The foot is a complex mechanical structure of the human body composed of 33 joints, 26 bones, and more than a hundred muscles, tendons, and ligaments that all work together to bear weight, allow for locomotion, and transmit force. The most common causes of foot and ankle pain are due to:
-Awkward landings -Rolling the ankle -Overuse or ‘incorrect loading’ (conditions such as tendinopathies and plantar fasciitis) -Improper footwear – high heeled shoes in particular can cause problems -Pathological. Although it's very rare, bone tumours can be found in the lower portion of the tibia and fibula
Plantar fasciitis. A condition characterised by pain in the arches of the foot, often debilitating pain for the first few steps in the morning or after periods of inactivity.
Heel fat pad. (HFP) Often mistaken for plantar fasciitis, - pain after being immobile, pain underneath the heel and pain that improves with rest. This will feel like a bruise and make it very uncomfortable to walk.
Ligaments – There are many ligaments that control and support the ankle joint. This enables mobility for our bodies, however sometimes they allow too much movement and these ligaments tear or over-stretch. The most common ligament injury is the ATFL (anterior tibiofibular ligament) which is damaged on a common inversion sprain. Other ligaments such as the deltoid ligament, one of the strongest ligaments in our body, often this ligament when stretched will pull off a small chunk of bone from its attachment point. This can lead to pain, instability and a longer rehabilitation.
Tendons – The achilles tendon - connects your calf muscles to your heel. This is commonly overused and aggravated as a result. Other tendons in the foot and ankle may be aggravated particularly through traumatic injuries, including the peroneals and tibialis posterior.
Stress Fractures – Often referred to as a hot spot. Stress fractures will require rest and gradual exercise increase to allow adequate healing. Depending on the location this may require immobilisation in the form of a moon boot.
These are just a few common injuries but there are many structures throughout the foot and ankle that will cause pain. It’s important to book an appointment at the onset of pain, to have your injury evaluated to avoid long term issues.
Treatment and management This will depend entirely on the injury that’s occurred, but the most common methods are:
-Soft tissue massage -Joint mobilisation -Stretching -Manipulation -Exercise prescription