Ankle and Foot

Ankle Conditions

Ankle Sprain

An ankle sprain occurs when one rolls, twists, or turns the ankle in an awkward way. This can stretch or tear the tough bands of tissue (ligaments) that help hold the anklebones together. Ligaments help stabilize joints, preventing excessive movement.

Causes may include: when the ankle is forced to move out of its normal position, landing awkwardly on the foot after jumping or pivoting, walking or exercising on uneven surfaces, or a fall that causing the ankle to twist.

Pain may include: swelling and bruising, restricted range of motion, or pain when bearing weight on the affected ankle.

A.M.I.T. ® Explanation: During an inversion sprain, the lateral stabilizing ligaments are stretched and sustain a certain degree of tearing. Additionally, the peroneus longus, metatarsal, and cuneiform divisions, peroneus brevis, septal and fibular divisions, and the peroneus tertius muscles are injured and inhibited. Once these muscles are inhibited, the ankle loses its neurological control, causing instability and future ankle sprains.

Shin Splints

Shin splints refer to pain along or just behind the shinbone (tibia), the large bone in the front of the leg.

Causes may include excessive force (overload) on the shinbone and connective tissue that attach the muscles to bone, running downhill, running on a slanted or tilted surface, running in worn-out footwear, engaging in sports with frequent start and stops, or physical training errors.

Pain may include tenderness and soreness along the inner part of the lower leg, mild swelling in the lower leg, or bruising. The pain can become debilitating and chronic.

A.M.I.T. ® Explanation: Shin splints are a complex problem found in all athletic activities, more commonly seen in patients who display over-pronation of the foot and ankle. Shin splints are divided into two types: anterior or posterior shin splints. We have determined there are two anterior types: tibialis anterior syndrome and anterior compartment syndrome. The posterior division has three types: medial tibial stress syndrome, posterior tibial syndrome, and posterior compartment syndrome. The cause of each occurs when the muscle attaching into these areas become inhibited. These include tibialis anterior, supinator and dorsiflexor divisions, tibialis posterior, tibial and fibular divisions, flexor hallucis longus, tibial and fibular divisions, extensor hallucis longus, interosseous and fibular divisions, and extensor digitorum longus medial and lateral divisions. These muscles attach to either the periosteum of the bone or the interosseous membrane. When any of these muscles become inhibited and stressed through athletic activities, they become inflamed and lose their ability to contract and relax under changing conditions, leading to pain at the attachment. In addition, the muscles cannot control concentric/eccentric control of the arch of the foot, allowing over-pronation to occur. This contributes to increased torque on the interosseous membrane.

Achilles Tendinitis

Achilles Tendinitis is an overuse injury of the Achilles tendon, the band of tissue connecting the calf muscles at the back of the lower leg to the heel bone.

Causes may include an intense or repetitive strain of the Achilles Tendon.

Pain may include mild aches in the back of the leg or above the heel after running or other sports activity, episodes of severe pain after prolonged running, stair climbing or sprinting, or tenderness and stiffness in the morning.

A.M.I.T. ® Explanation: Irritation and inflammation of the Achilles tendon, which is made up of the medial and lateral Gastrocnemius and soleus muscles, resulting in pain 1-2 inches above Calcaneus/heel. When muscles are overloaded due to multiple factors, they become inhibited and cannot contract efficiently leading to an overuse condition and pain. If muscles are not reactivated neurologically, the tendinous attachments begin to break down and eventually rupture.

Ankle Lateral
Ankle Medial

Plantar Fasciitis

Plantar Fasciitis is inflammation of a thick band of tissue, called the Plantar Fascia, which runs across the bottom of the foot and connects the heel bone to the toes. Plantar Fasciitis is one of the most common causes of heel pain.

Causes of Plantar Fasciitis are due to small tears in the fascia. Under normal circumstances, the Plantar Fascia acts like a shock-absorbing bowstring that supports the arch in the foot. If tension on the bowstring becomes too great, it begins to tear.

Pain may include: pain triggered or worsened within the first few steps after awakening, pain after long periods of standing or sitting, pain in the heel of the foot, or foot pain developing gradually throughout the day.

Causes of PCL sprains may include a direct impact on the front of the knee, such as landing hard on a bent knee during sports.

A.M.I.T. ® Explanation: The cause of this condition is inhibition of the primary arch support muscles (tibialis anterior, supinator and dorsiflexor divisions, tibialis posterior, tibial, and fibular divisions) of the foot. This leads to overstressing of the small flexor muscles of the toes and the plantar aponeurosis. Failure of the supporting muscles allows the foot to over-pronate, adding to the problem. This places all the stress of supporting the arch on the plantar aponeurosis and causes inflammation and break down.