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A sprain is when a ligament is over stretched. You can sprain the ligaments on the outside of your ankle, the inside, or the front. A sprain to the outside of the ankle is the most common. People usually get this injury when they “roll” the foot over by landing awkwardly as they come down for a jump, or walk/run on uneven surfaces and land on the outside of the foot. The outside of the ankle has 3 major ligaments, and the severity of the sprain is categorized by which ligaments are involved. The inside of the ankle has 1 very thick ligament, and is not injured as often as the outside. There is also a high ankle sprain. This is when the ligaments through the front of the ankle and up the leg are stretched. Those ligaments make up your ankle syndesmosis. All 3 can be associated with a fracture to the area as well. Treatment consists of rest/bracing, restoration of motion, strength, balance and sport specific exercise.
A stress fracture can occur in any bone of the foot. Typically caused form an impact or chronic stress to the area. One of the most common areas for injury is at the 5th metatarsal or the lateral bone of the foot. Usually the area of the fracture is point tender and feels worse with running and sometimes with walking. A stress fracture is typically diagnosed with the use of a bone scan or an MRI. Treatment consists of rest first then physical therapy to address what caused the Fx to begin whether it be lack of flexibility, functional strength or poor mechanics.
Over Pronation/Flat Feet
Pronation is a very typical occurrence through the foot as you walk. The typical pattern of weight through the foot is from the outside of the heel to the first toe. This weight distribution will typically cause your arch to lower a little, but normal pattern is when it comes right back to the neutral position. When the arch collapses more than it should or doesn’t come back when you’re walking, it is called over pronation. This can be caused by poor fitting shoes, developmental changes through the arch, and abnormal movement patterns with weakness through the lower legs that will cause the foot collapse.
The plantar fascia is a thick band of tissue along the arch and the bottom of the foot that gives support to the arch. It is a tight band of fascia that attaches on the underside of the heel and runs to the base of the toes. This diagnosis is usually used to describe pain that occurs at the inside arch and the heel. Typically, this is characterized by pain occurring at the heel with the first step in the morning and made worse with prolonged walking and running. Ice massage at the area of the pain can be helpful and analysis of biomechanical factors contributing to the injury is usually needed to completely resolve this condition.
The foot has 26 bones, countless ligaments and bands of thick connective tissue, numerous muscles that begin in the leg and end in the foot as well as start and end in the foot. Our feet take the pressure with every step we take, whether at a slow pace or sprinting to the finish line. With so many moving parts, areas can break down over time and give you pain through the foot. Other areas of pain through foot can be more overuse injuries, neuromas through the toes, misaligned bones, and combination of tears and fractures. Every foot is different, and will react different to the same stresses, and take different amount of time to heal. Added support to the arch as well as identifying and treating biomechanincal stresses will help to resolve pain.