Foot and Ankle Injuries

Stress Fractures

Stress fractures are very small micro fractures and are often found in the foot or shin region. It occurs usually as a result of repeated strain over a period of time. These types of fractures are often missed on x-ray but can be picked with a bone scan. Initially symptoms are often unperceivable, but can then present as pain with activity and eventually also at rest. The area is also often tender to press upon manually. If an actual fracture has occurred a period of rest will be required, but it remains of paramount importance to determine why the bone was put under such stress, whether due to a change in training or due to the body and postural malalignment. Physiotherapy has a role to play throughout the whole process from assessment to return to function and sport. It is imperative to correct technique and rule out future occurrences.

Shin Splints

Shin splints is an umbrella term often used to relate to pain below the knee along the shin bone or even in the calf. Pain is felt either along the front of the shin bone or along the back of the bone, especially in the lower third. It is an inflammatory problem in nature but if left unattended it may even progress to the development of stress fractures. It is very important to seek treatment from your physiotherapist early on so as to speed up the recovery process. Rest and massage alone are not enough to help this problem, we must ascertain why the muscles are being overused and thus causing repetitive trauma. Therefore a detailed assessment should include the whole leg, pelvis, foot and trunk stability both at rest and on the move. This will highlight the cause of the problem to allow a tailored corrective exercise treatment.

Severs Disease

Severs disease is an inflammatory problem found in the younger athlete and is related to periods of sudden growth. The problem is located at the back of the heel region. During a period of growth the muscles grows a little slower that the bone and can ‘tug’ on the heel area where it becomes inflamed. Although rest is a primary treatment option, Physiotherapy is very important in helping to decrease pain and assist in activity modification. A guided programme of strengthening and foot control exercises will be required during recovery along with maybe a heel raise to offload the area. There should be no lasting problems after this condition has subsided.

Ankle Tendonopathy

A tendonopathy is a problem where there is an irritation, inflammation or degeneration of a tendon. This is very common in athletes who do repetative movements with the feet and ankles, and is therefore very common in dancers.

Symptoms include pain and loss of movement. Palpable nodules may even appear within the tendon. Within the ankle region the tendons most commonly affected are that of Tibialis Posterior, which controls the arch, the Achilles tendon and the FHL (Flexor Hallucis Longis) if the big toe is overused.

It is a condition that is treated with great effect with physiotherapy and guided exercise. It is however essential to have a thorough assessment of posture, leg and foot placement, strength and control when on one leg as weaknesses in these areas can delay healing enormously.

Treatment should included a release of muscle tension and then a strengthening program incorporating correct posture. Correct core activation and leg strength from foot to hip will need to be addressed. We may also look at your footware and determine whether any support, taping or corrective devices need to be used.

Sprained Ankle

An ankle sprain is damage to one or more of the ligaments that support the ankle joint. There will almost always be an ‘incident’ wherein the ankle rolls and the person looses their footing. This is normally followed with pain over the front and side of the ankle. You may be able to walk on the foot again immediately, or be unable to bear any weight on the foot at all. Symptoms include pain, swelling and bruising and loss of range due to the previous two symptoms. Healing is quite slow as ligaments have a poor blood supply and guided physiotherapy is essential for both assessment, diagnosis and successful rehabilitation. It is important to continue rehab until discharge, as incomplete treatment will leave the ankle vulnerable to further sprains