Ankle and Foot Pain in Happy Valley
Our feet are biomechanically complex with demands to be flexible at times, such as on uneven ground, and rigid at other times, such as when running. With this wide range of demands, in addition to, external stressors such as footwear, things can go wrong in a hurry. Our feet literally bear our weight with every step and sometimes they need some TLC.
Our feet usually can withstand the torment we put them through but when things aren’t working properly it can be incredibly disruptive to our lives. Some common reasons our feet get hurt include:
- Poor fitting footwear.
- Structural abnormality.
- Intrinsic muscle weakness.
- Poor muscle timing.
- Functional weakness in hips.
- Repetitive overloading or overtraining.
These are the most common foot injuries we treat at Ascent Physical Therapy:
The term plantar fasciitis describes an inflammation of the plantar fascia. Your plantar fascia is comprised of firm connective tissue that spans from the front of your heel to the balls of your toes. Its primary function relates to stability and energy conversion through a process known as “The Windlass Mechanism”. This energy is kinetically stored and transitioned upward to power everything from walking, to running, and jumping.
So why is my plantar fascia inflamed? Typically, it is an ‘overuse injury’ where repeated microtraumas without adequate time for your body to heal, and the tissue to adapt to the stress, cause mechanical breakdown of the fascia. Usual culprits involve rapid increases in training volumes during walking or running. The most common contributing factors at play involve the mechanics of your hips and the degree of pronation during gait. If left untreated, other problems may arise from limping, and also, it is not uncommon for a bone spur to begin forming from the chronic pulling of the fascia on the calcaneus (heel).
Plantar fasciitis treatment involves manual therapy to normalize the tissue tensions and break up adhesions – connective tissue restrictions – that place undue burden in the region. Our team of expert physical therapists will perform a thorough evaluation to check for muscle imbalances in your hips and what is happening in your foot while you walk/run. Supportive footwear adds great value in expediting your recovery. In almost every situation, we recommend the acquisition of a night splint to allow your fascia to heal in a more neutral length, in addition to, an arch support used in your shoes. Walking barefoot or in unsupportive shoes is strongly discouraged.
Bunions, or Hallux Valgus, describes the malalignment of your big toe inwardly which causes tissue/joint stress around your 1st metatarsal phalangeal joint. There is debate over a genetic component to bunions but most agree that other likely contributing factors include footwear choice and gait.
Shoes with a narrow toe box (high heels or men’s/women’s dress shoes) place inward pressure on your toes which over time can contribute to this deformity, sometimes referred to as “toe crowding”. Due to the painful nature of this condition it can cause further alterations or compensations to your gait leading to additional dysfunctions and symptoms. In some chronic advanced cases, a surgery may be required to restore a more natural alignment.
Conservative treatment approaches such as physical therapy and supportive bracing have been shown to be quite successful for the vast majority of cases. Restoring the normal joint angles with targeted stretches and exercises is critical for long term success. In addition, proper fitting footwear is also required to prevent regression of symptoms. Using commonly found over the counter toe spacers are an excellent starting point but strengthening of your foot intrinsic musculature will help maintain a more stable alignment.
Typical symptoms of a heel spur or bone spur in your heel depend on the location of the spur itself and the size of the spur. There are 2 common locations for spurs to develop. One is on the front (toe side) of the heel bone (calcaneus) and is usually related to plantar fasciitis. Pain is usually experienced on the underside of the foot and can be dull and sore to sharp, as if stepping on a rock in your shoe. The other is on the top of the backside of the heel where the achilles tendon blends in and is usually described as dull and sore to sharp and can cause rubbing on your shoe (also quite painful).
Successful treatment options for either location is similar to the respective common associated condition. Heel spurs on the front underside, associated with plant fasciitis, is treated by reducing strain to the tissues and strengthening the region. Heel spurs on the upper backside, associated with achilles tendinopathy, also need to have the local strain reduced for inflammation control followed by strengthening of the achilles tendon complex.
Injuries to the achilles tendon complex are usually related to running, jumping, or power movement athletes. This commonly happens when a tendon has experienced slow degeneration and then you attempt a sudden or forceful loading of it, resulting in a tear or strain. Examples include planting to sprint, landing from a jump, or an unexpected stumble. If your achilles tendon completely ruptures, you need to contact an orthopedist immediately, this is a surgical situation that should not be delayed.
After an achilles tendon injury, physical therapy treatment of the tissue for pain relief, unloading of strain, and remodeling for prevention of future repeat injuries is essential. At first, the focus is on protecting the injured area and managing inflammation & pain. Once the localized healing has begun, a focus on prescriptive safe loading activities and proper lengthening stretches are taught. Under or over prescription of activities can delay healing, or worse, cause more damage.
Our doctors of physical therapy at Ascent Physical Therapy specialize in one to one treatments for up to an hour and your therapist won’t change from session to session. Having a caring provider who understands your symptoms and where you’re at in your recovery greatly accelerates the process.
If any of these sound like a problem you’ve been experiencing and foot pain has been interfering with your life, call us today to get started on a plan of care that works for you. Ascent Physical Therapy is conveniently located off Sunnyside Road in Happy Valley. We also love treating our neighboring communities of Damascus, Gresham, Clackamas, and Sandy at our top rated physical therapy clinic!