FOOT AND ANKLE PAIN
The foot and ankle joints are very complex parts of the body designed to take our whole weight with each and every step we make.
The foot and ankle has to be many things all at once, for example it is required to spring and sprint, it has to absorb force and recoil numerous times everyday, it has to compensate for uneven, slippery surfaces whilst also being stiff and strong and or mobile and supple.
The foot and ankle have 26 bones and over 30 joints, more than 100 muscles, ligaments and tendons all of which can be a source of pain, stiffness and dysfunction. Foot and ankle pain is a very common presentation to emergency departments and GP surgeries accounting for 10 to 15 percent of all musculoskeletal injuries.
Pain is by far the biggest issue with foot and ankle problems which is usually well located to a specific area, so not as hard to differentially diagnose as back pain for example. It is always useful if you can put one finger on where it is sore, it will give your physio a really good idea which structures maybe affected.
However there still is possibility that pain in your foot and ankle can be coming from your lower back, hip or knee (referred pain). So you will always be screened through your assessment to eliminate other structures as a source of foot and ankle symptoms.
COMMON CONDITIONS AFFECTING FOOT AND ANKLE
The expert Physiotherapists at Fay Pedler clinic are well versed in foot and ankle anatomy and function so you can be assured of correct diagnosis and appropriate treatment plan.
Thorough history including onset of symptoms, mechanism of any injury, force involved, site and spread of pain, pins and needles, numbness, muscle wasting, weakness, instability and loss of function will all be discussed.
Examination will include:
- Active and passive range of movement tests of all joints
- Strength testing with manual resistance or weights
- Functional tests. To replicate common positions or movements we might perform on a daily basis. Such as squats, lunges, steps, jumps and hops.
- Balance. This is an excellent way to find out how stable and strong the foot and ankle feel
- Special tests including ligament stability tests and specific joint tests looking for re-production of symptoms and/or instability
- Palpation. It is very important to palpate and feel the injured area so we can confirm site of tenderness, degree of swelling and degree of irritability
- Neurological examination. Especially relevant if there is any numbness, tingling, weakness or muscle wastage present. This will involve checking sensation, reflexes and strength
- Foot posture and position
- Screening Lumbar spine, hip and knee for signs of stiffness or weakness
- Initial advice Including POLICE (Protection Optimal Loading Ice Compression Elevation).
- Advice on normal timescales for recovery and what to expect from rehab
- Joint mobilisations. Helps to free up joint stiffness following injury
- Massage and other soft tissue techniques to release tension and tightness in muscle, ligaments and tendons
- Taping. Can help support an injury especially in early phase of recovery
- Shockwave therapy
- Electrotherapy including ultrasound and TENS. Mainly used for pain relief
- Progressive strengthening exercises/programmes
- Post-operative care. We are well versed and have extensive experience in recovery and rehab following foot and ankle surgery. Including Scarf and Aiken osteotomy, following ankle fracture, joint replacement/fusion, tendon repair etc.
- End stage sport specific rehab, Hop, Skip and Jump
- Agility tests
- Onward referral for screening xray if required or Orthopaedic referral for longer term conditions. We are very familiar with the local NHS and Private treatment pathways, so on the rare occasions that conservative physiotherapy input has not provided the desired outcome we will (with consent) write a detailed discharge summary advising reasons for further scans and onward referral