Foot and Ankle Problems

The foot and ankle work together…although your foot and ankle are pain free, they may cause pain or weakness in other areas.

Key points to keep in mind about how your foot and ankle work:

• The arch of the foot and the muscles around the knee act as a spring to absorb shock.
• The arch flattens and the knee bends as body weight is transferred over the foot with each step.
• The arch of the foot reforms during gait to create a rigid lever to help propel the body forward.
• The small amount of motion that occurs at the joints of the foot and ankle has a tremendous
  impact on how joints and muscles of the leg, trunk and upper body function during any activity
  where the feet are planted on the ground.
• Motion occurs in three directions (planes of motion) at all joints of the body including the foot and
  ankle. These planes allow motion from front to back, side to side and in a rotational or twisting
  direction.
• When the foot first strikes the ground, the proper amount of controlled motion that occurs in the
  three planes of motion allows key muscles in the hip and torso to activate and stabilize the joints
  of the leg and spine. The foot is frequently the first link in the chain of joint and muscle reactions
  that allows us to perform dynamic activities such as walking, running, hitting a golf ball or hiking
  on uneven terrain with stability and balance.
• A pain free foot and ankle that is limited in mobility or does not provide enough stability can be a
  major contributor to pain and weakness in areas far removed from the lower leg.
• A foot with an arch that is too high or too low tends to be a poor shock absorber. This can lead to
  an overload of force on the joints and muscles of the hip and back.

Frequent Complaints:

Sharp pain in the sole of the foot that occurs when standing or walking after a period of sitting or
lying down…

• Heel or mid calf pain when walking or running
• Pain in the knees when ascending or descending stairs
• Hip pain, buttock or low back when walking or standing
• Difficulty balancing during dynamic activities such as throwing a ball, swinging a golf club, or
  walking on uneven surfaces.

Physical Therapy for the Foot and Ankle:

• Improving foot and ankle mobility may require manipulative treatment to improve your ability to
  move with balance and stability.
• Exercises should help stimulate and strengthen muscles around the leg that directly affect foot
  control as well as muscles of the hip and abdomen that control the shifting of body weight onto
  the foot. In our opinion, the best exercises are those that closely resemble actual foot function
  in an upright position.
• Shoe wear considerations are important to improve foot function. Your therapist or physician at
  Buffalo Spine and Sports Medicine will make a recommendation based on an examination of your
  foot and by observing how your foot moves when walking. Please refer to the article on
  Foot Types and Shoes.
• Orthotics (custom or “over-the-counter” shoe insoles) are occasionally required to help improve
  leg and trunk muscle activity. They are not a replacement for exercise and manual treatment.
  Many failures in orthotic management can be traced to either an incorrect orthotic prescription, for
  example a device that is too rigid for an already rigid foot, and/or a lack of exercise training to
  improve the patient’s leg strength and control of weight shifting in gait. At Buffalo Spine and
  Sports Medicine we have found that the best approach to foot management is to optimize the
  mobility and strength of your leg and foot first, then, prescribe orthotics to help improve and
  maintain foot and leg function.

by Walter Brown, PT