Ankle and Foot

It is truly remarkable that the ankle and foot function as well as they do when you think about how small they are and how they are able to support our entire body weight. Maintaining proper alignment, good foot wear and dynamic balance are critical elements in maintaining the health of these joints.

Ankle

The ankle is a very stable joint comprised of three bones. The lower end of the tibia (shin bone) and the strut-like outer bone (fibula) form the curve that fits the talus (upper foot bone). This design is very stable and is often described as a mortar and pestle. The ankle’s bony stability means it is at low risk for arthritis however sprains to the ligaments are quite common as is over-stressing muscles and tendons.

Ankle Injuries

When you are standing still the ankle bones fit quite snugly together meaning that there is a low risk of injury in this position. However if you jump and land with your toes pointed down, the stability is compromised making you more at risk of spraining your ligaments. The most common injury is to the ligaments at the outer aspect of the ankle (fibular), such as when you roll over on your ankle, however depending on how you land you can also sprain the inner ligaments (deltoid).

Before you sprain your ligaments the muscles around the ankle should react to prevent the injury. This can strain the muscles known as the stirrups (tibialis anterior and posterior) however these strains are more common with low-level repetitive movements that are poorly executed i.e. pronation during walking or poor foot wear. Achilles tendon strains and tears are another common cause of ankle pain.

The Foot

The foot is comprised of 7 bones in the rear and mid-foot and 19 bones in the front of the foot and toes. There are ligaments spanning between each bone and muscles that may traverse only a short distance or begin just below the knee and extend to the end of our toes.

The stability of the foot is highly dependent on its shape. Anatomists borrow the architectural term “keystone” to describe the shape and to help to explain the stability of the foot. This shape is considered one of the most stable in architectural design.

Injuries can occur to any structure however some of the most common conditions are over-stressing the big toe to cause a bunion, plantar fasciitis from over-pronation or stress fractures to the bones in the front of the foot from repetitive over-straining.

Treatment

At The Orthopaedic Therapy Clinic your therapist will partner with you to determine the best course of treatment for your injury. When you are having symptoms the most important first step is to understand what you have. Our therapists provide a thorough assessment to determine whether your symptoms are caused by the joint, ligament, muscles or are referred from other structures such as the low back.

Once the injury is diagnosed the next step is to determine where you are in the recovery sequence. Treatment is predominately determined by your stage of healing as more acute injuries usually require a plan to reduce pain and inflammation. Some ankles will benefit from bracing and when required we will help you to determine the best type of support to protect the injury as you recover. As you continue to heal the focus of your therapy shifts to the restoration of flexibility, rebuilding strength and re-establishing normal movement patterns. The final stage is to determine a strategy to help you return to full activity, sport and long-term prevention of re-injury.

Conditions we treat

Our therapists have extensive experience in the care of both acute and chronic ankle and foot condition. We work with clients after surgical repair of tendons i.e. Achilles tendon repair or removal of bunions. We provide therapy after sprains, fractures and dislocations both in non-operative and post-operative conditions.