05/01/2020
Help for Ankle and Foot Injuries!
A question patients often ask is; “Can sports chiropractic care help treat an ankle sprain, calf strain, or “plantar fasciitis” and other foot injuries such as metatarsal pain or “neuromas””. The answer is yes! Briefly, many times these injuries involve altered biomechanics, poor movement coordination and balance, and joint and soft tissue dysfunction. Either these faults combine with overuse to lead to the injury over time, or are the result of the original injury not healing properly, as with an ankle sprain, especially a chronic one. These causes can all be treated with spinal and extremity joint adjustments and soft tissue manual treatment to the muscles, fascia, tendons and ligaments. Rehab and prevention exercises are also added to the mix as needed. Also, pain and injury further up, in the knee, hip and back can be related to poor function in the lower extremity, starting with the foot. Below are some self care techniques that are often prescribed during treatment and can help those who need care but are staying home right now. Even if you are not in pain and are not suffering with any specific injury currently, these can help release quarantine related tension and stiffness in the leg and foot!
ANKLE/FOOT SELF CARE: Use the following foam rolling/self myofascial release techniques to release muscle and fascia restrictions. **Note, with foam rolling or ball rolling or other self myofascial release techniques, we are looking for tight, bound up tissue, and not just “sore spots”. Areas of tightness will usually be sore also, but focus primarily on the tightest spots and not necessarily the spots that are just sore. Also, some of these videos show the Prepare to Compete ® “active rolling” technique, where the tissues are stretched with joint motion as you roll. This technique can be less painful and also can help restore normal joint motion as you release scar tissue and adhesions. Tissue that is too painful or does not seem to “release” may be tendon or muscle border tissue, and should not be rolled. Seek professional treatment for acute injury or chronic pain and tightness, especially if you are unable to walk or run without pain or altered form/pace/duration or frequency.
1) Foam Rolling Calf https://vimeo.com/269427635
Lying on the floor, place one leg on top of the foam roller just above the ankle joint, to one side of the achilles tendon. To protect the back, maintain a neutral spine position (slight arch in the lower back and contract the lower abdominals between the belly button and p***c bone). Roll up the outer or inner calf on either side of the achilles tendon, all the way up to just before the back of the knee, scanning for any tight spots. Next, use the “active rolling” technique by stretching the calf as you roll (foot moves towards leg). (Careful: do not roll directly behind the knee as there are nerves and blood vessels there). Finish by going back and focusing more on the tight spots you found during the scan, using shorter strokes and again also use the active rolling technique. Repeat the sequence on the other side of the achilles and then do the other leg. *Note- You can also place the opposite leg crossed over the leg being treated to increase force (not in video). But be careful not to hyperextend your knee.
2) Foam Rolling Front of Leg (tibialis anterior/toe extensors) https://vimeo.com/269427797
Place the foam roller under the outer front leg just above the ankle. To protect the back, maintain a neutral spine position (slight arch in the lower back and contract the lower abdominals between the belly button and p***c bone). Roll up the outer front leg all the way up to just below the knee joint, scanning for any tight spots. Next, use the “active rolling” technique by pointing the foot down as you roll, stretching the muscles and fascia in the front of the leg. Finish by going back and focusing more on the tight spots you found during the scan, using shorter strokes and again also use the active rolling technique. Repeat the sequence on the other leg.
3) Foam Rolling Side of Leg (peroneals) https://vimeo.com/269428552
Place the foam roller on the outer leg just above the lateral malleolus (thickening of the outer leg bone (fibula) at its end. To protect the back, maintain a neutral spine position (slight arch in the lower back and contract the lower abdominals between the belly button and p***c bone). Roll up the outer front leg all the way up to just below the knee joint, scanning for any tight spots. Next, use the “active rolling” technique: first, point the
foot down to the floor before you start rolling, and then move the foot up and in as you roll, stretching the muscles and fascia on the side of the leg. Finish by going back and focusing more on the tight spots you found during the scan, using shorter strokes and again also use the active rolling technique. Repeat the sequence on the other leg.
4) Plantar Arch Release https://vimeo.com/269428879
Standing or sitting, place a golf ball, tennis ball or other self-massage ball under the arch of your foot. Starting just below the toes, roll with even pressure towards your heel, scanning for tight spots. Move the ball more towards the outer foot and also the inner foot and roll upwards to check the entire arch. Try using the “active rolling” technique by first pointing the toes slightly downward and then moving them upwards as you roll.
5) Ankle Self Mobilization (no video)
Seated on the floor or a chair, cross one leg over the other with the lower leg across the knee just above the ankle joint. For the left leg, use your right hand to hold the foot, with the thumb across the top of the foot and fingers across the mid arch. Stabilize the lower leg with the left hand. Next, use the right hand to move the foot all the way to the right (inversion) and then all the way to the left (eversion). Move slowly and use the complete available range, feeling for the end range and trying to increase the range.
**Do not force the foot to move, this should be a slow and gradual movement and you should not feel pain. Also, if you have “extra” motion, meaning there may be some joint laxity, you may not feel a restriction and should just loosen the joint carefully and not try to increase the range. Next, move the foot up and down (dorsiflexion and plantarflexion) to increase joint motion in those directions. This exercise is a great way to warm up the ankle joint and its ligaments and joint capsule, an often overlooked area that can be restricted and cause chronic foot, ankle and leg muscle injury. Often professional treatment of chronic scar tissue and rehab exercises are needed to fully heal both acute and chronic injury here, especially chronic ankle sprains (even very old ones) and after injuries like leg and foot stress fractures that required the wearing of a boot.
This is "Foam Rolling Calf" by Training History on Vimeo, the home for high quality videos and the people who love them.