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 . 

Cupping: Not just for Olympic Champions

Fiona McMahon, DPT , PT

Cupping

If you are like most Americans, you have probably heard a lot about “cupping” because of Olympian, Michael Phelps. Phelps has been seen tearing it up in Rio with purple hickey-like spots all over his back. Like kinesiotape in London and Beijing, cupping has become the new hot thing for top level athletes.

We, at Beyond Basics Physical therapy have been using cupping in our treatment of patients for a while now. Our aim is to improve athletic and recreational performance, and the mobility of restricted (or stuck) tissues to help the tissues function better and lessen our patients’ pain.

In our practice, we use cupping as an extension of our hands to help tissue that has been immobile secondary to injury or disuse, to regain its’ optimum mobility. By improving mobility, cupping can help to reduce painful pulling on tissue, improve blood flow, and reduce dysfunction around the adhered area.

In our practice we find that cupping can be particularly helpful in treating old surgical scars, such as cesarean section scars, to reduce painful pulling and disruption of the function of nearby organs and muscles. We also like to use cupping on notoriously tight and troublesome structures like the iliotibial band to help with conditions like runner’s knee.

Cupping is like any treatment modality, it is not a magical cure that will immediately banish all your ills. Cupping is a tool used by therapists and acupuncturists in conjunction with other treatment modalities to correct any other underlying factors that may be contributing to a patient’s condition. It may not turn you into an Olympian like Michael, put in conjunction with a skilled physical therapy program it can help you feel a whole lot better.