I do a lot of balance work with my clients, and one of the first things I look for on an initial evaluation is range-of-motion (ROM) of the ankle joint. If the ankle joint is deficient in ROM, trying to balance is like walking on stilts. If one has a small perterbation to balance, the first place to correct it is at the ankle. If the ankles are stiff, wobbling and/or falls can occur. Years of putting feet into shoes causes significant atrophy of the muscles of the toes, feet, arches, as well as shortening of the Achilles’ tendon and calf muscles. The feet are sensory organs, a lot like the eyes and nose. There are hundreds of tiny organs called proprioceptors that relay information of the distortion of the ankle joint to the central nervous system and brain, giving it input about your environment and eliciting a response from your body. For instance, when stepping on a slanted surface or rough terrain, the foot and ankle send this information to the brain, and the brain responds by firing certain muscles and relaxing others to keep you upright. If the feet and ankles are stiff (decreased ROM), it is very difficult to ‘stay in orbit’, so to speak. But, this lack of ROM is not set in concrete, but it does take some effort to regain the natural ROM. I have clients remove their shoes and start by standing on a tennis ball at the base of the toes, and working the ball in a grid-like pattern down to the front of the heel. Wherever they encounter a tender spot (and there are many), I have them remain on that spot and apply a little more pressure. Twice a day for a minute on each foot is a good start; as the tenderness abates (usually within two weeks, I have them progress to a golf ball-there are also balls made for just this kind of exercise. Next, I have them stretch the calf, using either a rolled up towel or a half foam roller. They begin with toes forward and the ball of the foot on the towel. Keeping shoulders over hips over ankles, I have them step forward with the other foot. In the beginning, most cannot step forward and need to keep the other foot behind the foot being stretched. I then have them turn the toes inward and outward to stretch the different areas of the calf. Finally, I have them stretch the top of the foot. The muscles of the top of the foot, front of the ankle, and shin tend to be extremely tight, and initially this stretch can be painful, so I have them ease into it by sitting in a chair and taking the top of one foot behind them, placing the top of the toes on the ground. Then they roll the ankle in and out, fanning the stretch across the top of the foot, ankle, and shin. I’ve had good success with improving balance for my clients by using these stretches. On a personal note, I was able to get rid of my orthotics after about two months of these stretches-I had worn them for three years, and had a great deal of foot pain at times. I’m happy to say I no longer wear the orthotics nor do I have ANY foot pain.
PS. I’m attempting to add some photos to show the stretches. I hope they come through-JB
Stay well, John R Blilie, M.S.