The foot and ankle: A step-wise approach

Garry Kushnir, PT, DPT Apr12th 2021

by Dr. Garry Kushnir

Each foot is made up of 26 bones, 30 joints and more than 100 muscles, tendons and ligaments.  Since there are so many different bones and joints, it allows our feet to move in many different directions and planes.  This is very important because it allows the feet to conform to most different types of surfaces and terrains.  The other side of the mobility coin is instability.  In the body, excessive mobility generally leads to instability in a joint.

This is what happens when a joint, such as the ankle, is repeatedly sprained.  The ligaments that stabilize and prevent excessive movement of a joint have been repeatedly overstretched and cannot return to their original tension.  Physical therapy is able to help improve and correct this condition by strengthening the muscles in the foot and ankle that help stabilize it.  Also, improving a patient’s balance will also help prevent future sprains. 

Another common affliction of the foot/ankle complex is called plantar fasciitis.  This is the term for inflammation of the tough, fibrous tissue on the bottom of the foot.  This usually shows up as pain in that area that is worse in the morning when first getting out of bed.  Most people report that the first few steps are very painful and then subsequently less so.  A physical therapist can decrease the pain and decrease the amount of tightness in the tissue to help prevent it from coming back.  

Have you ever experienced pain in the back of the foot, just above the heel?  Then there is a good chance that you had some level of a condition referred to as Achilles Tendonitis.  The Achilles tendon, or heel chord, is the tissue that connects the calf muscle to the heel.  It allows a person to go up on their toes and perform jumps. This is usually caused by too much muscle tightness in the calf muscles.  This condition is very successfully treated with physical therapy.

There are a host of other conditions that affect the foot and ankle.  The majority of these conditions can be treated with physical therapy rather than more drastic measures.  Your physical therapist is a valuable resource and can be a great source of information.  Please feel free to contact yours with any questions that you might have.

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