndrome
What is it: Lack of blood flow to a muscle compartment of your lower leg. This can be disguised as shin splints or a stress fracture. It can come on with increased load to your lower leg, like increased mileage of running.
How it’s treated: Correct the muscle imbalances. Myofascial release (massage, Instrument assisted soft tissue manipulation (IASTM, aka. scraping), trigger point therapy, fascial stretch, Active Release Technique (ART)). To detect trigger points and fascial tightness from your calf, hamstring and foot. I have found that Cupping and Taping has worked very well with this condition.
If these treatments don’t work, an x-ray is needed to rule in or out any stress fracture.
Morton’s neuroma
What is it: Nerve pain in between the long bones of your foot and near the ball of your foot (your toes). This can cause pain, numbness, and tingling near/in the ball of your feet and your toes. It comes from a nerve in your foot that becomes irritated and then becomes thick and builds a nodule.
What to do: This one can be hard. Conservatively the goal would be to create space for the nerve to reduce the irritation. Here’s how to do that. Using a lacrosse ball, roll the ball of your foot on the ball to spread the toes out. Myofascial release of the calf and bottom of the foot is needed. Adjustments to joints indicated in evaluation. Then we want to exercise the foot with toe spreading exercises and toe curling exercises (short foot exercises). Wearing shoes with a wide toe box would be very helpful. Shoes like Altras (running/hiking shoes) and VivoBarefoot (outdoor, indoor, exercise, hiking shoes) and True Linkswear (golf shoes) are great shoes. Wearing toe spreaders to help spread your toes out will also give the nerve some space in the foot.
If these don’t work I then refer to a trusted podiatrist just down the road from me in Provo, Utah.
“Flat feet”
What is it: It’s not a true condition, but just a characteristic of someone’s feet. It’s also not a very good indicator of any injuries or pain to your feet. There are many people who have flat feet but deal with no pain to their feet at all. Flat feet would indicate lack of support to the foot with lost arch support. If needed, inserts in your shoe and strengthening exercises to the foot would help this.
These are some of the most common ankle and foot pain that we see in our office in Provo, Utah at Uintah Spinal Health. We work with many other healthcare providers to help you recover as needed. If you, or anyone you know is dealing with ankle and/foot pain, send them our way. We would love to help them recover and get back to the road again and enjoy doing what they love doing, foot pain free.