Foot / Ankle or Calf Pain – Don’t ignore it. Strength will help but sometimes you may need help prior to exercising

This is called “referred pain”, and it can be unwise to ignore.

See, there are opposing forces below and above your ankle.

Below your ankle and along the bottom of your foot, is a ribbon-like ligament called plantar fascia . It connects your heel and your toes,  supports the arches of your foot and links the stable and mobile sides of your foot.

And generally speaking we flog the crap out of this poor ligament…wearing bad shoes… Long days on your feet…and frequent sports sessions without recovery…

… until it’s a trembling old wreck, SCREAMING AT YOU to do something!

Above the ankle, things aren’t much better.

The soleus  and the gastrocnemius (gastrocs) are the two main muscles in your calf.

When the ankle and joints in the foot, 33 in all, are tight and not moving freely your feet lose mobility. The Soleus and Gastrocs work mainly to propel the body-weight forward through the mobile section of the foot onto the next step. With the foot tight the muscles in the calf are trying to force your bodyweight through a stiff unyielding structure creating opposing forces from above and below the ankle to act on each other. Never good!!

To maintain your forward momentum the calves are trying to produce more force than they are capable of and will eventually get tight and sore and damaged.

Exercise such as High Load Strength Training (below) for the feet has been shown to be the most effective treatment for Plantar Heel Pain aka Plantar Fasciitiis though some times prior to exercise we need to get the ankle and feet moving before starting the exercise program. Some of the ways this can be done are

Soft tissue release

Myofascial Release

Massage

Foot Mobilisation Therapy

The high-load strength training is shown below and has been shown to be successful at improving PHP by numerous studies including  study by Kongsgaard in 2009.

To do the exercise a towel inserted under the toes to  activate the windlass-mechanism of the foot/ arch. The towel ensures that the toes are dorsal flexed at the top of the heel-rise.  Ideally perform the exercises every second day for three months. Every heel-rise consists of a three second concentric phase (going up) and a three second eccentric phase (coming down) with a 2 second isometric phase (pause at the top of the exercise).

i.e. 3 s up – 2 s hold – 3 s down – repeat

Start with 3 x  12 repetition maximum (RM).

After two weeks, increase the load by using a 5kg weight and reduce the number of repetitions to 10RM, simultaneously increasing the number of sets to four.

After four weeks, do 5 x 8 RM . add more weight as you get stronger.

A key coaching point is that the calf-raises need to be done slowly to decrease the risk of symptom flaring.