Foot Mobilizations

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Biomechanics Magazine August 2006

Foot Mobilizations

By: P. Gallagher, PT

Previous entries in this series have been directed to the patient.

This one must be done by a practitioner.

(NOTE: the print version has two pages of photographs explaining the

procedure)

http://biomech.com/showArticle.jhtml?articleID=192700648

Last month we covered a basic exercise for alignment and

strengthening for the foot and ankle. This month we present a

technique often used to help increase range of motion in the foot and

reduce some of the swelling in the foot often seen after ankle

sprains. The foot sometimes needs a little help to regain functional

mobility that has been lost due to inactivity or dependent swelling

and its secondary tissue adhesions. Increasing foot ROM also often

helps decrease the secondary Achilles tendinitis that can occur after

ankle sprains that require immobilization. If the forefoot is not

stiff, the ankle and Achilles tendon do not have to overwork when the

patient is training to regain gait and function.

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Caution: Do not press down too hard or overstrain the joints and

muscles.

It is possible to cause a fracture.

Starting position: With the patient seated on a mat, place a 2-inch

pink rubber ball under the center (medial to lateral) of the foot

(Figure A). Place your hands on the patient's foot on either side of

the ball. The proximal hand is the stabilizer and the distal hand is

the mobilizer. Curve the foot down around the ball (Figure . Force

should be directed to the center of the foot (medial to lateral), not

to the sides (Figures C and D).

Find the metatarsophalangeal joint and place the ball under it. With

the patient's knee bent, mobilize the foot by curving it around the

ball. Have the patient extend his or her toes against your force,

then relax for three repetitions. Repeat with the leg straight.

Repeat with the ball under the metatarsocuneiform joints.

Repeat with the ball under the naviculocuneiform joint.

Repeat again with the ball under the talonavicular joint.

With the patient's leg straight, slide the distal hand toward the

toes and curve the foot over the ball for a final stretch. Have the

patient point the toes to compare the mobilized to the unmobilized

foot.