JUNE FOCUS – THE FOOT AND ANKLE

How are you all getting on? In may I completed the full moonwalk! That is, the marathon length walk in London at night. This month’s exercises formed part of my preparation for the challenge, and also in my recovery!!

Unless we notice pain, the foot and ankle are areas of our body that we commonly ignore. The joints and soft tissues forming this area are subject to immense amounts of daily pressure on a general day-to-day level. Then if you add in problematic footwear, ageing, sports training, weight gain….We can see they may start to struggle.

I see foot and ankle problems quite commonly. Sometimes people present to me with pain in this area, and this is often the result of a tendon or ligament strain, or  poor range of joint movement causing local restriction and discomfort. Often I choose to look at the feet as part of a treatment for an issue elsewhere. When I examine people, it is easy to see that the position and function of the foot might well be part of the problem they are presenting with. The change in foot position will effect the mechanics coming up the lower extremity, into the pelvis and spine. So treatment of this area is often very necessary to solve a problem elsewhere.

You would be well advised to keep a close eye on the pattern of wear in your footwear. This will give you an indication of whether additional support with insoles is necessary. Also, if it’s an item of footwear you use regularly, maybe they need to be repaired or changed.

EXERCISES


These exercises shouldn’t cause pain, if you experience a problem, stop the exercise and consult your Osteopath or other medical practitioner. If you have an existing complaint, it would be wise to consult your practitioner to check these exercises are appropriate for you.


Foot articulation with elastic exercise band


This exercise also creates some stretch in the hamstrings and calf muscles. This is good practice, but you can take the stretch off by bending the knee more, or not coming up quite as high, according to your comfort levels.
Lay on your back with both knees bent, feet flat on the floor. You will need a length of elastic exercise band. Hook the mid part of the band around the bottom of your foot, hold the two ends together close to your body. Circle the foot and ankle 5 times in one direction and then 5 times in the other, repeat on both sides. To be effective, really push to the end of the range of movement. If you’re stiff, this might well cause cramp. Rest and let that ease, then try and pursue the exercise again.

The wobble board

This exercise can help improve your balance over time, but if you have balance problems, be very careful.

Stand on your wobble board next to a wall or chair for support. Practice tipping the board forwards, then backwards, then from side to side. The ultimate would be to do this without the need for support and there are many more exercises you could do to further aid your balance, and work on stabilising through the ankles. A wobble board can be bought fairly inexpensively at a sports shop or online.

Hamstring and quadriceps stretches


To stretch your hamstrings, use the position for the foot articulation exercise with the theraband. Don’t articulate through the foot and ankle, work on feeling the stretch in the back of the thigh. (You will also feel stretch in the calf too). Think about pushing the heel to the ceiling, straightening the knee, and pulling the “sit bone” at the pelvis down to the floor to maximise the stretch. Try and hold for a count of 30 on both sides.

To stretch the quadriceps at the front of the thigh. Hold onto a chair or wall for support if necessary and bring your heel up towards your bottom. hold for a count of 30 on both sides.

THE BITS THAT CAUGHT MY EYE IN THE NEWS


Those with a greater need for calcium, such as osteoporosis sufferers or post-menopausal ladies should make sure they are receiving adequate calcium through their diets and/or supplements. Perhaps this is something to discuss with your GP. The news that calcium supplements raise the risk of heart attacks will obviously be a concern to many. It has been suggested that calcium should be obtained through food – milk, cheese and green left vegetables. Calcium obtained through supplements has a “flooding” effect on our systems, whereas if obtained through our food is absorbed slowly.

A recent craze in barefoot running has caused a spate of leg and foot injuries. Injuries vary, from calf strains, stress fractures to achilles tendonitis. Perhaps those participating went too quickly from their usual footwear to barefoot? The different styles of running create pressures in different parts of the foot. The cushioned heel and stiff sole of the modern training shoe wasn’t invented until the 1970’s. Barefoot running has been practiced by humans for millennia, and still is the norm in some areas today. Some people opt for the barefoot running shoe, like a glove for the foot. If you wish to practice barefoot running, the key is to break yourself in gradually. Start walking around barefoot, then run no more than a quarter of a mile every other day in the first week. Gradually increase the distance, and stop if you experience a problem. Those with reduced sensation in their feet, as is the case for some diabetics, should not practice this. More research is continuing to evaluate the value of barefoot running.

Vitamin drips. Recently these have been reported in the news due to celebrities using them. Often used as a hangover cure. It has been reported that they are of no harm as long as the practitioner is fully versed in clinical hygiene and locating a vein for the drip. A few people have experienced anaphylactic shock as a result. The worry is, it will encourage excessive alcohol consumption, as some may just seek this as the solution the morning after.