Common Foot / Ankle Injuries – Part 1

Feet. Totally the most neglected, and probably underappreciated part of the body.

Imagine being a foot; shoved into smelly, tight shoes all day. No ventilation. Minimal support. Sucks even more to be a women’s foot, strapped into those way too high heels.

Our feet get put through hell on a daily basis, and for many without a second thought; yet we rely on them for just about everything in life.

My dad tells me regularly ‘feet are one of the most important parts of your body’. You must always have a spare pair of dry socks and a sturdy pair of shoes. That’s from his army days but he is absolutely 100% right.

The foot is made up of 26 bones that form many small interconnected joints. There are a multitude of ligaments, tendons, muscles and cartilages as well as nerves and blood vessels all of which can be injured as a result of overuse or trauma.

There are a handful of more common foot / ankle related injuries that we tend to see on a regular basis. Most of these problems are due to a combination of overuse from repetitive loading, biomechanical insufficiencies and poor footwear choices.

Let’s go through the basics of a few of these.

PLANTAR FASCIITIS. Often felt as a painful area at the base of the heel caused by inflammation of the ‘plantar fascia’ which is a strong fibrous band on the sole of the foot. It attaches into the base of the heel and spans out along the arch to attach beneath our toes. Its main role is to maintain the arch on the inside of the foot. Repetitive running and/or jumping loads can overload this tight band of fascia resulting in pain at the attachment into the heel bone. Pain is often worst upon rising in the morning and in come cases can refer out into the middle of the foot.

ACHILLES TENDINITIS is a painful inflammation of the Achilles tendon at the back of the ankle. This tendon, formed by a continuation of the calf muscles, is one of the strongest, thickest in the body. Overload of this tendon is most commonly see in the running population and is usually due to increases in training load or intensity of training along with poor running biomechanics. The tendon itself can become hot, swollen and red. In more severe cases walking can be painful.

PERONEAL TENDINITIS is an inflammation of the peroneal tendons where they attach into the outside of the foot. Another problem commonly seen in runners, especially those that run on uneven surfaces such as sand or bush trails or people who play sports that require a lot of change of direction. Such activities place a lot of stress through the peroneals as they work hard to stabilise the ankle. Pain is felt along the outside of the foot and can be accompanied by swelling.

Treatment for the above conditions generally involves reducing inflammation, rest from aggravating activities, soft tissue releases to tight overactive muscles & correcting any biomechanical insufficiencies. Training loads and footwear should also be discussed.

STRESS FRACTURES result from excessive impact placed through one particular region. Repetitive loading can be too much for soft tissues and joints to absorb, this stress can get transferred to the bone. Initially the lining of the bone can become inflamed but if loading continues then this can weaken the bone and result in a stress fracture. The most commonly affected bones in the foot include the second & third metatarsal (toe) and in a bone on the inside of the foot called the navicular. Commonly seen in runners due to the repetitive action of the foot striking the ground.Pain will generally worsen with activity and ease with rest. Early diagnosis and immediate rest are important to the recovery of this problem. Stress fractures take 6-8 weeks to recover and will often require a period of time in a walking boot.

Living an active lifestyle is awesome and everyone should be part of that BUT when you put your body through repetitive stresses each and every day you do become vulnerable to suffering these sorts of injuries. Be smart when it comes to training loads and frequencies, listen to your body & make sure you have supportive footwear.

Those beautiful white free fly knit weave’s that cost you $200 + are ‘latte shoes’ only. Invest in a pair of supportive shoes for exercise & sport.

Oh and get a foot massage every now and then. They deserve it.

If you think you may be seeing signs of any of these problems (or having any other weird wacky foot pains) make sure you get them checked out by a physio. Often catching these problems early will mean a quicker and easier recovery.

Stay tuned in the coming weeks for Part 2 of this blog which will go cover more about the acute injuries we see in the foot & ankle area. Think ankle sprains, calf tears.