We recently had a patient with chronic insertional achilles tendinopathy and anterior distal tibiofibular joint sprain. We looked at his footwear and all seemed to fit well. After trying many types of taping techniques (ie mulligan and kinesio taping) with no decrease in his pain. Finally we had him bring in his boots again and we altered his lacing pattern. In his next therapy session he experienced a decrease in pain in both areas.
The following pictures demonstrate the before and after of the changes we made:
My theory for why this reduced his pain is that the lacing pattern limited his range of motion at the ankle joint. Limiting the ankle range of motion resulted in increased compression of the front of the ankle and placed increased tension on the achilles tendon. This is not a cure all for all foot and ankle problems. It something to explore during the course of physical therapy.
With any lower extremity injury it is important to look at footwear and make adjustments. I have never seen this reaction to physical therapy for insertional achilles tendinopathy and anterior distal tibiofibular joint sprain before, but I will certainly be looking out for it in the future.
Apex Orthopedic Rehabilitation located in the Gabriel Realty Buidling at One East Ridgewood Avenue in Paramus, NJ provides orthopedic and sports physical therapy services for the greater Ridgewood, Paramus, and Bergen County region. This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your doctor or healthcare practitioner before engaging in a orthopedic or sports physical therapy rehabilitation program.