Ankle Pain
Ankle injuries are usually determined by how the mechanism of injury and the type of tissue that is damaged – ligament, tendon or bone. The Ankle joint is the articulation of the tibia, fibula and talus held closely together by ligaments. Ankle foot pain can range from a mild discomfort to gait-altering pain in the ankle and may be caused by local structures within or around the ankle joint. The onset of pain may be caused by an injury, such as a sprain, or by a degenerative condition such as arthritis. Ankle sprains make up approximately 80% of all ankle injuries and occur when the ligaments overstretch to a point where there may be a partial or complete tear. The most common mechanism of injury, which usually occurs in sporting activities including soccer, tennis and basketball, is a “rolled ankle” and the severity is determined by examination and scans.
Other causes to mention include rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and gouty arthritis.
Treatment
The most common and well known protocol for an ankle sprain is the RICE protocol in order to reduce the swelling initially but this method has been questioned by research lately (Check out this blog)
George St Chiropractic treatment for any injury depends on the severity and its grading. Our main focus is maintaining and restoring range of motion, reducing pain and increasing function. Both massage and functional active release will be performed on the muscles involved which may include the gastrocnemius, soleus, peroneus longus & brevis, tibialis anterior & posterior. George St Chiropractors will only perform gentle mobilisation techniques in the restricted planes of motion to gently breakdown the adhesions within the connective tissue structures. The patient may then graduate to a more elaborate exercise program to enhance stability and restore proprioception (our brains perception of the joint).
Heel Pain: Plantar Fasciitis & Heel Spur
The Plantar fascia is a fan-shaped, strong band of connective tissue which holds the foot bones and joints in place and attaches from the heel bone to the ball of the foot. Our main goal is to normalise the biomechanics of the foot, ankle and lower limb to avoid excess load through this tissue. Bruising or over-stretching of this connective tissue can cause inflammation and heel pain. In many cases, plantar fasciitis is associated with a heel spur. Pain is usually felt under the foot in front of the heel and tends to be worse when you first get out of bed.
Heel spurs tend to occur over a very long period of time (many months and even years). They are often found as incidental findings even before the presentation of pain. They occur from overly tight structures such as the plantar fascia, ligaments and muscles which pull on the heel bone (the calcaneus) where they attach. It is also associated with activities such as running, walking and jogging when these structures are not elastic enough and people may complain of having chronic intermittent heel pain.
Plantar fasciitis & heel spurs has a higher prevalence in:
- Middle aged & Older
- Flat-footed or high arches
- Constant aggravation through running or always standing
- Road Runners
- Overload through extra weight
Treatment
The George St Chiropractic Team’s treatment is aimed at restoring the elasticity to the tight structures and correcting any foot, ankle and knee mechanics. We use deep tissue massage and functional active release to lengthen the Achilles tendon, the muscles of the calf, plantar fascia and deep muscles of the foot. We often need to mobilise the foot, ankle, toes and knees to normalise the biomechanics. In some cases sports tape is used to support the arch and occasionally an orthotic may be recommended.
People usually respond very quickly. We will advise you on how to avoid recurrence. The main aim will be to:
- Decrease pain and inflammation.
- Identify and minimise mechanical dysfunction.
- Strengthen the small muscles of the foot to stabilise arch
- Remain compliant with home-stretching techniques