Foot & Ankle Injuries
We see all sorts of ankle and foot injuries in our clinic. Some caused by general incorrect or overuse, some caused by sudden unavoidable accidents, some caused by other medical conditions. Either way, they can be debilitating to your mobility and training program.
Overuse injuries, like achilles tendinopathy (tendonitis), plantar fasciopathy (fasciitis) and bone stress injuries can be extremely frustrating and are common in our running and CrossFit clients who spend a lot of time running, skipping and jumping.
More acute injuries, like ankle sprains and muscle strains tend to happen more due to unfortunate accidents or sudden loads, but both can usually be treated successfully in our clinic.
Some of the common issues we treat in athletes and the general population are:
Achilles Tendinopathy
Achilles tendinopathy is the updated term for achilles tendonitis, and is an umbrella term for what can happens over time when the achilles is asked to do more than it has the capacity, or strength for.
There are different kinds of tendinopathies which often require very different treatments, so it is important to ensure you have an assessment with an experienced Physiotherapist to ensure you are treating the correct one.
3 common types are:
True Tendinopathy: Usually pain in the middle of the tendon, is often painful in the morning and tends to warm up with activity.
Peritendonitis: Not painful in the morning and tends to worsen with repetitive movements. This is the kind that may have inflammation involved.
Insertional Tendinopathy: Pain is lower down, closer to the heel and is painful in certain positions, particularly when stretched into end range (ankle dorsiflexion) and when compressed or squashed, for example by a shoe.
Treatment:
Treatment times vary a fair amount, with mild cases that are caught early often being managed within a couple of weeks and more severe, long standing issues can take around 3-6 months.
Load management, possibly with a period of time off to allow pain to settle, and appropriate re-strengthening of the tendon and supporting muscles is normally the gold standard of treatment.
Stretching, massage and dry needling are usually less helpful but in some cases may be appropriate.
Anti-inflammatory medication might be useful intermittently for peritendonitis, but is often not helpful in the long run or for true tendinopathies.
Ankle Sprains
Ankle sprains happen when the ankle is suddenly bent into a position which overstretches or tears the ligaments that stabilise the joints.
The grade of the sprain will influence the treatment and timeframe of recovery:
Grade 1: A mild stretch or tear of a few ligament fibres, can be treated with Physiotherapy in around 2-4 weeks.
Grade 2: A moderate tear involving more fibres, can be treated with Physiotherapy in around 4-6 weeks.
Grade 3: A severe or complete tear, will often require immobilisation (with a boot and crutches), or in rare cases might require surgery. Recovery is usually 3+ months.
Treatment:
It’s important in severe ankle sprains to clear the ankle of any fractures which can sometimes occur at the time of injury. You may need to have an X-Ray, but once this is cleared and Physiotherapy can start with a fairly straight forward plan.
In your first session we will often tape or brace the ankle to help support it in the early days which often helps the pain quite strongly.
From there we will begin you on a gradual exercise program to encourage stronger healing of the ligaments and a return of stability of your ankle.
A few of the other injuries or issues we treat:
Plantar fasciopathy/fasciitis
Gastrocnemius strains; “pulled calf muscle”
Bone stress injuries and fractures
Ankle mobility issues. e.g. dorsiflexion in the squat