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Ankle Pain

1. PLANTAR FASCIITIS

Anatomy of the Foot

Ankle foot Pain

The feet are flexible structures of bones, joints, muscles and soft tissues that help us stand upright and perform activities like running, jumping and walking. To understand Plantar Fasciitis, we need to have some basic knowledge of how our foot and ankle looks like beneath our skin.

The front of our foot consists of our toe bones which are connected to longer bones (Metatarsal bones) that extend to the middle of the feet. The middle of the foot is made of bones which are aligned in a pyramid-like fashion to form the arches of the feet. At the back of the foot, a bone (Talus bone) supports the leg bones to form the ankle. The heel bone (Calcaneus) is the largest bone in the foot.

The Plantar Fascia is a ligament which supports the arch on the bottom and acts much like a bow-string, which absorbs tension when the foot bears weight. It is particularly important in maintaining gait as the Plantar Fascia is constantly stretching (Windlass Mechanism) with each step we take.

Causes of Plantar Fasciitis

Plantar Fasciitis is a common cause of heel pain among adults. It is a condition that develops as we age, though chances of experiencing Plantar Fasciitis earlier can increase with the presence of a few risk factors, as discussed under “Risk Factors”. It is usually linked with overuse of the Plantar Fascia ligament (like prolonged standing or running), hence creating microtears at the part of Plantar Fascia that is closer to the heel bone.

Symptoms of Plantar Fasciitis

You might have Plantar Fasciitis if you have the following:

Ankle Foot

  • Stabbing Pain and stiffness at the bottom of the heel (See Figure 3, marked in blue dotted line)
  • Pain is usually worst with the first few steps after awakening
  • Pain can be triggered with long periods of standing or rising from sitting

 

Risk factors

Though Plantar Fasciitis is still largely being studied and researched on, these general risk factors have been found to cause this condition among many patients:

  • Age. Plantar Fasciitis is most common among those aged between 40 and 60.
  • High Impact Exercises. Certain high impact activities put a lot of stress on the Plantar Fascia – such as long distance running, jumping activities, ballet dancing – and can bring about an earlier onset of plantar fasciitis.
  • Improper Foot Mechanics. Being flat-footed, having a high arch or even having an abnormal pattern of  alking can affect the way weight is distributed when you’re standing and put added stress on the plantar fascia.
  • Obesity. More weight means more pressure on the Plantar Fascia.
  • Certain occupations. Some occupations like teaching, working at a factory, can mean that you will be on your feet for a long time. This will stress the Plantar Fascia as well.
  • Hard surfaces. Walking or standing too long on hard concrete surfaces might result in pain acting up as well.

 

Popular Solutions for Plantar Fasciitis

Most physicians might recommend their patients to rest well, modify their lifestyle or activities, ice massage or to take non-steroidal anti-inflammatory drugs. However, these might only short-term improvement in pain relief and disability. Stretching and physical therapy might be prescribed to patients who have pain that just would not go away. Arch supports, heel cups and night splints can also help in keeping the foot in its natural position and unload unnecessary stress from the Plantar Fascia.

When these less invasive methods fail, patients might need to have steroid injections which can help to reduce inflammation in the heel and provide some pain relief. When even this fails, then a surgery can be done to release the strained Plantar Fascia or to remove a severely wounded part of it. This is why surgery is usually turned to as a last option.


Non-invasive treatments for foot pain at The Pain Relief Practice


Shockwave Therapy uses powerful acoustic energy to stimulate deep tissue repair. Its effectiveness in treating Plantar Fasciitis, have been recently studied and there is growing evidence that shockwave therapy is the best in improving the symptoms and quality of life of patients over the long-term. Shockwaves are sound waves that are generated by a machine which creates vibrations on the heel. These vibrations are then transported through the tissues. What these vibrations do is that they purposely create a wound on the heel. Do not be alarmed, this is all done in a controlled way. When this controlled injury is created, our body naturally wants to repair itself and forms new blood vessels at the heel. These vessels then help to bring substances in the blood which can help to regenerate the injured tissue as well as repair the microtears in the Plantar Fascia.

 

Not only that, these shockwaves physically alter our nerves at the heel region slightly, so we do not sense pain. Hence shockwave therapy is not just painrelieving, it aids in healing as well. This is why shockwave therapy stands out as a n effective long-term solution in comparison to ther treatment methods.

2. ACHILLES TENDINITIS

Physiology of Ankle

Achilles Tendon is the largest and strongest tendon in your body. It is a tough band of fibrous tissue that connects the calf muscle to the heel bone. When calf muscles contract, like when we are walking or jumping, the Achilles tendon pulls on the heel. Basically, any movement that requires your toes to be on the ground and the heels to be lifted up, requires the work of the Achilles tendon. Yes, that means even tiptoeing! While the Achilles tendon might be strong, it is also vulnerable to injury as blood supply to the tendon is low and we place high amounts of tensions on the tendon during our daily activities.

Causes of Achilles Tendinitis

An injury to the Achilles tendon or repetitive overuse of the tendon can cause it to become irritated and inflamed or even torn, leading to Achilles Tendinitis. Exercising on inclines such as running up a slope, over-exercising or wearing improperly fitting shoes including high heels are the main causes of inflammation of the Achilles tendon.

Symptoms of Achilles Tendinitis

  • Pain, tenderness and swelling over the Achilles tendon, even when resting
  • Sometimes, clicking or cracking sounds might be heard when lifting off with the foot
  • Walking, running, jumping and any other activity that involves pushing off with the foot will be painful
  • Pressing on the Achilles tendon area is painful
  • Stiffness of the ankle region in the morning

 

Treatments

Standard advice from doctors will be to rest your foot from all activities so that your tendon has time to heal. Placing an ice bag over the tendon for 15 to 20 minutes and repeating the process four to five times a day might also give some relief. Calf stretching and strengthening exercises can also help to relax the calf muscles.

Non-invasive treatments for ankle pain at The Pain Relief Practice

1. Shockwave Therapy uses powerful acoustic energy to stimulate deep tissue repair. Its main assets are fast pain relief and mobility restoration. Studies have shown that shockwave therapy can increase blood flow to the tendon and aid with the healing of the inflamed tendon. It is extremely safe and has been widely used around the world for certain soft tissue disorders and musculoskeletal complaints since the 1990s.

2. Radiofrequency Therapy is deemed one of the best treatment options available for chronic Achilles tendinitis. It uses energized particles to cause controlled wounding at the tendon. The body then recognises this wounding and initiates a healing response. It has recently been proven that radiofrequency therapy can also encourage the body to create more blood vessels in the treated area, hence speeding the healing process.

If you suffer from difficult pain, aches or stiffness, simply call, SMS or WhatsApp 9337 6918 to find out how Radiofrequency Therapy & Shockwave Therapy can help you feel better.

 

Location

The Pain Relief Practice,
Shaw House

350 Orchard Road

#10-00, Shaw House

Medical Suites @ Orchard

Singapore 238868

Call for appointments

PRP @ Shaw House:

Call: 6235 1387
SMS / Whatsapp: 9782 1601

Email Address

physio@painrelief.sg

 

Special online rate

$90 for 1st Shockwave Therapy

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