Foot & Ankle Pain

BACKGROUND:

The average person takes 6,000-10,000 steps every single day. Athletes can easily double, or even triple those numbers. This means that our feet play a vital role from the second we wake up to the second we go to bed. For most people, foot care is not a factor until they are suffering pain. We want you to be proactive and maintain feet health before it becomes a problem. Armed with knowledge about the various types of foot pain, you can take steps to prevent pain and slow degeneration.

Approximately 25% of the bones in your entire body lie in your feet. That means a lot of things can go wrong. If the joints in your feet aren’t moving properly, they, along with the surrounding joints and muscles, may start to hurt. Unfortunately, there is no one type of foot pain that we can diagnose, as the sheer number of bones, joints, and muscles in close proximity can result in multiple conditions, varying in severity. 

Feet stand as the basis of our foundation in almost every activity that we do. Because of this, we need our feet to be stable. However, as we age, our arches tend to collapse due to normal wear and tear. Ideally, our feet should be stable, and our ankle should be mobile. When the arch collapses, pronation patterns occur in our gait, resulting in mobility, not stability of our feet. This becomes problematic because it causes stability in our ankle joint. We want our ankles to be mobile, remember? When our ankles become more stable or immobilized, it forces the foot to either invert or exvert our feet. Remember that there are four ligaments holding the inside of our ankle together opposed to the three on the outside of our ankle. Because of this, we are more likely to invert (roll the ankle inwards). Approximately 20-40% of all athletic injuries are due to ankle sprains and strains, with excessive inversion mobility being the cause of 85% of these injuries.  

Are you prone to ankle sprains? You don’t have to be. Let us help you get to the root of the problem!

Our feet are most stable in dorsiflexion. Being limited in this motion will likely cause overcompensation of  inversion of the ankle because our stronger (deltoid) ligament are located to the medial side of our foot, leaving the outside of our ankles more vulnerable. This is why most ankle sprains are due to inversion injuries and we find bruising and swelling on the outside of our ankle when sprained.  

Whatever the problem may be, it can go far beyond localized pain, and may result in stress on the knees, hips, and lower back, altering the way we walk, sit, and go about our day-to-day business. 

ANATOMY:

The foot and ankle consists of thirty-three joints and twenty-six bones, along with hundreds of muscles, ligaments, and tendons. They all work together to bear our weight, maintain the arches in our feet, keep us balanced, and allow for movement. The movements associated with your feet and ankles are dorsiflexion (toes pointed up towards the ceiling), plantarflexion (toes pointed down like tip toeing), inversion (foot tilted exposing inside arch towards ceiling), and eversion (foot tilted with outer ankle pointed towards the ceiling). The deltoid ligament (comprises of four ligaments: the posterior and anterior tibiotalar ligaments, tibiocalcaneal ligament, and tibionavicular ligament) are located in the medial side of our ankle and is thick and strong. While the outside or lateral side of our ankle comprises of three ligaments (anterior talofibular ligament, posterior talofibular ligament, and calcaneofibular ligament.) This makes it so that we are more likely to invert our foot, rather than evert because the ligaments in the inside of our ankle are stronger than the outside. Our foot and ankle functions as the base of our foundation in almost every essential movement we do, such as walking, standing, and bearing weight.

DIAGNOSIS:

In our office, we are passionate about discovering what is bothering you at the core level. Due to the complexity of its structure, the foot requires a thorough examination to determine the underlying cause of the pain. Our examination consists of specific orthopedic tests, range of motion assessments, radiographic imaging if there are red flags, and a precise neurological evaluation to accurately diagnose and treat the problem.

Generally when our patients complain of heel pain, it narrows down the diagnosis, with the two main conditions being plantar fasciitis or heel spurs. The first issue is the result of inflammation in the tissue connecting the heel bone to the toes, while the second is an abnormal bone growth that lies on the base of the heel. Bad posture or bad shoes are usually the culprit. In either case, rest, mild pain relievers, better quality footwear, and a little physical therapy can go a long way to providing relief. 

Other types of foot pain are present in the balls, arches, and toes of our feet. This can be the result of a plethora of conditions, ranging from simple inflammation and nerve damage to arthritis and abnormal bone structure. Again, there are multiple treatment routes we can take, but a detailed examination will certainly yield a more precise, effective relief to your foot pain, wherever it occurs.

Imaging:

Although we do not have an on-site imaging center, we are partnered with Radnet and SimonMed for all of your X-ray, MRI, CT Scan, and Ultrasound needs! If there are any red flags noted by the doctor, imaging can be necessary before performing any treatment.

Frustrated by the pain and just want ease of mind to know what is actually going on in your body? The doctors at ProActive Chiropractic can provide you with a prescription to get imagining done if it is within reason with the assessment.

Labs:

Sometimes the root of your condition is not structural. Inflammation, allergies, or deficiencies in our chemical make-up can keep us from recovering fully or quickly. We never want our treatments to plateau until you’ve reached your goals.

Our office is conveniently partnered with LabCorp and Cyrex Laboratories to help better understand your diagnosis when needed. If our doctors believe that a blood and/or urine analysis will benefit your health, they will order these labs at generally a lower cost than what your insurance can. Our goal is to get you the most affordable and efficient comprehensive assessment possible to save you time and money.

TREATMENT:

First and foremost, an examination is key to offering a diagnosis and prognosis for the pain in your feet. We like to address the muscular and joint issues that may present after a detailed examination, followed by an evaluation of the knees, hips, and lower back. That way, we can ensure your foot issues don’t impact the rest of your body, as is common with many conditions.

After scanning your feet with 3-D analyzation software, orthotics may be incorporated with the adjustments along with a variety of tools like Graston, Myofascial Release Technique, Low Level Laser Therapy, gentle stretching, or a combination of them to address the soft tissue structures. 

Chiropractic Manipulative Therapy (CMT):

Scientific evidence proves that chiropractic techniques help patients by restoring joint mobility to provide proper functional movement patterns and balance out the nervous system. This decreases spasms, stiffness, and pain while promoting optimal health.

We have many options to address the structural components that contribute to your pain. We always consider our patient’s preferences first, so when it comes to corrective adjustments, we provide a variety of methods to achieve this goal. Our specialty is manual adjustments. We are experienced in high velocity, low amplitude manipulations to the joints of the body in order to deliver the most comfortable and effective adjustments.

Our one-of-a kind chiropractic tables feature an automated drop piece that utilizes an air compressor to address the joint in both directions in a gentle way. It allows the doctors to adjust front to back and back to front. The drop piece is maneuvered by foot so there are no extra knobs at the side of the table allowing patients to move around comfortably. 

Sometimes we discover smaller yet specific adjustments need to be made. For this, we use an innovative device, called the Activator, delivering a small impulse to the appropriate joint. Whether you love or are intimidated by the “cracks,” the doctors at ProActive Chiropractic will adjust to your preference while still administering the adjustments needed.

Graston Technique and Fibroblaster Instrument Assisted Soft Tissue Mobilization (IASTM) Tools :

When joints get stuck, the soft tissue structures around them suffer as well. When the muscles and connective tissues around the joint are not moving and gliding along each other, scar tissue and fascial distortion occurs. We have multiple tools of different sizes and shapes to help address these issues.

Graston is a patent protected, innovative instrument that assists in soft-tissue mobilization, improving flexibility and decreasing pain by effectively breaking down fascial restrictions and removing scar tissue between muscles. Proactive Chiropractic is Graston certified and a Preferred Provider®. 

Fibroblaster IASTM Tools help our doctors diagnose and treat patients by providing controlled microtrauma to break scar tissue and fascial restrictions to restore full range of motion to keep you in the game.  

Functional Custom Orthotics and Shoes:

There are three main arches of the foot: the medial longitudinal arch, the lateral longitudinal arch, and the anterior transverse (metatarsal) arch. These three arches work together as a strong and supportive tripod, called the “plantar vault,” that helps evenly distribute our weight to obtain the maximal shock absorbency throughout our body to protect our bones, nerves, and joints.

The “righting reflex” or the “labyrinthine righting reflex” automatically corrects the orientation of our bodies so that our eyes are always level. The feet are the foundation in all of our weight-bearing activities so when they are not level, we subconsciously tilt different structures in our bodies to keep our eyes level. This results in overcompensations and under-compensation in various muscle groups. For example, if one arch is collapsed, that knee will internally rotate, which externally rotates the hip, rotating the pelvis, forcing the shoulder to drop on that side, resulting in our head tilting. This domino effect starts at the feet, but directly affects all the other joints of our bodies. This is why leveling out your feet is so essential in overall body health.  

In our office, we have paired up with the world’s leading provider of individually designed custom orthotics to use state-of-the-art technology to analyze the three arches of the feet, making sure the forces you put on them are distributed properly. If the 3-D foot scan detects an unleveling in any of the arches, customized orthotics will be manufactured just for you to rebalance your entire body. They fit a variety of shoes depending on your activity level, how much your feet sweat, and the kind of shoes you want them in.

We never want to sell you anything that does not serve you. If your custom orthotics need to be tweaked to your liking or you do not like them for any reason after wearing them for 45 days, we will remake your orthotics or give you a full refund. Put your best foot forward and try them out! You have absolutely nothing to lose!  

Therapeutic Exercises:

Our journey to improve your health and wellness does not stop when you leave the office. At ProActive Chiropractic, we honor a mutual collaborative effort by our doctors and you, our patients. While in our office, we believe it is our job to manually correct the underlying source of your pain by adjusting and performing techniques that you would not be able to do on your own. We then encourage you to perform customized rehabilitative exercises at home, in the office, or at the gym to better hold the adjustments made. We believe in a team approach where the doctors will align and balance patients on the table, and patients do their part in building the right habits, muscles, and strength to hold those adjustments. These specific exercises help relax painfully tight muscles and build strength to key muscles groups which are imperative for spinal support.

We understand that educating our patients on their condition and teaching them how to prevent it is key to success. We want our patients to know when to come into the office and when they can fix ailments on their own. Our goal is always to save you time and money.  

So many people think that if they can keep up with the latest Barry’s Bootcamp, Orange Theory, Rumble, P90X, Barre, Pilates, or Jiu Jitsu workout, that they have the proper strength to be out of pain. “I can deadlift 500lbs, run a 4.6 second 40-meter dash, and kill it in all my workout routines, so why am I in pain?!” The truth is that these people are great at compensating. To complete these workouts, they may be using their muscle groups improperly.  These workouts are often complex and work on the big “show-me” muscles that are usually overcompensated anyways. When the doctors at ProActive Chiropractic break these big muscle groups apart and muscle test each individual muscle, these athletes are often surprised at how “weak” their muscles are when separated from another. 

We constantly want to be a part of the newest workout routines, machines, tools, and fads. But is it good for us? These new trends are made to hype up new training licenses, not necessarily because they have been researched and proven to help improve health.  

The exercises given at ProActive Chiropractic are designed to focus on the smaller, undercompensated muscles that support the joints, ligaments, and deep muscles that help with posture and overall performance. The truth is that new workouts emerge for purposes of more certifications to promote the fitness business. They consist of complex movements that people cannot efficiently achieve without going back to the basics. You crawl before you walk, right? Same concept.

Sure, you can perform these complicated exercises, but are you using the right muscle groups to perform them, or are you creating more of an imbalance and thus pain? Are you breathing correctly and can your brain connect to all the different muscles of your body so that one muscle group is not taking the brunt of the work for another muscle group? The doctors at ProActive Chiropractic will let you know! They will literally show and teach you the tools to perform these exercises properly, leaving you pain-free and even improve your posture.

Understand that these are not glamorous, complex exercises you see at your workout class or on the newest feed on your IG or TikTok account. However, they are needed, effective, and present a challenge in that you have to rehabilitate your brain to connect to muscles that it has been neglecting for a long period of time. Check out some of our favorite therapeutic exercises on our YouTube channel! 

We are excited to help you get back to the movement you love, and by performing the prescribed exercises given by our doctors, we will get you there in no time!

Kinesiology Tape:

Kinesio Taping is a rehabilitative taping techniqueto increase stability around hypermobile joints. Additionally, the tape offers better circulation to the injured area, reduction of swelling and inflammation, speedy recovery of overused muscles, and reduced muscle cramping. It’s one of our go-to’s for sprained ankles.  

We use different types of kinesiology and medical tape to suit your needs. When using tape as a brace, the doctors at ProActive make sure to give you the support you need while also allowing the surrounding muscles to properly engage so that your own muscle and body becomes a natural brace for itself as a result. Depending on allergies, sport, and how much you sweat, the doctors will use their expertise to know which tape and style of taping is needed for you!  

NormaTec:

Come check out the most advanced rehab and recovery solution in just one small package! Whether you are trying to maintain a healthy workout routine or training for the Olympics, the NormaTec is your go-to to decrease inflammation and soreness. NormaTec’s cutting edge compression systems are the ultimate in recovery to fit your needs.

NormaTec sleeves have been scientifically proven to enhance the body’s natural ability to recover, increase circulation, reduce pain, rejuvenate muscles, boost flexibility, and clear out lactate and metabolites. The benefits of NormaTec are so significant that 97% of professional teams rely on its technology to train harder and achieve more. Check out what the buzz is all about.

At the end of the day, this device feels like a nice massage. Our patients usually find time in their busy schedules to come in, kick up their feet, relax, and meditate or look over emails while receiving all the great benefits of NormaTec.  

Low-Level Laser Therapy (LLLT):

Research on Low-Level Laser Therapy reveals that it is a non-invasive and efficient method to reduce healing time after any sort of injury— with zero side effects.

At ProActive Chiropractic, we offer laser therapy using devices from the world leader in Low-Level Laser Technology, Erchonia. Cold lasers have been deemed to be safe and successful in pain management and recovery.  

Similarly to how plants use sunlight for energy to grow, the cells in our body convert the non-thermal photons of the laser into energy, which is then used to heal the damaged tissues faster.
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Get expert foot pain treatment in the San Francisco Financial District area. Call 415-762-8141 or schedule an appointment online now. To experience quality care that’s proven successful in the Financial District of San Francisco, call ProActive today.