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Massage Today
April, 2013, Vol. 13, Issue 04

Dealing with Painful Foot Injuries, Part 1

By Ben Benjamin, PhD and Karen Ball, LMT

Are you or your clients tired of living with painful feet? The foot is a complex mechanical genius, with 26 bones, 33 joints, 107 ligaments and 19 muscles and tendons. Our feet are our trusty servants, providing a foundation upon which to "take a stand" and move forward in life.

Whether taking a leisurely stroll or pounding the pavement in a competitive race, they adjust instantly to support our every move.

But most of us tend to take our feet for granted, and rarely give them the time of day — until they hurt, that is. And hurt they will, if neglected. According to a report issued earlier this year by Harvard Health Publications, there are at least 300 different types of foot problems, and three out of four Americans will suffer some kind of foot ailment in their life.

Feet hurt for many reasons, from poor alignment, weakness and fatigue to injury and disease. Let's consider the most common injuries that occur in this area of the body. In part two, we'll go on to discuss general self-care principles and a reflexology protocol designed to help soothe and restore ailing feet.

Localized Damage: Common Foot Injuries

The most common injuries affecting the foot region are ankle sprains, muscle strains and tendon injuries. Here is a quick guide to several specific structures that often cause pain, organized by the location in which the pain is felt.

foot injuries - Copyright – Stock Photo / Register Mark Lateral ankle: Pain felt on the lateral aspect of the ankle, and accompanied by a bit of swelling, typically indicates a sprain of one of three ligaments. Most commonly injured is the anterior talofibular ligament, toward the anterior ankle. Second most common is the calcaneofibular ligament, right under the lateral malleolus. Last is the posterior talofibular ligament, located toward the back of the lateral ankle.

Medial ankle: On the medial side of the ankle are the deltoid ligaments. They are more commonly sprained in older individuals, but we've treated these injuries in many young people as well. There are four separate deltoid ligaments, the most anterior structure is right under the tibialis anterior tendon, and the other three work their way around the medial ankle toward the heel.

Dorsal foot: If the dorsal aspect of the foot is painful during walking, this suggests an injury to the extensor tendons of the toes or to the interosseous muscles, which are located between the metatarsals and serve to stabilize the foot.

Plantar surface: When pain is felt on the plantar surface of the foot — especially at the anterior portion of the calcaneus — the most likely suspect is either the plantar fascia or, if the pain is deep, the plantar ligament. These are among the nastiest of all foot injuries because they take a long time to heal.

The only way to definitively identify a soft-tissue injury in the foot — or anywhere else in the body — is to do an assessment. Only then can you determine what type of treatment(s) might be useful, for example massage, friction therapy, manipulation, cranial work, injection therapy or surgery.

Be sure to get a consultation with a physician as well. Many diseases, including Raynaud's, congestive heart failure, pulmonary hypertension, and gonorrhea can cause swollen, painful feet. For sore feet that are not associated with a serious injury or disease condition, a combination of basic self-care and targeted reflexology techniques can often provide great relief. We will address those options in our next article.

Click here for more information about Ben Benjamin, PhD.

Karen Ball, LMT, Certified Reflexologist and Aromatherapist has been working as a manual therapist since 1983. Through the Academy of Ancient Reflexology, Karen offers the 315-hour Therapeutic Hand & Foot Reflexology Professional Certification, and a growing roster of weekend workshops and classes in conventional reflexology, Thai reflexology and allied subjects. For more information, visit


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