Surviving Summit: A little foot and ankle TLC
November 3, 2015
Many people hate them because of their bad looks or smell. The truth is, the foot and ankle serve as the vital interface between our bodies and the environment. If our feet and ankles didn't function properly, navigating the community would be incredibly challenging and dangerous, especially in the High Country. So, sit back, kick off your shoes and let me remind you how much your feet really do for you.
Between the foot and ankle, there are about 33 joints and over 100 muscles, tendons and ligaments, which carry with them a dense network of nerve endings. These nerves send and receive important signals that affect one's balance and sense of position, otherwise known as proprioception.
The efficiency of this process is tested when hiking on uneven terrain, riding in bottomless powder and even just walking in the dark when there is less input from your vision. Balance is hindered after an ankle sprain because the ligaments that carry the proprioceptive information are stretched, and so they don't register tension and loading as accurately or efficiently. This can lead to chronic ankle spraining since there is less ankle stability and less balance control. It can be a vicious cycle, so focused balance training is imperative after even a mild ankle sprain.
The foot and ankle complex is designed for two main functions. One is to provide a rigid platform needed for day-to-day activities, such as walking. The second is to act as a mobile adapter that conforms to the contours of uneven terrain, which allows us to participate in a wide variety of activities, such as biking, skiing, hiking on rocky trails, etc.
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The joints of the foot and ankle are multi-planar, meaning they are designed to move in multiple directions. Two of the most familiar ankle motions are pronation and supination. These refer to composite motions: first, heightening of the inner foot arch (supination), and second, dropping of the arch (pronation).
Foot shape, size and position vary between people, but the functional role is consistent — to serve as the sensitive and adaptable interface between our body and the ever-changing environment.
Find your balance
Regardless of your history of ankle sprains, balance training should still be part of your workout regimen. If you put time and energy into training while you're healthy, you are less likely to experience an injury. It will also lead to better performance!
Balance training, also known as neuromuscular re-education, can easily be incorporated by:
Modifying the stability of surface you're standing on,
Decreasing your base of support,
Adding body movements to shift your center of mass, and
Modifying visual input.
Here are a few tactics and exercises to get you started.
1. Step on something squishy. It sounds funny to say, but you'll remember this simple idea: All you have to do is stand on something with some squish, like a foam pad, BOSU dome or even folded towels at your house. Standing on a balance board also fits in this category.
Exercise: Squats on the BOSU (blue dome).
2. Decrease your base of support by standing with a narrow stance or on one foot.
Exercise: Stand on a single leg (use a foam pad if you want a challenge).
3. Just move. Put your body, arms or unweighted leg into motion. The movement of your body creates what's called a perturbation. Another type of perturbation is when something from the environment shifts your center of mass and challenges your stability.
Exercise: Standing on one leg, perform leg circles with the non-weight bearing leg, one minute each direction.
Exercise two: Standing on one leg, bounce a gym ball against the wall.
4. Find visual challenges. Closing your eyes will make balance incredibly challenging. A visual tracking activity will also challenge your stability by relying less on stable object fixation.
Exercise: Standing on one leg, look left and right or up and down. Head movements also incorporate vestibular system activation, which is another component of balance.
You are really only limited by your imagination when it comes to balance training. Try combining any four balance training keys to create your own challenging exercise. The foot and ankle are where the rubber meet the road, so it's important to work on this often-neglected area and stay on track with all of your athletic endeavors.
Eric Dube is a licensed physical therapist and orthopedic clinical specialist with Howard Head Sports Medicine in Summit County.
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