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Persistent foot or ankle pain?
Have you considered the talonavicular or calcaneocuboid joint elements?
Foot and ankle conditions such as sprained ankles or ankle
fracture are commonplace injuries - in fact, they are so common that they represent some of the most frequent injuries in the accident and emergency departments in hospitals and GPs across the country.
Most of these foot or ankle injuries that are mild will usually heal ok within 8 weeks but a percentage of injuries, especially
- more complex
- recurrent/reinjuries (not 1st time)
- more severe
ones will take longer. One of the causes of this foot and ankle persistent pain to consider are the small joints
of the foot, which unfortunately may get forgotten in medical or rehab care after foot and
Treating them can make the difference to that last bit of
pain or restriction sometimes felt.
The anatomy of the foot is highly complex - so many small bones, ligaments, tendons and
joints within the foot held firm with multiple moving parts and muscles.
The main ankle joint is termed the talocrural joint. This is
the joint at the end of the shin bones (tibia and fibula) where it meets
the first foot bone (talus). The majority of foot movement comes from
this joint and most injury is to the ligaments that support this joint.
Further into the foot, down from the talocrural (ankle) joint, you will come across the small joints of the talonavicular and calcaneocuboid. There
is much less movement at these two joints in comparison to the
talocrural joint. Of course, there are some movement at these joints
during walking and weight-bearing on the foot to allow for normal
There is a small amount of up and down movement and also some
rotation in this joint when we put weight on to our foot during walking.
This movement varies from person to person and even varies from left foot to
right foot but an idea of the expected amount of movement can be
assessed by your senior physiotherapist.
The calcaneocuboid joint is located between the
calcaneum bone and the cuboid bone. It is more towards the outer side of
your mid foot. This joint has very little natural movement but does
have a small amount of movement during walking.
These joints have developed and collectively important as they allow a
flexible platform in which we can move, walk, jog, run, correct our position/posture etc. Our foot is
impressively designed with many small interacting joints, muscles and
ligaments in order that we can be both flexible and strong.
joints, the talonavicular and calcaneocuboid are particularly important as they have particular functions which are important roles in the arches that form naturally in our foot as we
A good ankle physiotherapy case example of the contribution these small joints can make to recovery:
Mr B, 31 year old male
Sprained his ankle badly playing football resulted in a small fracture
of the ankle and significant swelling.
He spent some time in an air boot to
help the protect the fracture and injury and allow the bone to heal and when he came out of the boot he found he had a
stiff and sore ankl (this is a normal/natural outcome following injury and immobilization).
He was given some foot and ankle exercises to do and found that in general his ankle
started to loosen up nicely and as he could get back to walking and
things were improving he decided not to stop his physiotherapy sessions.
Unfortunately even 8 weeks later Mr X found that although he had improved he still had
problems when he was walking up hills, slopes, stairs, uneven surfaces or had been on his feet for a long
He decided to go back to his physiotherapist.
Mr B was assessed by a senior physiotherapist who found that his main
talocrural (ankle) joint was moving nicely but found that his
talonavicular joint didn’t have as much play and movement as his
un-injured foot and that the up and downwards movement was slightly
Joint mobilization was performed and Mr B was shown
how to do these mobilisations at home. He worked on these for several
weeks and noted an improvement in his uphill and slope walking.
In summary, these small mid foot joints do not provide a large
percentage of the movement in the foot during walking but they do
contribute. They also contribute to the arches that form a flexible but
strong platform on which we are able to stand and move.
This allows us incredible mobility and function on two feet.
injury it is important to pay attention not only to the
- obvious main
movers at the talocrural (ankle) and
- subtalar (hindfoot) joints but also
- mid foot joints of the talonavicular and calcaneocuboid joints
If you find that you have been having persistent foot or ankle pains or discomforts that have yet to be resolved, contact us to see one of our senior physiotherapists to assess and treat you.
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Phoenix Rehab Physio Services
Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.
PHYSIOTHERAPY & PHYSICAL THERAPY
See all the conditions our principal physiotherapists treat.
HAND THERAPY & CUSTOMIZED SPLINTING
Patients who sustained injuries to their elbows, forearms, hands, wrists
(sprains and fractures) and fingers, usually will benefit / require Hand Therapy to
- manage and decrease hand pains
- improve range of motion, strength and dexterity
- increase the function of their hand
following injuries or post-operations
Commonly treated hand pain injuries includes
REFORMER CLINICAL PILATES & WELLNESS PILATES
Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility and breathing.
It is a system of safe and effective exercises, which
meet specific individual needs, to treat a wide range of injuries
You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.
TRADITIONAL CHINESE MEDICINE (TCM)
- Cupping TCM
- Auricular Therapy TCM
- Herbal TCM Medicine & Supplementation
DEEP TISSUE RELEASE & SPORTS MASSAGE THERAPY
Sports and deep tissue release massage helps to increase nutrient-rich blood
flow to tired, tight and tense muscles to accelerate recovery and shorten downtime / recovery period required.
It also prevents
muscles from scar tissue micro-tears (and potential ruptures), and increases muscle
performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.
Read the benefits of regular deep tissue release therapy here.
All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).
See our entire team here with introductions and their specializations.
At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
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(or check your pains / injuries)
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