Caring for foot and ankle injury
The natural response of the body when injury occurs is to protect that part from further harm. Rest of the affected ankle and foot is crucial to prevent damage.
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If you don’t adhere to the much needed rest and continue with your usual activities you hinder or prolong the healing process.
In the initial stages, the application of ice over the area aids to reduce swelling. The overall management of the condition is tailored to the challenges and severity of your condition.
Physiotherapy is vital from the very beginning of the injury for healing to progress well and this includes muscle strengthening and balance training.
Brace/ Insoles
Some individuals have high foot arches and this makes them prone to this condition hence an insole is required to assist in the proper placement of the foot.
Your footwear also needs to have enough support and cushioning to prevent further damage to the foot and ankle.
Therapeutic exercises
The appropriate exercises are begun after a period of rest and are usually performed daily and should not cause pain to the affected area.
The exercises are progressed as the affected foot improves.
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Strengthening exercises
This begins when pain has reduced considerably and the individual can tolerate movement of the affected foot. Initial exercises involve those that only allow contractions in the muscles of the leg without moving the ankle or foot.
For example, sit on a bed with your affected foot in front of you and touch the edge of the bed so that the entire foot is against it. Gently push against the bed with the affected foot, so that there is no movement in the leg but only the muscles in the leg contract.
Hold the position for about 15 to 20 seconds and relax. Repeat this throughout the day.
Strengthening exercises may also be performed with resistance or weights. The individual may be encouraged to make use of resistive bands or ankle weights. These exercises need to be performed slowly and with control in order not to cause pain or further harm.
The exercises are performed by wrapping the resistance band or ankle weights around the foot.
Lie on your side with the affected foot on top of the unaffected and gently turn the foot upwards with the toes pointing to the ceiling.
Hold the position for 15-20 seconds and allow the toes to point away from the ceiling. Repeat at least thrice daily and later increase weights and resistance and number of repetitions.
Foot and ankle exercise
• Lie on a bed and gently move the affected foot and ankle up and down towards the bed, as far as you can tolerate.
You should feel a mild or moderate stretch in the leg but not pain.
Repeat throughout the day.
• You may also gently move the foot in and out as much as you can tolerate without pain, only a mild stretch in the leg should occur. Repeat this throughout the day.
Ankle stretch with towel
Sit on a bed with the affected leg stretched in front of you. Your back should be straight or against the end of the bed.
Place a towel around the ball of your foot, while holding the ends of the towel.
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Gently bring your toes towards the rest of your body and hold the position for about 20 seconds and relax. Repeat throughout the day.
Calf wall stretch
Stand straight, facing a wall with both hands (open hands) on the wall. Place the unaffected leg in front of the affected one.
While maintaining a straight knee for the unaffected leg, gently bend the knee of the affected leg as you lean towards the wall ensuring that your heel touches the ground during the stretch.
You should only feel a mild stretch in the leg not pain. Hold the position for 20 seconds and repeat throughout the day.
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Preventing re-injury
Ensure that you wear appropriate shoes at all times, especially if you are an athlete. If there is a need to wear insoles or braces, do so always to place the foot in a good position always.
If the footwear is worn-out, replace them with one that provides enough support and cushioning.
Check your training programme (duration and intensity) and surfaces for the training (smooth or rough or inclined).
The writer is a senior Physiotheapist at the 37 Military Hopital. panierus@live.com
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