Category Archives: Ankle/Foot Health

Common ankle injuries are discussed with tips to help/prevent ankle injuries.

Plantar Fasciitis

Ever wake up in the morning, walk to the bathroom and feel a pretty intense pain along your heel or at the bottom of your foot? You will attempt to walk through it and you will notice as the day goes on the pain will get better. If this sounds like you then you may be experiencing symptoms of plantar fasciitis.

What is it? The plantar fascia is a thick band of connective tissue that runs from the heel of the foot to the base of the toes. When this connective tissue becomes inflamed it is known as plantar fasciitis which is a common cause of foot pain.

What caused this? The symptoms of plantar fasciitis are due to a number of causes. It can be due to being overweight or sudden changes in weight gain, poor arch of the foot (such as flat feet), or due to an overuse injury. An overuse injury resulting in plantar fasciitis is usually related to those who are frequent runners or a person who works on their feet 8 hours a day resulting in excessive stress/strain to the foot.

How do I treat it? When one experience this pain you should elevate your foot and ice it to help bring the inflammation down. You should also make an appointment with your doctor who will design a treatment plan for you which MAY include injections, orthotics or physical therapy.

In the meantime, here are some at home exercises that can help ease your pain. See your local physical therapist for additional stretches and strengthening exercises that will help improve your condition.

Use of a golf ball to roll back and forth on your plantar fascia. Be sure you are using adequate pressure as you roll the ball back and forth.
Use of a golf ball to roll back and forth on your plantar fascia. Be sure you are using adequate pressure as you roll the ball back and forth.
Perform same technique as you would with the golf ball.
Perform same technique as you would with the golf ball.
The use of a frozen water ball is my favorite. The cold helps to reduce inflammation and the rolling of the water ball back and forth helps to stretch out the plantar fascia.
The use of a frozen water ball is my favorite. The cold helps to reduce inflammation and the rolling of the water ball back and forth helps to stretch out the plantar fascia.

Physical Therapy BEFORE surgery?

Although this has become a common treatment plan for surgical patients many patients consistently ask me.. why? If you’re about to let someone cut into your body to repair something wouldn’t you want your joint to be functioning at its maximum capacity before someone grabs a scalpel?

1-2 months of physical therapy before surgery can mean full range of motion and improved strength before going under the knife. The stronger your are before surgery and the better your joints are moving before surgery means for a happy and less pain-free recovery later.

Here is a brief list of common surgeries that can benefit greatly from pre-operative physical therapy

  • Torn rotator cuff/labral repair – improve shoulder motion and strength before surgery to return to daily activities with improved ease after surgery
  • Total Knee/Hip Replacement – a stronger knee is a happier knee/hip after surgery, especially in populations over 50 where for some there can be significant weakness
  • Lumbar Discectomy/Fusion – a strong core before surgery means more support for your back after surgery
  • Cervical Discectomy/Fusion – improvement in posture and flexibility in the neck can reduce stress to the cervical spine
  • Meniscus or ACL repair – depending on the severity of injury there can be a severe loss of motion/swelling before entering surgery. It pays to have good range of motion and to get swelling under control before surgery – both of which can be achieved with pre-operative physical therapy

So- before you let someone convince you to go under the knife immediately, think about the potential that pre-operative physical therapy can do for you in the long run.

Do you buy the right sneaker?

We all have probably heard of the kinetic chain in the body at some point. At times, many joint problems start with the foot. The way a person walks and the type of foot wear they choose to wear can be a factor to pain in the foot, knee, hip, or even the low back. Remember, the foot bone’s connected to the leg bone, the leg bone’s connected to the knee bone, etc etc

So how can we pick out the right type of sneaker to wear? Well, I’m sure this is not news to anyone but always make sure when you try on the sneaker there is a good arch support. Why arch support? Well arch support helps the foot perform with correct mechanics when walking or running to prevent abnormal stresses on other joints such as the knee, hip, and back. However, there is another simple test you can do the next time you go to buy sneakers to know you are buying one to further help match the correct mechanics of the foot.

Take a look at these pictures

IMG_4199 IMG_4185

Notice where the foot bends in these pictures. This is where the foot bends each time we walk and push-off with our foot. Now, take a look at this picture


Notice when I squeeze the sneaker it bends in the same position our foot should? Well, this is one way to know you are buying a good show that will match the mechanics of your foot when you are walking. At times you may pick up a sneaker that bends directly in the middle. (which would be under the S on the sneaker in this picture) If that happens, when you wear the actual sneaker it will not match the mechanics of the foot when walking which in turn can cause pain to other joints.

I hope this simple tip helps. Oh, and don’t worry.. I always look like the weird one in the sneaker store!


Ankle Sprains – Brace it or leave it?

If you are an athlete or just plain clumsy like myself I am sure you have twisted your ankle at any given point. Sometimes we can walk it off and other times it results in swelling and pain when we attempt to stand or walk. However, it is important to know that you should NEVER apply a brace unless the injury was a fracture or dislocation (which at this point I hope you have seen your MD). Most people want to throw a brace on immediately because it temporarily relieves pain. So what’s the problem? Well a brace can actually make your ankle worse by restricting your motion and causing your ankle to become even more stiff. If you leave a brace on for a long time you will actually begin to lose motion in your ankle which will in turn make it even harder to walk normally.

So, what should you do?

If you ever sprain your ankle bad enough that you have swelling then you should always remember R.I.C.E.

  • R – REST
  • I – ICE

This is critical to perform the first 72 hours after any ankle sprain that involves swelling. You should lay on your back with the affected ankle above your heart (elevation) with ICE around your ankle. You can do this by stacking pillows up on your bed/couch to keep your leg elevated. Just remember, ICE ICE ICE! Ice helps constrict blood vessels to reduce overall swelling. You should also be aware that while in this position you should try to move your foot up/down as well as make circles with your foot. When you do either of those 2 exercises the muscle in your calf acts as a pump to help move the swelling out of your ankle.

With that said, DO NOT be afraid to move your ankle. It may be painful at first but the faster you get it moving again the faster you will feel better. The longer you “baby” your ankle and not move it the more stiff you will become. When this happens you will have the pleasure to be spending long days in physical therapy with me trying to regain your motion/strength.

To recap – Ice & rest for the first 72 hours, DO NOT brace, and DO NOT be afraid to move it!

One final simple exercise to get your ankle moving – try to move your ankle as if you were writing the letters of the alphabet. This will help get your ankle moving in all directions.

Please let me know if you have any questions about this or any other tips/advice I give! Have a great night.