FOOT AND ANKLE INJURIES

FOOT & ANKLE INJURIES

Foot and ankle pain can take many forms, from acute soft tissue injuries to the ligaments, bones and tendons in the ankle, to normal age-related degenerative processes such as osteoarthritis. Ankle sprains are very common both in sport and everyday life, and there is substantial evidence to demonstrate the effectiveness of physiotherapy in their management. Other common conditions we treat include achilles tendinopathy, plantar fasciitis, Tibialis posterior dysfunction and foot/ankle fracture.

How can physiotherapy help?

There are many treatments physiotherapists can offer for foot and ankle pain. These will vary depending on the exact condition and the specific deficits found on assessment. Treatment will usually aim to restore correct movement to the foot and ankle, where possible in order to allow a normal walking pattern, as well as either functional movements including squatting and using stairs. Treatment is then likely to aim to improve strength and balance in the ankle and leg in order to enable return to all normal activities. Hands on therapy including joint mobilisation and massage is helpful with some patients with ankle pain. We can suggest off the shelf or custom-made orthosis in addition to exercises in order to manage certain conditions. Furthermore, we can provide moon boots to rest the ankle in acute injuries including ankle sprains. 

Expectations/timeframes and outcomes - research based 

Ankle sprain - For chronic lateral ankle ligament sprains research suggests that 4-8 weeks of physiotherapy training programmes involving strength and balance exercises led to improvements in pain, function and risk of recurrence. For acute injuries further research demonstrates that 4-8 weeks of physiotherapy exercise was effective at reducing the risk of recurrence. The use of bracing is also recommended at return to sport, and physiotherapists can prescribe and recommend appropriate braces. 

Achilles tendinopathy - For achilles tendinopathy research suggests that 12 weeks of physiotherapy including a progressive loading programme of targeting the calf and achilles tendon, whilst monitoring the pain response throughout is effective in improving pain and disability. 

Posterior tibial dysfunction - A recent study has shown that eccentric strengthening exercises for 6-12 weeks are effective at reducing foot pain and disability compared to other forms of exercise and no treatment. Therefore this should be advocated in the early stages of PTTD under the guidance of your physiotherapist.  

 

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