Foot and Heel

foot-heel

The ligaments of the ankle joint are comprised mainly of the medial (inner) and lateral (outer) collateral ligaments. These are extremely important in the stability of the ankle.

 

ANKLE LIGAMENT INJURY

INTRODUCTION       

The ligaments of the ankle joint are comprised mainly of the medial (inner) and lateral (outer) collateral ligaments. These are extremely important in the stability of the ankle.

The outer or lateral collateral ligament comprises of:

Front: Anteriortalo-fibular Ligament
Middle: Calcaneo-fibular Ligament
Back: Posterior talo-fibular Ligament

The inner or medial collateral ligament is thicker and stronger than the outer ligament as all its bands mass around the inner part of the ankle. That’s why it’s relatively common to see lateral ligament injuries whereas the medial ligament is seldom affected. Since lateral ligaments are the commonly injured ones, we’ll focus on these injuries in this section.

 

 

CAUSES

Inward twist of the ankle is the most common cause for the lateral collateral ligaments injury which could happen when walking with high heel shoes, landing on the uneven ground, playing sports such as basketball and so on.

 

 

SYMPTOMS

Depending on how serious the ankle sprain is, the symptoms of ligament injury may include the following:

  • Pain on the outer side of the ankle which gets aggravated by pressing or inward stretch of the ankle
  • Swelling
  • Redness and warmth
  • Limping because of the pain

 

TREATMENT

The aim is to reduce the inflammation and swelling and to lessen the pain and help in healing.

Medical Treatment – The doctor may prescribe some anti-inflammatories and pain killers if necessary.

 

 

PHYSIOTHERAPY

  • Cryotherapy: To reduce the inflammation and swelling
  • Ultrasound: To reduce inflammation, promote healing, increase blood circulation of this area and prevent adhesion inside.
  • Interferrential: To relieve the pain and decrease the inflammation
  • Laser: Aids in pain management and helps with wound healing
  • Ankle Taping: Taping or strapping supports the ankle, reducing the stress from the involved muscles and tendons.
  • Friction Massage: To break up the scar tissue and prevent the adhesion
  • Exercises: To maintain the joint’s range of motion and muscle strength to improve the functional ability to get the patient back to the normal daily activities
  • Gait assessment: Assessment and correction of walking techniques to avoid further strain to surrounding structures.
  • Balance and proprioception exercises: To improve muscular responses in the ankle and allow for safe return to work/ sports/ daily activities

SELF-HELP TIPS

  • Rest and elevate the affected leg to prevent further injury and reduce the swelling
  • Use ice pack on it to reduce the inflammation and swelling
  • Use an ankle brace
  • Use a good, supportive shoe
  • Avoid H.A.R.M – Heat, Alcohol, Running (or any strenuous exercise) and Massage in the acute(inflamed) stage.

 

Call us for an appointment or send your queries to: info@physioasia.com

HEEL PAIN

Heel pain is a common condition characterized by a sharp pain or discomfort in the heel on weight bearing. It settles down quickly if treated early and given enough rest but may become worse and chronic if initial symptoms are ignored.

The plantar fascia is a thick and tough band of fibrous tissue, running along the base of the foot from the heel to the base of each toe.  It stabilizes the many small joints between the foot bones and acts as shock absorber during weight-bearing activities like standing and walking to high impact activities like jumping, sprinting, etc.

 

COMMON CAUSES OF HEEL PAIN:

Heel pain can be either due to plantar fasciitis or heel spur syndrome.

 

PLANTAR FASCIITIS

As a person gets older, the fascia becomes less elastic. The heel pad becomes thinner and loses the capacity to absorb as much shock. There may be some swelling, small tears or bruises in the plantar fascia with the pounding force on the heel.

The younger people who are more active in sports, may suffer from heel pain too.

RISK FACTORS

  • Being obese/overweight
  • Diabetes
  • Prolonged standing or walking
  • Increasing activity over a very short period of time
  • Injury
  • Being flat-footed or having a high arch
  • Wrong or improperly fitting footwear
  • Wearing high heels for long will cause tight calf muscles and plantar fascia due to the foot positioning
  • Heel pain sometimes results from excessive turning and flat foot which puts additional stress on the fascia and may ultimately lead to plantar fasciitis.

 

 

HEEL SPURS

A heel spur is a bony growth that develops on the underside of the heel bone, where the fascia is attached. This is a result of excessive and repetitive pulling of the plantar fascia on the heel bone. The heel spur may press into the sensitive nerves and soft tissues, causing pain in the foot. A heel spur can develop along with plantar fasciitis, but may also occur by itself.

Heel spurs can be seen as hook shaped protrusions in X-rays.

HEELS SPURS ARE COMMONLY SEEN IN:

  • Middle-aged patients
  • Athletes are especially prone to heel spur due to the repetitive stress on their heels
  • Abnormal walking pattern or pronation i.e. in turning of the foot or when the foot regularly hits the ground in unusual ways, damage can occur since tissues become stretched or stress excessively, leading to formation of a heel spur.

 

 

SYMPTOMS

  • Burnng, stabbing, or aching pain in the heel or along the arch of the foot
  • Most people would feel it first thing in the morning because the fascia ligament tightens up during the night sleep.
  • Resting provides only temporary relief.

 

PHYSIOTHERAPY

In most cases, plantar fasciitis/ heel spur does not require surgery or invasive procedures to stop pain and reverse damage. Conservative treatments are usually all that is required. Physiotherapists are able to determine the cause and type of your heel pain and treat it accordingly. Treatment involves pain relief and lower limb strengthening program.

Radial Shockwave Therapy: A new non-invasive treatment that works by initiating a healing response by the body by causing blood vessel formation and increased delivery of nutrients to the affected area.

Ultrasound: improves cell metabolism and cell membrane permeability, thus enhancing tissue healing.

Laser: Aids in pain management and helps with wound healing.

Mobilization & Manual Therapy: Significant effect to restore any restricted mobility between the foot bones or muscle. This helps to reduce pain and stiffness.

Foot Taping: Taping supports the foot, placing stressed muscles and ligaments in a restful state.

Stretches/Strengthening Exercises: Stretching the tight muscles/fascia as well as some leg/ankle strengthening exercises can help to reduce the strain on the fascia.

Although heel pain may generate only slight discomfort, they can worsen and generate severe pain over time. In most cases, luckily, treatment only needs to be through conservative methods. Often, heel pain sufferers try to ignore initial pain and other signs of damage.

However ignoring the problem only makes it worse, and it’s important to seek help and treatment as soon as possible to prevent further damage.

 

OUR TIPS

  • Visit a physiotherapist and have it treated early.
  • Wear the proper shoes for each activity.
  • Do not wear shoes with excessive wear on heels or soles.
  • Prepare properly before exercising.
  • Pace yourself when you participate in athletic activities.
  • If obese, lose weight. 

Call us for an appointment or send your queries to: info@physioasia.com