There are many different reasons why a person may experience foot and ankle pain. The anatomy of the foot is complex as it is made up of may small bones connected by ligaments, muscle and a connective tissue called fascia. They need to all work together to allow the foot and ankle to work properly. Our feet and ankles take a lot of stress in our lives and are often injured in falls or playing sport. Below is an outline of the most common foot and ankle areas to cause pain:
Flat Feet (Pes Planus) & Arch Problems
Patients commonly present in our clinic with dropped arches. This is when the arch on the inside of the foot has dropped down towards the floor. This may cause the foot to roll inwards (known as over-pronation). This is often visible by looking at the different wear pattens on the soles of our patients shoes. Flat feet can have an effect on the mechanics of the knee, hip and low back too. Over pronation can cause injury to the achilles tendon which is on the back of the ankle. This may also lead to shin pain. Some patients present at a young age with flat feet whereas in others, they develop these problems slowly throughout their life. Symptoms of flat feet can be changes in foot shape, swelling and pain.
Ankle sprains are common and vary hugely in there severity. They are the result of a sudden pull or twisting force through the ankle joint. Depending on how much damage has been done to the ligaments and fascia, there may be swelling, bruising, redness of the skin and significant pain; especially on weight bearing. Sometimes it is necessary to have the ankle x-rayed to eliminate the possibility of a broken bone. The more an ankle has been sprained in the past, the more unstable the joint becomes and its therefore more likely to happen again at some point in the future. Treatment should initially involve P.R.I.C.E – Protection, Rest, Ice, Compression, Elevation, however, as our recent blog post on the management of ankle sprains in children suggests, ‘optimal loading’ has become a key factor in the speed of recovery
This is when the ball of the foot becomes painful and inflamed. Its often a burning and piercing type of pain when there is any pressure placed through the area. Although it is generally thought of as not serious, the pain can be very debilitating. It can be brought about by running / jumping activities, poor fitting shoes or by having flat feet.
The plantar fascia is a fibrous band of connective tissue that runs lengthways along the sole of the foot between the heel and the toes. It supports the long arch of the foot. Plantar fasciitis is when this becomes swollen and painful. The pain is normally located in the instep of the foot and can commonly be felt as a sharp pain in the bottom of the heel when the foot starts to take weight through it. As with almost all inflammatory conditions, using cold on the area will help. It is important that the problem is not ignored for a long period of time as there is the possibility of developing a ’spur’ of bone on the heel which then becomes a more invasive treatment to solve.
The calcaneal tendon (achilles tendon) is located at the back of the foot / ankle, and is formed by the two muscles of the calf. It joins the calf muscles to the heel bone. Excess running / jumping / springing can cause pain within this area. Problems here, as with most of the foot and ankle, are associated with poor arch mechanics.
How can Osteopathy Help with Foot & Ankle Pain?
Our Osteopathic techniques are designed to stretch, loosen and mobilise inflexible joints. This can be very effective around the foot and ankle to reduce pain. Exactly what we will do to you would depend on what we diagnose, your age and your fitness.
As osteopaths we will look at the areas that are affected by or can affect the foot and ankle. These include the knee, hip and low back. An improvement in function here could have great benefits on how the foot and ankle works.
We may tape the foot / ankle if we think it requires extra stability. We always try to give advice on exercise and lifestyle in order to give you the maximum control over your own pain.
Occasionally, orthotics or other supportive aids may be advised. If we need to send you for x-rays or blood tests and its ok with you, we will ask your GP if they are happy to arrange this.