Symptoms of a foot injury can develop suddenly in response to an acute injury or may develop more slowly over time. Common symptoms of a foot injury are as follows:

• Pain along the top, bottom, inside or outside of the foot or toes
• Weakness in the muscles that move the foot or ankle
• Difficulty moving the foot in one or more directions
• Pain with weight-bearing or moving the foot
• Symptoms that alter your gait pattern or cause you to limp
• Signs of joint or bony instability
• Numbness or tingling in the foot
• Signs of redness, warmth or swelling in the foot

ANATOMY OF A FOOT INJURY

To better understand physical therapy’s role in treating foot injuries, it helps to know a bit about the anatomy of the foot. Below are some foot anatomy facts:

• Each foot has 26 bones including the bones of the toes. Joints are formed where bones connect
• The foot can be divided into the hindfoot, midfoot and forefoot
• Each of these areas functions differently to help you stand, walk, run, etc
• Numerous ligaments connect the different bones and help to give the foot its shape and stability to withstand the forces of weight-bearing
• Nearly 30 muscles--some originating from the lower leg and others within the foot itself--work together to create the delicate balance of foot mobility and stability
• The plantar fascia is a thick layer of connective tissue running between the heel and ball of the foot. The plantar fascia: Helps create the arch of your foot, Acts as a shock absorber for the foot, Assists in changing the position of the foot as you walk
• Many nerves traverse the foot to supply motor and sensory information to the area

As you can see, the foot is complex. An injury can occur to any of these structures and identifying the correct injury is important for selecting the best treatment. There are two basic categories of foot injury–acute injuries that happen suddenly and those that develop more slowly over time. Below are some examples of how these injuries might occur:

Trauma-

• Dropping something on your foot
• Kicking something with your toe
• Twisting your foot or ankle while running

Overuse: repeating an activity or motion at a high volume

• Training for a marathon
• Performing box jumps in training
• Dancing ballet

If you decide to work with a physical therapist to help correct your foot injury, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your sessions yet in the comfort of your own home.

PHYSICAL THERAPY INTERVENTIONS FOR PIRIFORMIS SYNDROME

Conservative treatment for piriformis syndrome is the first line approach. This may include pharmacological treatments like NSAIDs or muscle relaxers and almost always physical therapy. Treatments for piriformis syndrome will always be individualized to address a patient’s impairments but several physical therapy interventions have been shown to be helpful in the management of this condition:

Lifestyle modification: lifestyle modification to reduce compression or irritation of the sciatic nerve can be helpful in reducing symptoms. Avoiding sitting for prolonged periods and daily stretching for example are often recommended.

Modalities: modalities like ultrasound, hot or cold therapy can be utilized to reduce inflammation, promote tissue healing and reduce pain and spasms which may be beneficial early on in a treatment session.

Manual therapy: addressing myofascial restrictions, trigger points and other restrictions in soft tissue around the glutes may be important to address your symptoms. Your therapist may perform these interventions using their hands or may employ other tools like dry needling, foam rolling or IASTM.

Stretching: stretching of the piriformis muscle can address muscle length issues and may help alter pain sensations and decrease muscle spasms to reduce compression on the sciatic nerve.

Lumbar and sacral spine-focused treatments: your therapist may direct their treatment to the spine itself if they feel this is a contributing factor to symptoms. Manual therapy techniques and exercises may be prescribed to address these impairments.

Muscle strength and performance exercises: if biomechanical factors are thought to be contributing to piriformis syndrome your therapist may prescribe a series of functional hip and gluteal strengthening exercises to ensure the small piriformis muscle isn’t trying to do the work of these larger muscles.

Functional training and restoration of activity: as underlying factors are addressed and symptoms subside, your therapist will incorporate more functional activities to ensure proper biomechanics, motor control and coordination when performing these activities. They will also educate you on how to return to your prior level of activity with an eye on prevention of piriformis syndrome in the future.

The symptoms of piriformis syndrome can surely be a pain but you should feel confident that the physical therapists at Evolve Physical Therapy know how to help. Call today to schedule an initial evaluation.