Without Happy Ankles and Feet, We Don’t Have a Leg to Stand On!

foot

By, Amy Stein, DPT and Fiona McMahon, DPT

Our ankles function to help us do simple tasks from walking down the hall, climbing stairs to advanced tasks like cutting during a high level soccer game. Ankles need two things to do their job well. They need stability to allow us to transfer our weight onto them and mobility to absorb forces, like little shock absorbers when we move. A deficit in either one of these area’s can affect our ability to efficiently do certain activities and may cause pain in the foot and ankle itself or further up the leg.   As physical therapists we evaluate and treat ankle and foot issues to get the athlete or non-athlete back to optimal function.  

Get this, the foot has 26 bones, 33 joints and 100 muscles in it. There is a lot to look at and unfortunately, a lot that can go wrong with the foot. As physical therapists and especially here at Beyond Basics Physical Therapy, we like to use a systematic approach when evaluating the foot and ankle. We look at the foot’s range of motion (how far it can move), its strength, it’s ability to move well (motor control), and whether or not something’s not moving well when it comes to the soft tissue or the joint of the foot. If something’s up with any of these categories we open our tool box and treat using functional manual therapy, neuromuscular and postural re-education and self care!

Things we look at

  • In standing we assess the patient’s baby squat ( or plié, as our former dancers would call it) we are looking to see if there is an issue with the tissue of the foot’s ability to stretch and fold
  • Heel raise: We look at our patient’s’ ability to go up on their toes, aberrant or weird motions tell us about motor control, strength, and joint mobility.
  • Arm Swing: We promise this isn’t to make our patients look silly. It allows us to assess pronation and supination, which are super important motions of the foot.
  • End feel: We will passively move the patient’s foot and ankle through its range of motion to assess how the joint feels. It can tell us a lot about what’s wrong and where it’s coming from.
  • Palpation: We pride ourselves on our hands at Beyond Basics Physical Therapy. One of our PT’s calls it our “brain hands”. Palpation can reveal a ton about what’s going on in the foot.

These are all pretty basic first steps when assessing our patients. They are the starting point, but by no means the finish line. Once we get the big picture we will refine our examination to see what’s going on when our patients are doing their specific sport or activity. Once we get a good handle on  what’s going on we select the most appropriate techniques for our patients. Each patient is different and one basic protocol for everyone isn’t how we roll at BBPT. If you think your ankles or feet could use a little extra TLC, book an appointment today. To get the ball rolling, check out our blog written by our therapist, Denise Small . 

BBPT Health Tips: Let’s Roll!

Fiona McMahon DPT,

Foam rolling. I certainly have a love hate relationship with my foam roller. My IT bands (the tissue on the side of your leg) hate it, but I love how it keeps my knees and joints happy. Foam rolling is a method to release knots in muscle and improve the mobility of tight muscles and joints. If you are a gym rat, runner, or athlete of any kind, consider giving foam rolling a try. In a review published in the International Journal of Sports Physical Therapy in 2015, foam rolling was shown to reduces delayed onset muscle soreness (DOMS), and temporarily increase range of motion.

First of choose your weapon…. I mean roller.

 

White roller: Great for starters: gentle, but can deform over time because it is softer.

white-foam-roller

foamroller6x36fsBlack roller: This roller is not for the faint of heart, it’s the toughest one of the bunch. It’s not a great place to start, nor is it good if you bruise easily, but for the foam roller aficionados out there, it is really great for a tight IT band and hamstring.

 

 

21nc-kpj2l-_sy300_Grey roller: This is a nice in between roller for those of us who need a little more than the white roller, but aren’t quite ready for the black one. It is actually a composite of both rollers.

 

 

 

Artisanal Foam Roller: This one retails for about 120$ on Amazon and is good if you are super fancy. I haven’t tried it because I’m not very fancy.13187983_252069785150011_953005372_n

 

The Stick and other hand rollers:

 

48d2a548-59cd-437f-b9a1-7a145ae1e592This one is good for those who travel often, because it occupies relatively low amounts of space in carry-on luggage. It is also great for people with tight inner thighs and tightness closer to the pelvic bone, which can be difficult to get to using regular foam rollers. Retail names include: “The stick”, “the tiger tail”, and others.

Other Rollers:

There are other rollers that come in a variety of fun colors and designs. These rollers are less standardized so you may want to experiment if you feel like opting for one of the less classic varieties.

 

Now that you’ve picked your roller, let’s get rolling!

When foam rolling, you can adjust the weight you place on the roller by reducing the amount of support you give yourself. The more of your body weight you put on the foam roller, the more intense it will be.  If you find a particularly tender part oscillate your body on that spot to facilitate release. In addition, you can flex and straighten the area that you are working on to help with additional lengthening of the tissue.   Attempt 10-15 passes for each body part to help improve your function and tissue mobility.

 

ITB band rollingitb
Quad rolling

quads

 

Hamstring rolling

hams

 

Back rolling

rolling-back

 

Adductor rolling with stick

the-stick

 

Sources:
Cheatham S, Kobler M, Cain M, et al. The effect of self-myofascial release using foam roller or roller massager on joint range of motion, muscle recovery, and performance: a systematic review. Int J Sports Phys Ther. 2015 Nov;10(6):827-38

Happy Marathon Training Season! Preserve your Performance with Beyond Basics Physical Therapy!

Fiona's Marathon photo

Fiona McMahon, DPT

Marathon training season is just around the corner! If you are competing in the New York Marathon, it’s about time to lace up those sneakers and set off on your 18 or 20-week training plan. As an experienced marathon runner, I know personally the frustration and anxiety that can accompany being sidelined from the action. Prior to my days as a PT, I accumulated ankle injuries, knee injuries (both of my knees), and hip injuries while training for various races. These injuries were so upsetting, I had given up my weekends with my friends to wake up for 20 mile long runs on Sunday, I had gone through more sneakers than I care to think about, and coughed up $300 a race in entry fees. Total bummer.
At the time of my first marathon, I was not a physical therapist; rather I was working in a genetics lab in Maine. I was fortunate to have two physical therapists that worked for my company help me when my knee became so painful I could not stand to work at my lab bench, let alone run 26.2 miles. Through weeks of work, they returned me to my old self and I successfully completed my first marathon in Mount Desert Island, Maine. Since that time, I have run 4 marathons and sought the help of physical therapists to help stave off injuries and allow me to train at my top capacity as I push closer towards a Boston Marathon qualification time.
Physical therapy helped me gain a critical awareness of my deficits as a runner. I found out I had a weak butt, tight iliotibial bands, and hamstrings. Who knew?! There is a lot as runners that we tend to overlook in terms of physical fitness. Many of us believe that putting in the mileage alone will prepare our bodies to endure the stress of months of training on hard pavement. It won’t. We need a strong core and hip stabilizers to reduce the impact on our joints. We need long and strong muscles to help generate enough force to efficiently move your body the length of the race. If you are only thinking cardio with marathon training, chances are good you are missing something that could help your overall time and health.
If you are starting out on your first 26.2 mile journey (or any athletic journey), or completing your 30th, don’t ignore your body’s signals that there might be an injury that needs attention. Treating an injury early with good physical therapy treatment is often much easier than treating one later on. Early treatment also minimizes disruption to your original training plan.
At Beyond Basics Physical Therapy, we go beyond what is offered in many physical therapy clinics. Our clinicians are orthopedic experts and spend an hour with their patients in one-on-one treatments, creating specialized plans to keep you in tip-top shape and return you to training faster. We are trained to look at the athlete holistically to determine the specific cause of a patient’s injury/deficit rather than a cookbook “one size fits all approach).
As clinicians, our goal is not only to heal our patients but to empower them to know more about their own bodies and to be able to take control of preventing future injuries. We take pride in our specialized home exercise plans, which a runner or any athlete for that matter, can take with them for the rest of his or her athletic career. I encourage you as a runner, to check us out and learn more about your running needs.