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(FAQs) Ankle Pain & Foot Pain

Causes of Foot and Ankle Pain

Foot pain and ankle pain are some of the most common painful conditions that Dr. Melander treats at North Shore Spine and Sport.  Foot pain in the heel or foot pain in the arch are commonly experienced and often diagnosed as plantar fasciitis.

Pain in the ankle, pain in the top of the foot, and pain in the side of the foot are often due to either an acute stress at the ankle (IE: an ankle sprain) or due to a more cumulative strain (IE: tendinitis).

Foot pain when walking, foot pain at night, foot pain when running, and foot pain when standing are all extremely common and Dr. Melander will be able to help you identify what is going wrong and how to counter the issue as quickly as possible.

Foot Pain Causes:  Foot pain causes are variable, but most commonly due to some dysfunction or acute/repetitive strain to the foot and ankle complex.  Dysfunction may mean a loss of adequate ankle range of motion that causes a subsequent increased demand on the foot to do more.

Acute and repetitive strain to the foot and ankle may result from activities like running and jumping, poor foot support, worn out sneakers, tight or narrow footwear, or cumulative tension to calf and shin musculature.  Other common causes of foot and ankle pain include nerve entrapments from as far away as the lower back or hip.

Dr. Melander is well trained in evaluating these situations and can help you determine what is happening.

Foot / Ankle Pain: Treatment, Prevention, Exercises

Foot and ankle pain treatment (foot and ankle pain relief):

Foot and ankle pain treatment is dependent on the foot pain cause, but common interventions include activity modification or load management (in the case of running-related foot and ankle pain for example), new shoes if sneakers are worn out and not supportive, foot and ankle strengthening, ankle mobility training, and finally hands-on manual therapy to calf, shin, foot, and ankle tissues.

Foot pain and ankle pain prevention:

Most foot and ankle pain can likely be prevented by mindfully managing the stress or strain imposed on the foot and ankle during normal daily activities and exercises.  Circumstances that may precede foot and ankle pain include rapidly increasing running intensity or mileage, unresolved ankle mechanical issues from previous ankle sprain(s), and poor foot support or narrow footwear.  Maintaining adequate ankle mobility as well as strength in the calf, shin, and foot will be extremely effective at mitigating the likelihood of foot or ankle pain.

Foot pain and ankle pain exercises and stretches:

In many respects this is completely dependent on the type of foot or ankle pain as well as the individual suffering the foot and ankle pain.  Some generally sound and foolproof strategies for the foot and ankle include ankle dorsiflexion mobilizations, calf strengthening, and big toe extension mobilizations.

Causes of Plantar Fasciitis

What causes plantar fasciitis?

Plantar fasciitis is caused by a gradually worsening irritation to the plantar fascia, the connective tissue along the bottom of the foot that extends from the heel as far as the toes and is continuous behind the heel to the achilles tendon.

A true plantar fasciitis implies that the plantar fascia is inflamed.  Many examples of foot pain are default diagnosed as plantar fasciitis despite no evidence of true plantar fascial inflammation; these examples are better referred to simply as plantar foot pains (pain in the bottom of the foot).

Common situations that give rise to plantar fasciitis or plantar foot pain include excessive foot and ankle pronation, calf weakness or calf tension, and in some cases nerve entrapment of nerve irritation through the calf and under the foot.

Plantar Fasciitis: Treatment, Symptoms & Exercises 

Plantar fasciitis treatment:

Dr. Melander uses a combination of hands-on manual therapy like Active Release Techniques® and Functional Range Release®, coupled with foot and calf strengthening and foot or ankle mobility training via Functional Range Conditioning® to treat plantar foot pains. 

Plantar fasciitis symptoms:

Plantar fasciitis symptoms usually involve pain along the bottom of the foot, particularly near the front of the heel and near the arch.  Many people report that their foot pain is worse following periods of inactivity and sleep, and they experience “first step” pain upon standing up.  Some people may also be aware of tension or pain in the calf area.

Plantar fasciitis stretches and plantar fasciitis exercises:

Dr. Melander always prefers isometric training or eccentric training in place of isolated stretching, but once someone understands the nuance of isometrics and eccentrics, they can apply those principles to a stretch. Generally speaking, efforts made to improve toe extension (especially the big toe) and improve ankle dorsiflexion can have a favorable impact on plantar foot pains.

While holding the toes in extension or the ankle in dorsiflexion (with hands or with foot and ankle pushed against a wall), perform isometric holds or eccentrically load the tissues being stretched for maximum effect. Some people report relief by rolling the bottom of the foot and calf on a ball (golf ball or lacrosse ball).

Plantar Fasciitis: Common Questions

What is the main cause of plantar fasciitis?  The main cause of plantar fasciitis is irritation (likely inflammation) of the plantar fascia, the connective tissue that extends from the toes to the heel to the achilles tendon.

What is the best treatment for plantar fasciitis?  In Dr. Melander’s opinion, the best treatment for plantar fasciitis is a combination of foot strengthening, ankle mobilization, and reduction in calf tension.  In situations of bilateral plantar fasciitis (both feet affected at same time), many people may need to consider different footwear or other gait related changes.

Can plantar fasciitis go away on its own?  Absolutely yes.  You can help it along by modifying any activity that clearly provokes the pain experience in the foot.

Is walking good for plantar fasciitis? Yes, hopefully.  No matter the injury we need to remain as active as possible.  With a foot issue, we certainly need to be mindful of the thresholds we work within that are non-painful, but so long as walking does not exceed a distance or intensity threshold that provokes pain, it is totally fine.

Sprained Ankle: Causes and Symptoms

Sprained ankle causes usually are due to “rolling” over the outside of the foot (inversion) which causes an acute stress to some of the ligaments and connective tissue in the front and lateral side of the ankle, as well as stress to some of the muscle structures in the shin and calf area.

The symptoms of an ankle sprain usually involve pain in the lateral ankle, swelling, bruising, and difficulty bearing weight and walking.  Sprained ankle treatment (sprained ankle care) in the acute phase of injury should involve deliberate movement of the foot and ankle through the largest non-painful range of motion possible (ankle CARs) as well as isometric strengthening in inversion and plantar flexion (ankle PAILs) to begin rehabbing the injured tissues.

As the ankle sprain healing progresses, ankle sprain exercises should include more dynamic motions like lateral bounding and weight-training to ensure the ankle is back to a pre-injury state. 

Sprained Ankle: Common Questions

How long does a sprained ankle stay swollen?  There are number of factors influencing how quickly a sprained ankle swelling will reduce such as severity of injury, age, and general health.  Common “low-level” ankle sprains will likely not be swollen for more than a couple weeks.

Is it okay to walk on a sprained ankle?  Yes, within reason.  No matter the injury we need to remain as active as possible.  With an ankle sprain, do not exceed any walking distance or intensity that clearly provokes pain, otherwise have at it!

How long does it take for a sprained ankle to heal?  Age, general health, and physical fitness factor greatly in healing times, as well as injury severity.  Most people with lower level ankle sprains should feel better within a couple weeks and may need to carefully navigate their return to normal activity for a few weeks thereafter.

What helps a sprained ankle heal faster? Movement, exercise, and modifying pain-aggravating activity.

How do I know if my ankle is sprained?  Chances are you rolled over the outside of your foot and ankle and are experiencing pain in the top and lateral side of her foot/ankle area.  You may be bruised, tender, and experiencing difficulty walking or bearing weight.  If you have any concerns, we strongly suggest you see a trained healthcare provider.

our Chiropractic

Dr. Melander has often described his work as new-school rehab, which is to say, an amalgamation of current best practices regarding pain or injury management, hands-on manual therapy or strength/mobility training, and endless advocacy and support for his patients.

In Dr. Melander’s opinion, the best providers in the field of musculoskeletal injury are able to draw from multiple disciplines to create the most efficient and impactful care strategy for their patients.  If you are injured or hurting and not sure what to do, please reach out, it will be our greatest pleasure to help you.

We serve Newburyport and surrounding North Shore communities, including: Newbury, West Newbury, Rowley, Byfield, Georgetown, Amesbury, Salisbury, Ipswich, Seabrook NH, Hampton NH, Rye NH.

Chiropractic FAQs

We've compiled a list of common chiropractic questions to help you get all the answers you are looking for. If you have additional questions if our chiropractic and treatment services in North Shore would be a good fit for you, please contact our team. 

How do I know if I should see a chiropractor?

Chiropractors are trained in the evaluation and management (IE: treatment) of issues affecting the neuromusculoskeletal system (muscles, joints, connective tissue, nerves).  Many people associate chiropractic care with the spine only, but this is an inaccurate reflection of many chiropractors in the 21st century who are experts in treating spinal issues AND extremity issues (arms and legs).  As a general rule of thumb, if you have a painful condition that does not get better given a few days of activity modification you may want to consult a professional like a chiropractor.  Your chiropractor should be able to evaluate your painful condition, offer you some perspective and guidance relative to the painful condition, and help you care for the painful condition if treatment is warranted.  Like any profession though, each chiropractor has different clinical experience and different post-graduate education that may lend their practice toward a focus on sports injuries or pregnancy/neonatal care or neurologic issues or nutritional issues to name just a few.  If you are considering seeing a chiropractor, make sure that their experience and skill set seems like a proper match for your complaint and your ultimate goals.

How do I choose a good chiropractor?

Choosing a good chiropractor does not have to be a complicated process.  To begin with, ask your friends or family if they know someone they trust and can vet for you.  Next, check online as most chiropractors should have fairly informative websites relative to their clinical interests and experience that may help indicate whether they are a good fit for your issue.  If you are still not sure who to see after taking those steps, call your prospective chiropractor’s office as either the staff or the chiropractor will be more than happy to answer any questions and tell you if your issue is something commonly treated in that office.  Many people also like to read online reviews and while some online reviews can be misleading, if the significant majority of a chiropractor’s reviews are super positive then chances are you can trust the expertise of that provider.  Lastly, and arguably the most important step in choosing a good chiropractor, remember that you are in total control of your healthcare decision making.  If you go to an initial or follow-up appointment and you are not absolutely confident in the assessment and plan your chiropractor has rendered, then seek a second opinion.

What can a chiropractor fix?

A chiropractor can help you fix a wide variety of painful conditions related to the neuromusculoskeletal system such as headaches, back/neck pain, shoulder/elbow/wrist/hand pains, hip/knee/ankle/foot pains to name just a few.  Injuries of actual orthopedic compromise like fractures are best handled by orthopedists, but chances are if your pain/injury is non-surgical in nature then a chiropractor may be a great option to help you.  The best chiropractors will explain what they can about your pain/injury, offer guidance and likely treatment as efficiently as possible (days to weeks, maybe months in extreme situations), and then remove themselves and let your brain/body do the rest.  A great deal of research these days indicates that in many healthcare interactions providers should try and limit their patient’s dependency on them, opting instead for interventions and language that fosters resiliency and self-efficacy (independence).

What happens at your first chiropractic appointment?

Your first chiropractic appointment should include a detailed discussion of your health history and presenting complaint(s), an examination of your complaint(s), a discussion regarding what is indicated by the examination relative to prognosis and treatment plan, and finally some form of treatment/intervention assuming time permits.  Many painful conditions can be evaluated thoroughly and completely in a matter of minutes and certain treatment interventions could yield immediate relief, while other conditions may require more complex evaluations and more lengthy treatment plans.  Above all, you should leave your first chiropractic appointment feeling confident that your chiropractor is the best option to help you with your problem and you should leave feeling confident that you are on the road to recovery.

How often should you see a chiropractor?

You should see a chiropractor as often as you want or need.  Perhaps the most common criticism of chiropractors is that chiropractors “need to see you for the rest of your life”, and while there are unfortunately examples of chiropractors who advocate for this kind of dependency, the significant majority of chiropractors today want to help you as quickly as possible with no long-term commitments of any kind.  The best chiropractor will see you the minimally necessary number of times to help you overcome your issue and suggest you follow-up if there are any residual issues or new complaints sometime in the future.  Many patients however recognize how good they feel after chiropractic care and therefore wish to see their chiropractor with some kind of recurring frequency (IE: once/month, twice/year, or more).  These examples though should be dictated by the patient based on their assessment of their body’s needs and absolutely not dictated by the chiropractor based on some kind of pseudoscientific reasoning.

Does insurance pay for chiropractor?

In many cases, yes, insurance will help pay for chiropractic care assuming the chiropractor is participating with your health insurer.  If your chiropractor is not participating with health insurance, then it is still possible you have an out-of-network benefit with your insurer and can seek reimbursement that way.

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