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Foot / Ankle

 

Achilles Tendonitis

2955313_origDiagnoses: Achilles tendonitis is an overuse injury to the tendon that connects the calf muscle to the heel.

Symptoms: Symptoms typically begin as a mild ache in the back of the leg or heel after participating in sporting activities or running. More severe pain is usually noted following prolonged running, stair climbing, or sprinting. Morning pain and stiffness might also be present.

Causes: Achilles tendonitis typically results from an overuse injury or repetitive strain of the Achilles tendon. Injury to this tendon can result when walking, running, jumping, or other exercises that require pushing off with the toes. Risk of injury also increases with age and when the intensity of the activity performed is not done so on a regular basis.

Our Physical Therapy Treatment: Treatment will be dependent on the patient and their response to exercise. Treatment might include:

  • Mechanical diagnoses/treatment
  • Stretching exercises
  • Lower extremity strengthening exercises
  • Manual mobilizations
  • Soft tissue mobilizations
  • Task specific performance analysis

Tarsal Tunnel Syndrome

tarsal-tunnel-anatomical-illustrationDiagnoses: The tarsal tunnel is a canal that forms between the bump on the inside of the ankle and a band of ligaments that stretches across the foot. The tibial nerve runs through the tarsal tunnel and provides sensation to the bottom of the foot. When the nerve is compressed, it is called tarsal tunnel syndrome.

Symptoms: Symptoms of tarsal tunnel syndrome can vary but typically include:

  • Shooting pain in the foot
  • Numbness
  • Tingling/burning sensations of the foot

Causes: Tarsal tunnel syndrome can occur following injury or disease, or due to the shaping of a person’s foot. Other potential causes include:

  • Flat feet/fallen arches
  • Excessive swelling due to an injury
  • Arthritis or diabetes
  • Other enlarged structures including varicose veins, cysts, swollen tendons, or bone spurs

Our Physical Therapy Treatment: Treatment will be dependent on the patient and their response to exercise. Treatment might include:

  • Mechanical diagnoses/treatment
  • Stretching exercises
  • Lower extremity strengthening exercises
  • Manual mobilizations
  • Soft tissue mobilizations
  • Splits/orthotics
  • Task specific performance analysis

http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/peripheral_nerve_surgery/conditions/tarsal-tunnel-syndrome.html

Toe Degenerative Joint Disease

A00209F03Diagnoses: Degenerative joint disease refers to a gradual “wear and tear,” in which the cartilage of the joints in the toes diminish over time.

Symptoms: Joints will typically be painful and inflamed, however severity is increased over time. Other symptoms could include:

  • Pain with motion or vigorous activity
  • Joint tenderness
  • Swelling, warmth or redness
  • Morning pain or pain after rest
  • Difficulty walking

Causes: Degenerative Disc Disease develops with general wear and tear of the body. However, increased risk factors include smoking, obesity, heavy physical labor, and a sedentary lifestyle.

Our Physical Therapy Treatment: Treatment will be dependent on the patient and their response to exercise. Treatment might include:

  • Mechanical diagnoses/treatment
  • Stretching exercises
  • Strengthening of muscles surrounding the joint
  • Manual mobilizations
  • Soft tissue mobilizations
  • Task specific performance analysis

http://orthoinfo.aaos.org/topic.cfm?topic=a00209

Sesmoid Pain

Image_Sesamoid_Fracture_Ellis_YPCDiagnoses: Sesmoids are bones in the body that are not connected to any other bones and are instead, imbedded in tendons. Two small sesmoids are found on the underside of the foot near the big toe, where they act as pulleys for tendons and assist with weight bearing. Like any other bone, the sesmoid or surrounding tissues can become injured, resulting in pain.

Symptoms: Sesmoid injuries typically result in:

  • Pain under the big toe, on the ball of the foot
  • Swelling
  • Bruising
  • Pain with motion of the big toe

Causes: Like any bone, pain can result at the sesmoid due to fracture. A person might also experience pain secondary to inflammation of the tendons surrounding the sesmoid. This is common with activities including repetitive activities involving the foot and ankle such as ballet and running.

Our Physical Therapy Treatment: Treatment will be dependent on the patient and their response to exercise. Treatment might include:

  • Mechanical diagnoses/treatment
  • Stretching exercises
  • Strengthening of muscles surrounding the bones
  • Manual mobilizations
  • Soft tissue mobilizations
  • Task specific performance analysis

https://www.aofas.org/footcaremd/conditions/ailments-of-the-big-toe/Pages/Sesamoiditis.aspx

Ankle Sprain

AnkleSprains_LGDiagnosis: An ankle sprain occurs when the ligaments holding the ankle joint together stretch beyond their normal length. Ankle sprains are classified into grades. Grade 1 is mild, grade 2 is moderate and grade 3 is severe. Some sprains are severe enough that the ligament will tear.

Causes: This injury occurs when the ankle rolls, twists or turns in a way that over stretches the ligaments such as landing from a jump or even stepping off a curb.

Symptoms: Some people report hearing or feeling a “pop” with pain in the ankle joint. Swelling and bruising occur soon after and you may have difficulty placing weight through the foot.

Our Physical therapy Treatment: The first 24-48 hours of treatment after an ankle sprain should consist of resting the ankle and controlling the swelling. You can rest your ankle in an elevated position, use compression bandages and ice to control swelling. Crutches may be indicated depending on the severity of the sprain. As you start to recover, treatment may consist of:

  • Mechanical evaluation/treatment
  • Range of motion exercises
  • Strengthening and stabilization
  • Balance training
  • Functional and sport specific exercises.

Plantar Fasciitis

Plantar-Fasciitis[1]Diagnosis: The plantar fascia is a thick band of connective tissue that runs from the heel to the ball of the foot and acts as a support to the arch. This tissue can get inflamed causing pain in the bottom of the foot usually with the first few steps of walking in the morning.

Causes: Plantar fasciitis is causes by repetitive stretching to the tissue. Risk factors include:

  • Prolonged standing or weight bearing activity
  • Rapid increase in length or intensity of activity
  • Tightness in the calf muscle
  • Overweight
  • Age (between 40 and 60)

Symptoms: Plantar fasciitis typically presents as a stabbing pain in the bottom of the heel and tightness/tenderness in the arch

  • First thing in the morning
  • Prolonged standing and walking
  • Walking barefoot or in shoes with poor arch support
  • After an intense running session


Our Physical Therapy Treatment: Goals of therapy will be to decrease pain and will focus on

  • Mechanical diagnosis and treatment
  • Improving lower leg flexibility
  • Manual mobilizations
  • Proper footwear
  • Addressing any lower leg malalignments