Category Archives: Foot

Can Your Feet Cause Pain in Your Knee, Hip or Back?

February 23, 2017 Teresa Stockton - Back, Blog, Foot, Hip, Knee

Can your feet cause pain in other areas of the body? Yes it can. The foot is an arch and arches decrease compressive forces by distributing them across the span of the arch. Engineers use arches in building and bridges to hold up greater weight across longer spans. The human foot has 3 arches that all work together to distribute the forces our bodies put on it. This allows us to walk, run and jump.

We start running into problems when the arch is either too flat or too high – causing the forces put through the foot to be abnormally distributed, resulting in strain.

Flat feet limit the range of motion of our ankle, causing our hips to rotate inward and move towards the center of our body.
High arches do the opposite to our hip joints.
These changes cause strain to our ankle, knee and hip joints, and our back.

People can be unaware that their feet cause pain throughout the body because they were born with flat feet or high arches and they do not know what “normal” feels like. As physical therapists we have treated many children who didn’t realize that their feet are not supposed to be sore. But instead of seeing them for prescribed foot pain, they come for pain in their joints or back.

Orthotics were developed to correct or adapt to changes in the foot. Orthotics should be fitted by a healthcare professional trained in assessing the foot and gait. Standing on a pressure plate in the store is not good enough. Why? If your foot hurts are you going to stand on it normally? Probably not. This results in an abnormal reading.

An orthotic by itself is not the best treatment. A physical therapist will assess your function, strength, flexibility and range of motion. Patients will present with other problems as the result of abnormal arches. Treatment with orthotics combined with strengthening and stretching exercises, balance training, functional training and manual therapy is necessary to restore full function.

Trigger Point Dry Needling

December 6, 2016 Teresa Stockton - Back, Blog, Foot, Knee, Manual Therapy, Shoulder

Dry needling uses small, thin needles to stimulate underlying myofascial trigger points, muscular and connective tissues for the management of many orthopedic conditions, both acute and chronic. By inserting a needle into the dysfunctional tissue, it often leads to a contraction of the muscle which then stimulates a relaxation. This leads to a reduction of pain, improvements in flexibility and a restoration of normalized movement when combined with corrective exercises.

WHAT IS A MYOFASCIAL TRIGGER POINT?
A myofascial trigger point is a hyperirritable spot within a taut band of skeletal muscle that produces local or referred pain. The trigger point can lead to increased pain, decreased flexibility and decreased muscle function if not treated. Trigger point dry needling is a safe, effective and efficient treatment technique to release these painful spots.

WHAT TYPE OF PROBLEMS CAN BE TREATED?
Muscle dysfunction can be the primary or secondary contributing factor to many neuromusculoskeletal conditions.

WHAT YOU NEED TO KNOW:
• Dry needling must be specifically prescribed by a physician.
• Dry needling is not covered by insurance, it is a cash based modality.

This information was written by The Jackson Clinics, a locally owned physical therapy practice in multiple locations throughout Northern Virginia. They specialize in outpatient orthopedics and sports rehabilitation. Their therapists and assistants possess advanced clinical skills in spinal disorders, sacroiliac joint dysfunction and peripheral joint problems, including rotator cuff injuries, knee injuries and foot and ankle pain. They also also have specialty programs in breast cancer rehab, vestibular rehab, pediatrics, post-cancer rehab, aquatic therapy and women’s health. For more information click here.

Hamstring Tightness and Plantar Fasciitis

August 2, 2016 Teresa Stockton - Blog, Foot, Leg

Plantar fasciitis is classically characterized by pain in the central to medial plantar heel. It is thought to be caused by chronic inflammation of the plantar fascia due to repetitive strain and trauma to the fascia. There are many other purported causes including, calcaneal spurs and increased intraosseous calcaneal pressure, among others. Many studies have shown inflammatory and histological changes at the origin of the plantar fascia and surrounding structures that are consistent with repetitive strain and degenerative changes including a thickening of the fascia.

Biomechanics has long been looked at when investigating possible causes of injuries. Alteration of the load-bearing characteristics of the foot has been suggested by several studies to be the underlying problem in plantar fasciitis. Microtears and chronic degenerative changes result from the increased tensile stress placed on the fascia due to the changes in biomechanics. Muscle tightness is one factor that can lead to changes in gait mechanics and load bearing of the foot. Hamstring tightness has recently been investigated as a factor in plantar fasciitis and has been shown to induce prolonged forefoot loading due to increased knee flexion during gait. A rapid progression through the contact phase of gait results from increased knee flexion and in turn increases forefoot pressure. The fascia is a fixed-length ligament, so an increase in forefoot pressure results in increased tension at its insertion on the calcaneus. The increased time spent on the forefoot in gait leads to a chronic traction injury that is localized to the hindfoot insertion of the fascia; which is consistent with the symptoms of heel pain.

Biomechanical deficits have long contributed to injuries. Only recently has hamstring tightness been shown to have an effect on plantar fasciitis. Hamstring tightness affects every step, resulting in a biomechanical deficit which may contribute to a tensile overload of the plantar fasciitis. Recent studies suggest that all patients with plantar fasciitis should be evaluated for hamstring tightness. Physical therapy treatment for plantar fasciitis should include hamstring stretching.

More information about Plantar Fasciitis can be found in the PTandMe injury center.

This information was written by Plymouth Physical Therapy Specialists. They are committed to using evidence-based treatments in their practice. This means that their therapists utilize the most current and clinically relevant treatments in their approach to rehabilitation. For more information click here.

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Achilles Tendon Care – New Therapy Can End Months of Pain

March 29, 2016 Teresa Stockton - Ankle, Blog, Foot

The Achilles tendon is the large cord-like structure at the back of the ankle. It is responsible for transferring the muscle forces generated by the calf, which in turn allows you to roll onto the ball of your foot during walking and running.

We don’t realize it, but this tendon can withstand tremendous stress. It can tolerate forces of greater than 1000 pounds. However, it is also a tendon that can become inflamed and injured. Symptoms include pain (in the tendon or where it attaches to the heel bone), swelling, weakness in the leg and morning stiffness. The discomfort that resolves as the day progresses is common.

Often, physical therapists see clients that experience chronic Achilles pain. New research concludes that there is hope for these patients. Recent studies have shown that a certain Achilles condition called tendinosis, responds very well to a specific program of, what we call, eccentric loading. Given enough time and proper technique, physical therapists can help these patients recover from a problem that may have been bothersome for several months.

Who do you know that is experiencing Achilles or some other type of foot pain? There is a good chance that physical therapy can help, and make dramatic changes in someone’s condition. Please, don’t hesitate to call your physical therapist.

PUT ICE ON A NEW INJURY
What should I put on a strained muscle or joint? This is a popular question. The answer is a simple acronym:

• R est
• I ce
• C ompression
• E levation

You need to rest an injured joint, muscle or ligament. Ice helps with pain relief and to some degree, decreases swelling. Compression and elevation help decrease the swelling that results from a soft tissue injury. Excessive swelling can cause additional cell/tissue damage.

VIEW A RICE PICTURE
Picture of a proper RICE technique on the knee:
http://www.ptclinic.com/downloads/1-1.pdf