Have foot and lower leg issues that aren’t clearing up? No matter how much you stretch and strengthen the lower leg or the foot, are things just not getting better? Perhaps you’re not looking at the correct area.
When pain or injuries persist through the exercises, modalities, or therapy we are using as treatment, the wrong part of the body is being addressed. We are essentially barking up the wrong tree.
I was reminded of this first-hand recently. Yes, I am a physical therapist, but sometimes I let the athlete brain take over. I began getting shin splints several weeks ago, so of course I started to work more on my foot strength and ankle mobility. The shin splints kept coming back, starting at around one mile in and going away around three miles.
This past weekend, the same pattern. I stopped to stretch my calves and anterior tibialis to calm things down, except this time I was unable to even hold a calf stretch; it was too uncomfortable. Instead, while I was standing there, I decided to do some leg swings. When I went back to my calves they were miraculously looser.
Sometimes, I just need to experience situations for myself to get a true understanding on how things in the body are related. This was one of those moments.
I frequently discuss with my runners how the hips and foot and ankle region are related. I talk about how important hip mobility is for mobility in the foot and ankle region. And yet I didn’t even consider that being an issue for myself because I tend to work hip mobility on a regular basis — just not right before a run.
In all reality, I ignored all the advice I give my runners — I didn’t do a warm up, and I didn’t do any dynamic running drills first. I just wanted to run because I was short on time. As a result, I suffered needlessly and wasted time.
I share my story for a couple reasons: 1) so you can stop punishing yourself for the things you may not realize, because we all do it, and 2) to give you an understanding on how all parts of the body are truly connected and related.
When dealing with knee, lower leg, and foot and ankle pain or injuries, you always need to consider the role the hip plays. The hip needs good stability and control in order to keep good alignment throughout the leg when it is planted on the ground. If it lacks control, the knee can fall inward, the foot can fall into increased pronation, and the leg can wobble. All of these issues will eventually contribute to an injury. It is not really a matter of “if,” but more a question of “where and when.”
Along with stability in the hip, the hip also needs to move well. A tight or stiff hip will result in compensations in the leg in order to still be able to get the foot off the ground and move your body forward. Besides that, tightness in one area can result in tightness in another. For example, there is a direct relation between tightness in the quadriceps and tightness in the calves
Along with that, when the muscles on the outside of the hip are tight, specifically the muscle at the top of the IT band, the leg creates a “whip” effect when it is unweighted and coming through. Over time, this can create injuries or pain from the repetitive torque it causes.
Ultimately, if you are experiencing issues in your lower leg and/or foot and they aren’t clearing up, it is time to look somewhere else. I would start at the hip.