Ankle Pain
Ankle Sprain
Ankle sprains are common injuries caused by the foot twisting or turning beyond its usual range of motion, causing the ankle ligaments to overstretch or rupture. Ankle sprains are estimated to affect 23,000 Americans per day. Ankle sprains account for 45% of all sports injuries in the United States, with basketball players being the most often injured.
Younger athletes, members of the military, and anybody who often runs, leaps, and changes direction abruptly while doing an athletic activity (“cutting motion”) are at a higher risk of spraining an ankle. Physical therapists assist persons who have had ankle sprains in reducing pain, regaining strength, mobility, and balance, returning to normal activity levels, and avoiding reinjury.
What Is Ankle Sprain?
Another scenario we see all the time in our clinic is when people go to the Doctor, and the Doctor tells them to rest and “try these painkillers” and “see how it goes”.
However, this is rarely ever the best advice and often 4 weeks later they end up going back to the doctor again because it hasn’t got any better. What’s even worse, they’re often given yet another prescription of even stronger pills, and advised MORE rest. This is ridiculous and explains why so many people in the U.S. are suffering with chronic lower Ankle pain.
Has This Type Of Thing Happened To You?
If You’re Currently Living With Ankle Pain, Here’s 7 More Reasons Why It Could Be Lasting Longer Than It Should:
How Does it Feel?
- Pain
- Swelling
- Impossibility of standing or walking on the afflicted foot
- Throbbing
- Stiffness
- Weakness
- An ankle joint sense of instability
How Is It Diagnosed?
- How did you become hurt?
- Did you hear a snap, a pop, or a tear?
- What activities are you experiencing difficulty with?
- What hobbies would you like to resume?
- Grade 1 (mild). The ligament has been overstretched.
- Grade 2 (moderate). The ligament has become overstretched or is partially ripped.
- Grade 3 (severe). The ligament has been entirely ripped.
What Can a Physical Therapist Do?
Physical therapists assist persons with ankle sprains in recovering faster than they would otherwise. The length of time it takes to repair an ankle sprain varies, but results may usually be obtained in 2 to 8 weeks. Your physical therapist will collaborate with you to develop a treatment plan that is tailored to your individual requirements and goals.
Your physical therapist may suggest you to do the following over the first 24 to 48 hours after receiving your diagnosis:
- Avoid any activity that produces pain and rest the region.
- Every 2 hours, apply ice packs to the affected region for 15 to 20 minutes.
- Consult a physician if you require further services such as medicine or diagnostic testing.
- Walk on the injured foot as quickly as possible and as much as you can without exacerbating the discomfort or edema.
- Use crutches or other walking aids to help with pain relief and balance.
- Wrap your ankle or wear an ankle brace for support and swelling prevention.
These self-treatments will allow you to remain as active as possible while minimizing discomfort and speeding healing.
Your physical therapist will assist you in:
Pain and swelling should be reduced. You will learn how to avoid or adapt your everyday and athletic activities so that recovery may begin. To regulate and lessen your pain and swelling, your physical therapist may use a variety of treatments and technologies, such as ice, heat, ultrasound, electrical stimulation, taping, particular exercises, and hands-on therapy, such as specialist massage.
Improve your movement. Your physical therapist will recommend certain workouts and treatments to help restore normal ankle mobility. These may begin with “passive” motions performed by the physical therapist to gently move your ankle and foot, and advance to “active” exercises and stretches performed by you.
Increase your adaptability. If any of your foot, ankle, or lower leg muscles are stiff, your physical therapist will stretch them and teach you how to stretch them.
Increase your strength. Ankle sprains can occur as a result of weak, damaged, or uncoordinated leg muscles. Certain exercises will help with healing at each stage of recovery; your physical therapist will choose and teach you the proper routines and equipment to utilize in order to gradually and safely regain your strength. Cuff weights, stretch bands, and weight-lifting equipment are among examples.
Increase your endurance. After an injury, it is critical to regain muscle endurance in the ankle and leg. Your physical therapist will teach you endurance exercises so that you may resume your daily activities. Cardio-exercise equipment, such as treadmills or stationary bicycles, may be employed.
Improve your balance. It is critical to regain your sense of balance after an accident. Your physical therapist will give you exercises to help you improve your balance.
Restore your agility. Leg movement speed and precision are vital in athletics and many daily tasks. Your physical therapist will assist you in regaining these abilities so that you may return to sports and your regular routine.
Discover a Home Program. Your physical therapist will teach you at-home strengthening and stretching routines. These exercises will be tailored to your unique requirements; if performed as directed by your physical therapist, they will help you heal faster.
Return to Activities. Your physical therapist will talk with you about your activity objectives and utilize them to develop work, sport, and home-life rehabilitation goals. Your treatment plan will assist you in achieving your objectives in the safest, quickest, and most effective manner possible. To assist you attain your goals, your physical therapist will teach you exercises, work retraining activities, and sport-specific methods and drills.
Reduce Recovery Time. Your physical therapist is qualified and experienced in selecting the finest treatments and exercises to help you heal safely, return to your normal lifestyle, and achieve your objectives faster than you would on your own.
If Surgery Is Required
Ankle sprains seldom necessitate surgery. If surgery is required, you will be directed by your physical therapist through a rehabilitation program that will last many weeks. Your physical therapist will assist you with minimizing discomfort, regaining mobility and strength, and returning to routine activities as safely and quickly as possible.
Shin Splints (Medial Tibial Stress Syndrome)
The disorder known as medial tibial stress syndrome (MTSS) produces pain on the inside of the shin (the front part of the leg between the knee and ankle). Because of the placement of the discomfort over the shin bone, MTSS is usually referred to as “shin splints”; pain can be felt on the inside or front of the shin bone.
One of the most prevalent athletic ailments is MTSS. It affects both the muscle on the inside of the shin and the bone to which it joins, causing the connection to become inflamed or possibly rip due to overuse. Up to 35% of athletes who run and jump, such as distance runners, sprinters, basketball or tennis players, or gymnasts, may be affected by MTSS. Military personnel, dancers, and other active persons can all benefit from MTSS development. Physical therapists assist persons with MTSS in regaining pain-free movement and learning exercises and strategies to avoid reinjury.
Shin Splints (Medial Tibial Stress Syndrome)
- Overpronation is the flattening of the arch of the foot while standing, walking, or sprinting.
- Participation in a sport requiring a lot of leaping and/or running
- Excessive hip movement (moving the hip through a greater range than is typical)
- A high BMI (more than 20.2 BMI)
- An earlier running injury
How Does it Feel?
If you have MTSS, you may have discomfort in the center or bottom third of the inside of your shin. When you touch the tender region, the pain may be acute, or it may appear as an ache during or after activity.
However, in most cases, the discomfort is triggered by activity and subsides with rest. When MTSS develops, the discomfort may be more evident at the start of activity and less noticeable as the exercise proceeds. The problem might deteriorate with time, and discomfort may be felt during and after any workout routine.
How Does it Feel?
Your physical therapist will do a comprehensive examination, including collecting a complete health history and seeing you while you walk and perform the activity that is causing your symptoms, such as running or jumping.
Your physical therapist will then perform a number of musculoskeletal tests and measurements to assess your strength, mobility, flexibility, and pain response. The most consistent symptom of MTSS is discomfort felt while applying pressure to particular places on the shin.
If the evaluation findings indicate MTSS, your physical therapist will discuss treatment goals with you and design a personalized rehabilitation program for you. If a more serious issue is suspected to be causing your discomfort, you may be sent to a doctor for more testing.
What Can a Physical Therapist Do?
Your physical therapist will identify the risk factors that have contributed to your MTSS and will educate you how to address those problems. A treatment plan will be created that is unique to you and what your body need to recover and avoid reinjury.
Your physical therapist may prescribe the following medications to alleviate pain:
- Rest from the strenuous action or exercise
- 1 to 3 times each day, ice the tender region for 5 to 10 minutes.
- Stretching exercises for the muscles surrounding the shin
- Taping the foot arch or the afflicted leg muscles
- Massage of the damaged tissue with one’s hands
Your physical therapist may instruct you on the following exercises to help strengthen weak muscles:
- Exercises that strengthen hip rotation, abduction (raising the leg away from the other leg), and extension (moving the leg behind your torso) to reduce stress on the lower leg
- Exercises that strengthen arch and shin muscular strength to reduce overpronation (flattening out) of the foot arch
Your treatment may also include:
- Stretching the calf and foot muscles
- Squats, reaching exercises, and heel raises are examples of single-leg exercises.
- Jumping athletes’ take-off and landing techniques have been modified.
- Walking and running leg and foot control has been altered.
- Suggestions for better-supporting footwear when walking or exercising
If your feet flatten out too much or if your foot muscles are weak, your physical therapist may also recommend orthotics or shoe inserts that support the arch of the foot.
Physical therapists assist athletes with MTSS in modifying their training programs in order to safely return to sport, and they provide particular advice for lowering the likelihood of reinjury.
Tarsal Tunnel Syndrome
What exactly is Tarsal Tunnel Syndrome?
How Does it Feel?
TTS’s most prevalent symptoms are caused by irritation of the tibial nerve and its branches. TTS patients may experience the following symptoms:
- Foot or ankle pain, numbness, or tingling that may spread into the lower leg, foot, and toes
- Muscle weakness in the lower leg and foot
- The big toe's weakness
- Swelling of the feet
- Symptoms that worsen with extended standing or walking
- Symptoms that subside with rest
- Foot and ankle temperature changes
- Sleep-disrupting pain
Basically, we can help you get back to living life free from the curse of chronic Ankle pain.
If you want to know what it costs – and what availability we have at our physical therapy clinic in Encinitas then just click the button below and complete the short form:
How Is It Diagnosed?
- Tap gently across the posterior tibial nerve in an attempt to mimic your symptoms.
- Tensing of the posterior tibial nerve, which looks and feels like a "stretch," in an attempt to mimic your symptoms.
- Conducting a nerve condition study—a diagnostic examination to detect how quickly a nerve transmits information.
- Other illnesses, such as plantarfasciitis, have been ruled out (inflammation of the tissue that runs along the bottom of the foot).
What Can a Physical Therapist Do?
Physical therapists are critical in assisting patients with TTS to improve and maintain their everyday function and activities. Your physical therapist will collaborate with you to create a treatment plan that addresses your unique requirements and goals.
Because the indications and symptoms of TTS vary, so will the approach to management. Your physical therapist may make the following suggestions and give the following care:
Activities for Nerve Gliding. Gentle nerve-moving movements that “glide” the nerves may help lessen discomfort and enhance function.
Exercises for Muscle Strengthening. TTS-affected muscles, such as the tibialis posterior muscle at the rear of your lower leg, should be strengthened.
Balance and coordination exercises. Improve your balance and coordination, which are frequently impacted by TTS.
Orthotics/Taping/Bracing. To reduce stress on the posterior tibial nerve, position the foot using ankle tape, a custom orthotic, or bracing.
Education, as with many other conditions, is critical. Understanding the underlying causes of TTS and learning to spot early signs and symptoms of stress may help you manage the disease more effectively.
Plantar Fasciitis
Heel discomfort can be attributed to plantar fasciitis. The plantar fascia is a thick band of tissue that runs from the heel to the ball of the foot and acts as an arch support, although it can become inflamed or even rip. When you walk or put weight on your foot, you feel discomfort. This is especially true for your initial steps in the morning. The discomfort can be localized anywhere on the foot, including the heel, arch, or ball.
One of the most frequent foot problems is plantar fasciitis. It affects up to 10% of the population annually and up to 2 million people annually in the United States.
The development of plantar fasciitis may be influenced by a number of factors, including:
- Age (over 40 years)
- Work, play, or recreation that requires standing or other forms of weight-bearing for extended periods of time.
- Starting a new jogging program or a job that needs a lot more standing or walking than you're used to can both cause rapid increases in the time and intensity of your workouts.
- Limited range of motion in the calf muscles
- Gained or Extra Weight (Body Mass Index greater than 30)
- A propensity toward flat feet (pronation)
Plantar fasciitis affects both elite and recreational athletes of all ages. Incidence rates among males and females are proportional.
In most cases, treatment may alleviate your discomfort and get you back on your feet in no time.
What exactly is Plantar Fasciitis?
Plantar fasciitis is a heel pain disorder. The plantar fascia, a broad band of tissue linking the heel to the ball of the foot that supports the arch, can become inflamed or rupture. When repetitive weight-bearing activities stretch the plantar fascia, the disease develops. Plantar fasciitis patients may also have heel spurs, which are bony growths on the heel bone. People with heel spurs, on the other hand, may not feel any pain.
Plantar fasciitis is most common in persons in their 40s, but it can affect people of any age.
Athletes who run a lot and non-athletes who are on their feet most of the day, such as police officers, cashiers, or restaurant employees, might acquire the disease.
Symptoms and Signs
The beginning of plantar fasciitis symptoms is typically associated with a rapid increase in activity. You may have a sharp pain on the underside of your heel as well as stiffness and/or discomfort along your arch.
Plantar fasciitis patients may encounter the following symptoms:
- When getting out of bed in the morning and taking the first steps of the day
- With extended standing
- Standing up after a long period of sitting
- Following a strenuous weight-bearing activity such as jogging
- When ascending stairs
- When walking barefoot or in shoes that provide inadequate support
As your body heats up, your discomfort may actually lessen during the day, only to flare towards the end of the day due to prolonged walking.
You may limp if you have severe symptoms.
How Is It Diagnosed?
The physical therapist will make a diagnosis based on your health and activity history, as well as a clinical assessment. Your therapist will also collect a medical history to ensure that you do not have any other diseases that might be causing your discomfort. Sharing information about your symptoms’ link to your employment and pleasure, as well as reporting any lifestyle changes, will assist the physical therapist in diagnosing your illness and tailoring a treatment regimen to your individual needs.
Your therapist may do the following physical examinations to evaluate if symptoms of plantar fasciitis occur:
- Pressing and massaging the heel region (palpation)
- Stretch the ankle gently to bend the top of the foot toward the leg (dorsiflexion)
- Gently push the toes against the ankle
What Can a Physical Therapist Do?
Plantar fasciitis is evaluated and treated by physical therapists.
When you are diagnosed with plantar fasciitis, your physical therapist will work with you to create a treatment plan that may include:
- Stretching exercises to enhance ankle and plantar fascia flexibility
- To preserve proper ankle and toe postures, wear a sleep splint.
- Choosing supportive footwear and/or shoe inserts that decrease foot pronation and stress on the plantar fascia
- Ice application to reduce pain and inflammation
- Iontophoresis (a gentle approach to distribute drugs through the skin) (a gentle way to deliver medication through the skin)
- Taping the foot to give temporary relief
Bunion (Hallux Valgus)
A bunion is a significant lump on the side of the foot that develops near the base of the big toe. A bunion is prone to becoming inflamed and bloated, resulting in foot discomfort. Although anybody can acquire a bunion, it is more common in women and older persons.
The joint may expand and become stiff and unpleasant with time, causing shoe fit issues, discomfort, and trouble walking. Physical therapists assist persons with bunions in improving the angle of their big toe, increasing muscular strength and walking ability, and reducing discomfort.
What exactly is a Bunion?
A bunion is a lump on the side of the foot that forms at the base of the big toe as it bends inward. Depending on the size of the measured angle at the toe, a bunion is classed as mild, moderate, big, or severe. A 20° or greater angle is deemed abnormal.
Bunions can be caused by a variety of reasons, including:
- Heredity
- The form of the foot
- Arches that are flat
- Laxity of the joints (too much flexibility in the joint at the base of the big toe)
- Osteoarthritis
How Does it Feel?
- Standing and walking cause pain and edema in the big toe joint.
- The hump on the side of the foot gradually enlarges, becoming inflamed and bloated, causing foot discomfort.
- Shoes cause pain, making it difficult to locate comfortable or fashionable footwear.
- Changes in your walking style.
- Walking has become more tough.
- Changes in balance, which increase the risk of falling, especially in elderly persons.
- Crossing of the big and little toes, resulting in toe crowding and probably further abnormalities and discomfort.
- Foot discomfort has a negative impact on one's quality of life.
Symptoms and Signs
If you first meet a physical therapist, the therapist will inquire about your medical history, how your symptoms started, and how they are now impacting you. Your physical therapist will evaluate the foot and big toe for swelling, deformity, or soreness, as well as your walking pattern, specifically how you bear weight on the afflicted foot.
Your physical therapist will assess the strength of your foot and big toe, as well as the flexibility and range of motion of your foot, and will inspect your footwear for optimal fit and wear patterns. If your bunion is considered significant, your physical therapist may advise you to see an orthopedic foot surgeon.
What Can a Physical Therapist Do?
Your physical therapist will treat your bunion symptoms with pain relief, exercise, gait training, and information on correct footwear and self-care. Physical therapy treatment aims to enhance the angle of the big toe, muscular strength, and pain relief.
Physical therapy treatments may include the following:
Massage Therapy. To assist correct the posture of the big toe, your physical therapist may employ manual (hands-on) treatment. Your physical therapist will gently move your big toe and ankle to minimize joint tightness and stiffness in the surrounding tissues, as well as to expand the bending range of motion of the big toe.
Exercise. Range-of-motion, stretching, and strengthening exercises will be taught to you in order to enhance the alignment of your big toe when standing and your walking pattern. Based on your personal demands, your physical therapist will create a tailored workout program for you.
Balance Exercise. Your physical therapist will teach you standing and walking exercises to enhance your balance while moving to help lower your chance of falling.
Symptom Control. You will learn how to manage any inflammation/swelling and discomfort with occasional foot elevation, self-massage, and cold or heat packs.
Your physical therapist may also use specialist tape on the big toe to enhance alignment and alleviate discomfort. Your physical therapist will advise you on the ideal footwear for your specific situation.
Devices and orthotics. Depending on your condition, your physical therapist may recommend and teach you in the use of splints, foot orthotics, or assistive devices. They might include:
- Toe separators and splints to relieve discomfort and strain on the big toe.
- Foot orthotics (custom arch supports) to assist keep the foot and ankle in a midline position when walking.
- To relieve discomfort and enhance walking capacity, use a cane, walker, or crutches (assistive devices).
Activity Training. Your physical therapist will give activity training tailored to your career, leisure activity, or sport as you restore strength and flexibility.
After Surgery
If your bunion deformity worsens to the point that you can’t find comfortable shoes or walking becomes problematic, you may consider surgery to rectify the big toe position. After surgery, a physical therapist can help you regain the strength and flexibility of your big toe, minimize discomfort, and improve your walking abilities.
Rehabilitation differs from person to person, depending on their health and the type of surgical treatment performed.
For around 4 weeks after most procedures, you will wear a special postoperative shoe to preserve your foot and avoid placing pressure on the surgical region.
To prevent placing weight on the surgery region and to assist guarantee that the bones heal properly, a hospital physical therapist will teach you how to walk using a cane, walker, or crutches. You will also be taught how to utilize ice packs and leg elevation to relieve discomfort and swelling.
Physical therapy should begin three to four weeks following surgery and last four to six weeks. The items indicated above will be included in treatments. The first session will focus on reducing discomfort and swelling with the use of gentle ankle range-of-motion exercises, ice packs, and light massage. You will begin gait training with your physical therapist’s precise instructions, and you will complete exercises in the clinic and at home.
To recover normal walking abilities, postoperative physical therapy will focus walking and learning how to correctly push off of your big toe. It will also involve exercises to strengthen the big toe and ankle, as well as movement to restore proper big toe bending. To regain complete walking capacity, it is critical to rebuild strength and bend in the big toe. To assist you return to your employment, leisure, or sport activities, you will be urged to do a home-exercise program in between physical therapy appointments as well as after the visits are ended.
