‘Restricted Ankle Movement leads to Pain underneath the Ball of Your Foot’

There are many painful conditions of the under-sole foot that are aggravated by weight bearing walking, standing or running. These conditions are not caused by a fall or impact injury but instead occur gradually over a period of time due to foot dysfunctional movement. The front section of the foot is known as the forefoot and includes our toes and metatarsal bone and in this article I will address painful conditions that arise on the under sole area of the forefoot. Painful Conditions such as Metatarsalgia which causes pain underneath the ball of the foot and Sesamoiditis which causes tenderness underneath base of the Big Toe are two common dysfunctional conditions of the forefoot.

Joints of the Ankle

Causes of ForeFoot Pain

• High arch Foot leads to excessive weight bearing Force being absorbed by the front of the foot

• Flat Feet causes excess compression into the structures of the forefoot

• Restricted Ankle Dorsiflexion which is the movement of the foot towards the shin bone

• History of Chronic Ankle Sprains

• Tight Calf Muscles

• Wearing of High Heel Shoes, Flat running shoes with poor arch support

To treat painful conditions of the ball of the foot, restricted ankle dorsiflexion needs to be improved. Restricted Ankle dorsiflexion leads to tightness and shortening of the calf muscles, Flexor Hallucis Longus muscle that controls bending of the Big Toe. In the addition the very important Tibialis Anterior muscle that controls ankle bending is held in an abnormal lengthened and stretched position. These Dysfunctions lead to collapsing of the inside long (medial) arch of the foot and abnormal rolling outwards and inwards movements of the foot causing excess load compression to the front of the foot. Treatment & management

• Manual manipulation of tight and abnormal short muscles of the calf, toe flexor muscles.

• Joint Mobilisations to the Ankle joint to increase Ankle Dorsiflexion movement.

• Measure the degree of improvement to ensure equal measurement with opposite ankle joint.

• If there is restricted Ankle Dorsiflexion for many years due to poor rehabilitation post surgery or due to the growth of bony spurs then a 6mm heel lift underneath both heels will help, under the guidance of your Practitioner.

Tomás Ryan is a Registered Physical Therapist (MIAPT) with The Irish Association of Physical Therapy and is based in Clonmel & Thurles. Contact Number: 0504 26672 Email your queries to: tomaspryan@gmail.com