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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 ankle injury.

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 movement.

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.

Two 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 weight bear.

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 time.

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 restricted.

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.

After injury it is important to pay attention not only to the

  • obvious main movers at the talocrural (ankle) and
  • subtalar (hindfoot) joints but also to the
  • 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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book your physio appointment or enquire now

Email questions and your preferred physiotherapy timings to nigel@phoenixrehabgroup.com or

WhatsApp / SMS your name, preferred date, time and enquiries to +6588001830

Clinic Locations: See how to get to us here

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.



HAND THERAPY &  SPLINTING

Patients who sustained injuries to their elbows, forearms, hands, wrists (sprains and fractures) and fingers, and requires Hand Therapy to increase the function of their hand following injuries or post-operations as well as custom made hand splints.

Commonly treated hand pain injuries includes



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 and conditions.

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)



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.

Done regularly, it will keeps your muscles healthy and fit with body/movement-confidence. Read the benefits of regular deep tissue release therapy here.



ALTERNATIVE THERAPIES

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 solution.

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We appreciate you as our valued clients and want you to know that the #1 way we grow as a clinic/brand is through word of mouth referrals from valued patients like yourself.

We do not rely on advertising - instead, we prefer and appreciate the goodwill and positive reinforcement from patients. When you have the chance, please tell your family, friends and physicians about the positive results and experience you have had in our physio clinics.

book your physio appointment or enquire now

Email questions and your preferred physiotherapy timings to nigel@phoenixrehabgroup.com or

WhatsApp / SMS your name, preferred date, time and enquiries to +6588001830

Clinic Locations: See how to get to us here