The foot is a sturdy structure, made to support your entire body weight as you stand, walk, run and jump. The foot consists of three distinct anatomical areas: the hindfoot, midfoot and forefoot. The hindfoot is made up of the calcaneus, also known as the heel bone, and the talus which sits atop it and forms the ankle joint along with the lower leg. The midfoot consists of a group of bones known as the tarsal bones: navicular, cuboid and three cuneiform bones. Finally, the forefoot consists of the long bones of the foot, the metatarsals, and the bones of the toes, the phalanges.

Numerous ligaments connect and stabilize the bones of the foot. Ligaments are made up of inelastic fibers and connect bones. Ligaments are long enough to allow the foot to move through its normal range of motion but sturdy enough to limit excessive motion. While the foot requires sufficient mobility to move, it also needs enough stability to withstand all of the forces of weight bearing. The ligaments of the foot play an important role in limiting motion, holding bones in the proper places and absorbing shock.

A foot sprain describes an injury to one of the foot ligaments in the form of stretching or tearing. This often occurs when the ankle rolls or the foot twists unexpectedly while running, slipping off a curb or stepping on uneven terrain causing the foot to move beyond its normal range of motion. Hyperextension of the big toe can also cause a sprain injury known as turf toe. Because the primary function of ligaments is to provide passive stabilization to the area, loss of stability can range from mild to severe with a ligament sprain.

We can categorize a sprain based on its severity:

• Grade I (mild): microscopic damage has occurred to the ligament but only mild local tenderness and minimal bruising/swelling is noted without compromising joint stability. Typically takes 2-3 weeks to heal.
• Grade II (moderate): partial tear/rupture of the ligament. Obvious swelling and tenderness noted over the injured ligament but joint instability is either minimal or absent. May require up to 6 weeks to heal.
• Grade III (severe): complete rupture of the ligament with severe swelling and tenderness. This injury may be difficult to distinguish from a fracture initially. Instability of the joint is noticeable due to the severity of the rupture. Prolonged time to heal is frequent and may require surgery to repair.

• Pain, tenderness and swelling over one of the foot bones
• Redness and bruising
• Difficulty walking on or moving the foot or ankle

If you decide to work with a physical therapist to help correct your sprained foot, 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 PT sessions yet in the comfort of your own home.

PHYSICAL THERAPY FOR A SPRAINED FOOT

In the first week or so after a foot sprain, your physical therapist will teach you how to protect the recently injured and newly healing ligament. You want to minimize any movement that causes pain or places any stretch or strain across the injured site. They may recommend bracing or taping to protect the injured area and reduce pain. They may advise the use of crutches if you cannot walk without limping.

Aside from protecting the area of injury, in this very early phase, your physical therapy treatment will focus on reducing inflammation and pain, and maintaining strength in unaffected areas above the injury. To achieve these goals your physical therapy treatment may consist of the application of ice or light soft tissue work to mobilize any edema. Modalities such as electrical stimulation or ultrasound may be applied to increase circulation, decrease inflammation and control pain.

As the healing tissues become stronger, inflammation subsides and pain is reduced, it is time to move on to the next phase of rehab which consists of light muscle activation and endurance work, graded active range of motion and more weight-bearing activities. Finally, in the later stages of healing your physical therapy treatment will focus on exercises and activities that prepare the injured ligament to withstand the stress and strain of everyday life and the sports and recreational activities we love to do. This may include stretching, strengthening, plyometrics, sport and work-specific activities.

If you are dealing with a sprained foot or foot injury of any kind, call Evolve Physical Therapy today. Our team of skilled physical therapists can evaluate your symptoms and create an individualized plan to help you feel better. Get started today by scheduling your initial evaluation.