Foot Posture and Ankle Biomechanics
What Foot Posture?
Foot posture is significantly important when dealing with any biomechanical and musculoskeletal conditions. The posture of the foot has been known to affect foot, ankle, knee, hip, back and even shoulder pain. Foot posture is made up of bones, joints, muscles and multiple arches within the foot. It can be categorised under many different umbrellas, however the main 3 are:
What Is Considered Normal Posture?
It is important to understand that a flat foot or high arch can be normal for your biomechanics. It is up to the physiotherapist to assess and determine what your normal biomechanics are prior to making any changes. One way of determining your normal biomechanics is looking at the Achilles tendon. If there is a curve in the Achilles tendon, there is likely to be poor biomechanics/posture.
How Can Foot Posture Be Corrected? Should I Use Orthotics?
The most well known correction for poor foot posture is orthotics. However, did you know that in most cases you can retrain/correct your foot posture with manual therapy and exercises?
Sometimes the poor posture is not able to be corrected by orthotics such as pronation (rolling of the medial arch) from the ankle. Orthotics are designed to provide a passive support to the foot however, that generally means there are active structures (muscles) not working. Orthotics are commonly used in the first stage of recovery to enable a faster return to activity/sport without pain.
The physiotherapist can assess and determine the cause of your poor posture. The physiotherapist can then provide best treatment modalities for your situation. Some techniques used include manual therapy to restore normal joint mobility and home exercises to retrain the inactive/weak muscles of the foot.
Ankle Biomechanics / Stability
Why Do I Keep Rolling My Ankle?
The ankle joint is designed to allow varied, multidirectional movement to allow for walking, running and jumping. The ankle is made up of ligaments on the outside and inside of the ankle and they provide stability and support. The ligaments also act as a biofeedback mechanism to stop rolling of the ankle. When the ankle is rolled the ligaments stretch and send a signal notifying the brain. The brain then sends a signal to your muscles enabling the muscles to contract and stop the unwanted movement. If the muscles are unable to activate in time, the ankle rolls resulting in the ligaments being stretched beyond their limits.
A moderate level ankle sprain can result in torn and/or stretched ligaments. When rolling the ankle multiple times, the ankle is able to move further (due to stretched or torn ligaments) increasing the ankle movement prior to a signal being sent to the brain. This outcome is called a chronic ankle instability.
Can I Improve My Ankle Stability?
Yes. Provided the ligaments are still intact, the muscles can be trained to determine a level of stretch resulting in activation and reducing how far the ankle rolls. If multiple ligaments are fully ruptured, the stability of the ankle is compromised and surgery may be required (depending on personal circumstances).
The physiotherapist will assess the level of stability within the ligaments and assist in determining the best pathway for your recovery. Treatment will likely include a balance exercise program and an ankle stability brace until the biomechanics and control are at a sufficient level.