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Taking Care of Your Feet

Taking Care of Your Feet

 Kathy Laub, MSPT


Stop for a moment and consider your feet. Are they stuffed into shoes that are fashionable but uncomfortable? Do your feet ache or burn after walking and standing for long periods of time because your arches are not properly supported? Are you wearing shoes that are old and worn at the heels, tipping your feet and ankles either inward or outward?


If you have answered yes to any of these questions, you are not alone. Americans are not known for taking good care of our feet, and yet one can easily make the case that our feet and ankles are among the hardest working parts of our bodies. When you consider that our feet and ankles not only carry our weight but also help to absorb shock and adapt to uneven terrain, you begin to appreciate their importance.


How common are foot and ankle problems?


They are very common, especially among three specific groups of people. Athletes suffer more injuries to their feet and ankles than any other parts of their bodies. Seniors can develop foot and ankle problems related to the aging process. And active people who are entering middle age often find themselves with foot and ankle pain because of limitations related to their changing bodies.


When is it appropriate to seek treatment and advice about foot and ankle pain?


The first rule of thumb is to pay attention to your feet and ankles and to seek early treatment for pain. Beyond that basic premise, I suggest that anyone who has just started an exercise program and is experiencing pain in their feet, ankles, knees, or hips should be assessed to avoid developing a chronic overuse injury. A foot specialist can screen you and make recommendations for shoe wear and corrective inserts.


We see many people on referral from doctors for pain and musculotendinous injuries. Improper alignment in the foot and ankle can contribute to those problems. We conduct a full biomechanical evaluation to assess alignment. Doctors also refer patients to orthopedic foot therapists following lower extremity fractures. Exercises to improve strength, endurance, and flexibility help reduce pain, restore function, and avoid re-injury.


Is it possible that my hip pain is related to my feet and ankles?


Pain in the knees, hips, pelvis, and low back is often related to foot and ankle problems because all of these joints work together. Each joint rotates when we walk and this rotary motion is translated at the subtalar joint just below the ankle joint. If the subtalar joint is moving too much, the joints above are also forced to move too much. This can cause such painful conditions as medial knee pain, bursitis in the hips, inflammation in the SI (sacroiliac) joint, and piriformis syndrome (pain in the hip and buttock that can radiate down into the leg).


How does a foot therapist decide on treatment?


The first step is a proper diagnosis. This can be difficult because often there are many things going on at the same time that are contributing to the problem. Heel tenderness, for example, can be due to any number of problems involving connective tissue, restrictions, atrophy in the fat pad of the heel, and rear foot alignment problems. There is an elaborate system of nerves, tissue, bones, muscles, and tendons in our feet: an accurate diagnosis enables us to address the underlying problem and not merely treat the resulting symptoms.


What are the most common problems foot therapists treat?


We see many patients with plantar fasciitis, which is painful irritation of the band of connective tissue on the bottom of the foot. (The problem area is often where the tissue connects to the heel.) People often seek our help for Achilles tendon and posterior tibial tendinitis (inflammation of the tendons at the heel and back of the ankle). The third most common condition we treat is ankle sprain, which varies greatly in severity and can lead to chronic ankle instability.


How can a foot therapist help?


We have a number of treatment options to help restore motion, strength, and flexibility and to reduce inflammation and pain. Our approaches include everything from taping and hands-on soft-tissue massage to sophisticated modalities such as iontophresis, which delivers medication directly to the inflamed area via electrical current. We also teach patients activity-specific exercises to improve function and balance. Foot orthotics, which can be prescribed for your specific problem, are very effective in helping to control unwanted motion and provide stability in the feet and ankles.


Kathy Laub, MSPT, holds a master’s degree in physical therapy and is a physical therapist on staff at Cayuga Medical Center. She specializes in orthotics and orthopedic problems of the foot and ankle. She can be seen on referral from your physician.


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