As a foot specialist and runner, an important factor about injuries is nipping them prior to them becoming a bigger issue. Some people are afraid to rehabilitate in the early stages, however proper rehabilitation in the early stages can speed up recovery. Where doing too much too soon can also interfere with the healing process.
What happens in an injury
Acute phase means a recent time period from when the injury occurred. Inflammation usually happens in the initial time period of an injury and it can be painful.
Inflammation is meant to help heal the tissue by replacing damaged and injured tissue to restore function. Acute phase usually lasts 4-6 days . Here it is important to try reduce pain, reduce inflammation, wearing supportive footwear / braces or taping. Within this time period, most of the emphasis should be placed on rest and reducing pain.
Rest, Ice, Compression and Elevation should be done to help to mitigate pain. Rest is key! Icing the area is helpful in trying to reduce swelling. Compression can be done with wraps, but more easily, compression socks or sleeve are easy to apply and help reduce swelling. Elevation helps with lymphatic drainage, which helps to move inflammation away from the injury site away to be metabolized. This phase is mostly just resting and icing
If no medical contraindications, prescription anti-inflammatories help to reduce the amount of inflammation and pain. It is very important to reduce the overall load on the injured tissue. That includes wearing Birkenstocks, or supportive sandals or shoes in the house, braces or in severe cases, an aircast to reduce the load on the injury. When throbbing reduces, then you know it is okay to carefully start doing rehabilitation exercises. Rehabilitation exercises should be provided by a licensed health care provider, physiotherapist, chiropodist, massage therapist or chiropractor.
Subacute – Intermediate phase 4-21 days
This phase is where rehabilitation exercises are started. Here exercises should be done in a pain free manner. In this phase the healing tissue is immature and fragile. Exercise should be gentle and cause no harm. The tissue may revert back to acute phase if stressed too soon. If that occurs, revert back to PRICE (protection, rest, ice, compression and elevation). In the beginning low resistance exercises and high reps should be done to help strengthen the site and surrounding muscles. Gentle stretches can also be done in this phase.
The final stage is to prep the body to handle sport specific exercises to handle their activity . It is important to monitor along the way and anything that makes pain again, may have to revert back to earlier stages. That may include resting, icing, compression, protection and easier exercises.
This is typically when an injury is longer than 3 months. Sometimes, we cannot totally rest out feet. Some occupations require us to constantly be on the move and that may not provide the rest needed to allow an injury to heal. Emphasis should still be focused on reducing the amount of load on the tissue, when possible. To allow it to rest and also do rehabilitation exercises in a manner that does not flare up the tissues or aggravate the tissue. This phase can also respond well with treatment such as shockwave therapy. Orthotics also help in this phase to help reduce the overall strain and load on the tissues.
The main point is to see someone as soon as possible when in an acute phase of a foot injury. Conditions of the feet can be very stubborn, as we cannot completely let the feet rest. Plantar Fasciitis, is one of the more difficult conditions to treat once it has turned chronic. Signs of chronic plantar are first morning step pain and stiffness.
Injuries can be stressful and impact our quality of life. Hopefully these few tips can help you manage a foot injury you may encounter.