Ask Nate Riess: Can Physical Therapy Treat Foot Pain?
Learn how physical therapy is successfully used to treat and relieve foot pain.
Foot pain can bring your busy life to a sudden stop. When a foot injury interferes with your activities, Summit Orthopedics offers a variety of specialists and treatments to help. Most of us know that rest is often a good conservative first step for an injured foot. And we know that if foot pain persists and worsens, surgical procedures are available for consideration. But not everyone may know that physical therapy is an effective foot pain treatment to resolve a wide range of foot and ankle issues. Physical therapist Nate Riess discusses the exercises used to treat foot pain. He also identifies the foot conditions that respond best to this noninvasive treatment.
Foot conditions treated with physical therapy
“Physical therapists are movement experts with a science-based understanding of the body,” Riess explains. “Here at Summit, we offer a repertoire of specific exercises for injured tissues in the foot and in other parts of the body. Our personalized therapy can help you extend your range of motion, reduce pain, restore function, and prevent disability.”
Riess explains that physical therapy is a conservative treatment that is effective for a variety of foot and ankle injuries.
- Nonsurgical conditions. “Foot conditions like plantar fasciitis, Achilles tendinitis, ligament tears, tendinitis, and ankle sprain may not need surgery,” he notes. “Tendinitis injuries specifically are typically overuse injuries. Some patients develop tendinitis from walking the dog every day; other tendinitis patients are marathon runners. Problems including Achilles tendinitis, posterior tibialis tendinitis, and peroneal tendinitis can affect a variety of soft tissues in the foot and ankle. And all of these conditions can be addressed and improved through physical therapy.”
- Surgical conditions. “And even when surgery is the right choice for injuries like ankle fractures and Achilles ruptures, there is a role for post-op rehabilitation physical therapy to help you maximize your surgical outcome.”
People affected by foot pain
“There’s no specific demographic for patients with foot pain,” states Riess. “We work with patients of every age. The age range we typically treat depends on the specific injury.”
- Ankle sprains. “This injury is common among children and teenage athletes,” notes Riess. “But we also see ankle sprains in adults and the elderly.”
- Achilles tendinitis. “These patients are commonly athletes or weekend warriors who remain active into their 50s, 60s, and 70s,” says Riess.
- Plantar fasciitis. This is another condition we see in a full spectrum of patients,” says Riess. “It’s worth noting that as we get older, we become more prone to plantar fasciitis.”
- Traumatic injuries. “Fractures or ruptured tendons can affect every age group,” notes Riess. “We see a high volume of these injuries from November through March because we live in Minnesota. Winter is beautiful here, but snow and ice make for slippery conditions and increase fall risks. I always encourage people to wear appropriate footwear and be extra cautious on sidewalks and driveways. With a little prevention, you can avoid these fall-related injuries.”
What you can expect during a physical therapy evaluation
“When you come in, we check for range of motion limitations, tightness, muscle weakness, instability or balance issues, and gait concerns,” explains Riess. “Many patients have weakness affecting the medial or lateral ankle stabilizers. It’s also common to see limitations, weakness, or instability in the calf muscles. These symptoms are all related to mechanical compensation patterns in the foot. And all of these issues can be addressed with physical therapy.”
Physical therapy exercises for acute foot pain
“The exercises we use depend upon the nature of the injury or condition,” explains Riess.
- Treatment for swelling. “Swelling is common following traumatic injuries like ankle sprains,” says Riess. “We’d ideally like to see you within a week or two of the injury. Elevation, compression, and rest will control swelling, soreness, and stiffness.
- Treatment for limited range of motion. “Typically, the more swollen the joint is, the less range of motion you have,” notes Riess. “Treating range of motion can be as easy as flexing the ankle. We may also have you move the ankle in circles or do alphabet exercises with the ankle. In this exercise, you draw the alphabet letters in the air with your foot, using your foot like a pencil.
- Treatment for gait mechanics. “Once you regain range of motion, we address gait mechanics,” says Riess. “Good gait mechanics give you a normal heel-to-toe pattern in your walk and support ankle stability. Band and free weight exercises put the ankle through various dorsiflexion and plantar flexion motions to reclaim ankle stability.”
Physical therapy exercises for chronic foot pain
“We tailor our approach to chronic conditions like Achilles tendinitis,” notes Riess. “If your condition is chronic, your range of motion might be fine, but weakness could be an issue. However, if we try to strengthen painful tendons too soon or too quickly, we could irritate them. Our objective is to control swelling and modify activity to safely remove irritating factors. These steps allow the foot to calm down, so we can begin the recovery process. A little bit of pain can be okay, but too much pain can put the patient in a dangerous position. That’s why it is important to have an expert guiding you through therapy. Some people think they can manage chronic foot pain themselves, but there’s a risk of doing exercises that detrimentally increase pain and cause it to linger longer.”
What is the time commitment for physical therapy?
The length of time you spend in therapy depends on whether your foot issue is acute or chronic. “If you have a mild acute condition, we might work together for four to six weeks,” says Riess. “On the other hand, chronic issues like plantar fasciitis may need several months of therapy treatment. A treatment program includes both onsite manual treatment and home exercises. We’ll monitor your progress and adjust the treatment plan accordingly. For example, we might start with weekly sessions and decrease them to every other week as you improve.”
Treatment timing has an impact on your therapy outcome
“The sooner you address foot pain, the greater the probability of a successful recovery,” notes Riess. “This is true for both acute and chronic foot pain.”
- Maximizing outcomes for acute foot pain. You’ll benefit from physical therapy even if you have a mild ankle sprain treated at OrthoQUICK and supported by crutches for a few days. “People don’t realize that a week or two of disuse during recovery can have a lasting impact on the ankle,” explains Riess. “This impact can include decreased range of motion, strength, and balance. Remember, once you have one ankle sprain, you are at higher risk to have another—and possibly more serious—sprain. Addressing disuse issues through therapy at the time of the first injury can minimize your risk for recurrent and possibly more serious injury in the future.”
- Maximizing outcomes for chronic foot pain. The longer chronic pain has been a problem, the longer it will take to rehabilitate the foot. “You can’t undo a year’s worth of pain overnight,” says Riess. “It takes time to safely rehabilitate tissues that have been damaged over time. That said, chronic pain patients should start to experience small positive changes within a few weeks after beginning therapy. These changes include things like decreased pain, decreased swelling, and improvements in walking tolerance. It may take six to eight weeks to see bigger gains. And I think it’s worth noting that your progress isn’t solely evaluated based on improvements in range of motion and pain. We also track improvement in function. Our ultimate goal is to overcome functional limitations and support you in reclaiming the activities you want to do.”
Summit Orthopedics offers personalized foot and ankle expertise
Our fellowship-trained foot and ankle physicians understand that your mobility depends on the health of your feet and ankles. If you have suffered an injury or are experiencing symptoms that make walking painful, our team of foot and ankle specialists can help with conservative treatment; proven, evidence-based surgical options; and expert rehabilitation support. Summit Orthopedics specialists have the expertise to evaluate your discomfort and develop a plan to quickly and safely get you back on your feet and on your way.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Plymouth, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.
More resources for you
Ask the Expert: Foot and Ankle Video Series
Ask the Expert: Foot and Ankle Video Series
Explaining what fractures are and how they happen, with specialized treatment options to get you back to your everyday active life.