Agonizing, Aching Ankles
Well hello again. It has been some time since the last post. What can I say, it has been busy at work and with a baby on the way there’s been little time. Prepping for things seems to take precedence to make sure we are ready. BUT I have decided to return before my blog membership lapses for another post!
As the weather turns cooler in these October months, people will start to work out indoors more. Unless, of course, they are those hardened people who are outdoors no matter what temperature, but that seems a bit extreme to me during our Midwest winters. With that said, as indoor exercise becomes more prevalent, so too does treadmill use and foot and ankle injuries.
Having a couple of snows and being in a pandemic has me reminiscing of travel…
The ankle and foot may seem like simple anatomy that many don’t appreciate looking at or smelling. However, it is a complex joint and support system which, when properly cared for, can greatly improve comfort and performance while neglect can cause considerable pain and discomfort/injury. If not properly supported, the ankle can transfer poor motion up the kinetic chain and place the dynamic stabilization upon the knee and hip. Sometimes, patients will present with knee pain that is actually caused by poor foot/ankle support that forces the knee to try to accommodate for weakness below. Main point: ensuring proper foot and ankle support and strength is important.
Again, this joint is complex and has many different moving parts. For brevity, this post will focus on the medial (inner) ankle. Why there? I like it and this is my blog. Also, the muscles in this region play an important role in arch support and foot/ankle motion. The muscles here are the tibialis posterior (TP), the flexor digitorum (FD), and the flexor hallicus longus (FH). The TP assists in plantar flexion (pushes the foot down on the gas pedal), FD curls the toes except the big toe, and the FH curls the big toe and helps with plantar flexion. The TP helps with maintaining the medial arch of the foot where a lot of action happens in everyday life and in sports.
If not properly supported, the muscles in this region - particularly the TP and FH - can get overworked and eventually begin to stretch out and lengthen. If a muscle is stretched too far, it will lose its normal strength and lose some of its action due to the new weakness. Typically, this occurs from overuse and over time but can also occur from trauma. The one that typically needs to be addressed is the TP, which can cause people to over pronate (arch collapses and rolls in during walking or running). As stated before, issues from below can lead to pain above. In clinic, many people present for knee or hip pain and during the exam it is discovered that the arch support and foot/ankle mechanics are what need corrected. The leg is not just the ankle, knee, and hip all working separately. In fact, the leg is a cohesive unit with each joint working together in tandem. If one of these goes down, the entire unit has issues. The fact that this group of muscles, along with many others in the region, can greatly affect not only the foot and ankle but other joints, illustrates their importance.
The best way of dealing with these issues is prevention. The arches of the foot can be helped by focusing on strengthening the muscles that support them. Again, with the pandemic raging on, there are many exercise programs that can be done at home via video streaming or utilizing search engines. If the pain has already set in, then seeing your physician and possibly going to physical therapy would be a good option for care. Make sure to be fitted properly for shoes. Having a shoe that is too big for the foot can lead to “toe-gripping” to stabilize the motion which causes fatigue and strain to the muscles, especially the FH. Having gait analyzed at a local doctor’s office, or even a running shoe store, would be a good idea to see if there is a type of shoe or insert needed to correct for over-pronation or collapsing arch.
Hit the trails but make sure to care for your feet and ankles so they can get you there!
If you take care of your feet, they will get you where you need to go. I recently saw a post on social media that rang true so I thought I’d share: “If you don’t make time for your wellness, you will be forced to make time for your illness”. While the quote was supposed to harp on the importance or eating right, exercising, and making time for mental health, it is equally important to listen to the body and seek therapy or rest if it feels off or hurting. Setting the body up for success by making sure everything is properly supported is paramount to keeping in the game.
As always keep moving and stay safe out there.