Archive for December, 2009
My Feet HURT!
I cannot tell you the number of people who I see with foot pain as their primary symptom. I can tell you that it is represented in all the different types of people who come into my office: School children, college athletes, professional athletes, age-group athletes, weekend warriors, football players, baseball players, professionals, retirees, and developmentally disabled young adults. (I’m probably leaving out some examples, but you get the idea!) I can relate to all of these populations, because the reason I’m a chiropractor in the first place has to do with foot pain.
There is a lot of literature available discussing why foot pain is so predominant in our society–sitting too long, running too much, walking too far, training on surfaces which are too hard, stretching to little, resting (not at all)…There are a multitude of means to address the pain–ice, rest, stretch, brace, cross-train. To me, all of the above is super frustrating! Why can’t you just do what you do, and not hurt?! Unfortunately, muscle tightness/weakness, postural imbalance, and overtraining are limiting factors to the ability to move through activities without pain…and foot pain does not happen in a vacuum.
An easy way to understand the biomechanical chain that exists in your lower extremity (hips/knees/feet) is to have someone hold your foot stable on the floor and then try to swing the opposite leg forward and back. Let you leg cross in front of you and then behind. You’ll find that you don’t get much rotation in the hips if you can’t move your ankle. Once you allow your ankle to move, then the hip rotation forces ankle movement–or it should. If your ankle is not mobile, the muscles and fascia on the bottom of the foot begin to tighten/weaken. At the same time, the demand for movement coming from your hips, puts continual strain on those tissues which breaks down the already limited ability of tight/weak tissues to absorb it, which in turn can lead to overuse injuries and pain.
The way I treat foot pain is not uncommon, except in the most easily accessible literature around! (Yes, I am frustrated by the rest, ice, stretch your feet tips in almost every article about foot pain!) You cannot address ONLY the feet. Remember that the hips and ankles are biomechanically connected. The hip flexors, glutes, adductors, quads, and calf muscles all contribute to ankle movement and vice versa.
First, I treat the adhesions which bind up and prevent movement in the soft tissue. Active Release Technique is the primary technique I use, Graston instruments are also helpful. Basic exercises to maintain stretch and release the shortened tissues are also important like rolling with foam rollers and TP balls. The final piece is to restore functional movement through exercises which drive the connections between the hips and feet. When all of the three factors are incorporated into a routine, I find that people can return to doing what they do, and not hurting!