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• Two of the most common musculoskeletal imbalances that can lead to foot pain are overpronation and a lack of dorsiflexion – and both issues are inherently linked
• Evaluating a client ’ s ability to dorsiflex requires two assessments , one with their knee bent and one with their knee straight
• If the assessments show that your client lacks dorsiflexion , you can start their corrective exercise program with self-myofascial release ( SMR ) techniques that promote dorsiflexion of their feet / ankles , as well as stretching exercises for the soleus and gastrocnemius muscles
• Once the SMR and stretching techniques are completed , incorporate exercises that lengthen the calf muscles under load and mimic the way the foot and ankle move during real-life weightbearing activities .
Foot pain relief exercises
The results you gather from these two assessments will provide you with valuable clues about the origin of your client ’ s foot pain – specifically , whether they lack the ability to dorsiflex . Once you know whether , and to what extent , they lack dorsiflexion , you can use this information to direct the client ’ s corrective exercise program . If a client does lack dorsiflexion , begin the program by selecting self-myofascial release ( SMR ) techniques that promote dorsiflexion of their feet / ankles ( on one or both sides , as needed ). Have them use a tennis ball or golf ball to massage under their foot ( i . e . plantar fascia ) while standing ( see Figure 5 ) and a tennis ball or cricket ball ( or similar ) to massage their calf muscles ( i . e . gastrocnemius and soleus ) while seated ( see Figure 6 ). Instruct them to massage all sore spots on both feet / calves for a total of two to three minutes each leg ( Price , 2013 ).
Once you have increased blood supply to the plantar fascia and posterior calf muscles ( and released any adhesions that may restrict range of motion / dorsiflexion ) with the SMR techniques , it will be appropriate to introduce stretching exercises for the
Figure 5 . Self-myofascial release technique for plantar fascia
soleus and gastrocnemius muscles . Use the assessments for dorsiflexion ( see Figures 3 and 4 on previous page ) as isolated stretching techniques . Instruct the client to hold each stretch for 10 to 15 seconds and repeat two to three times .
Once the SMR and stretching techniques are completed , incorporate exercises that lengthen the calf muscles under load ( i . e . eccentric strengthening ) and mimic the way the foot and ankle move during reallife weight-bearing activities ( e . g . walking , running and squatting ). Movements such as stepping and walking backward ( see Figure 7 ) and squatting ( all while ensuring the feet stay pointing forward ) will strengthen the soleus and gastrocnemius muscles eccentrically , helping promote dorsiflexion and reducing the effects of overpronation . Because eccentric strengthening exercises can be difficult for clients to perform correctly and are easily overdone , introduce these types of exercises carefully , beginning with only a few repetitions and progressing over time to 10 to 12 repetitions for two to three sets ( LaBella , et al . 2011 ).
Assessing a client ’ s ability to dorsiflex effectively , and addressing any limitations you find with corrective exercises , is the key to reducing foot pain . Enabling the feet and ankles to move more efficiently will not only alleviate painful symptoms in these areas , but will also reduce the effects of overpronation . The correction of these two common imbalances ultimately assists the entire kinetic chain in functioning and performing optimally as clients work hard toward achieving their goals .
Figure 6 . Self-myofascial release technique for calf muscles
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Figure 7 . Eccentric strengthening exercise for gastrocnemius
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Justin Price , MA is the creator of the Network Corrective Exercise Trainer Specialist Certification course , The BioMechanics Method ®. His techniques are used in over 25 countries by specialists trained in his unique pain-relief methods . fitnessnetwork . com . au / courses / corrective-exercise
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