What are foot mobilisation techniques (FMT)?
Simply put foot mobilisation techniques are a series of movements that are performed on the feet that address any joint ‘stiffness’ that is caused by the way the foot functions. Foot mobilisation techniques involve making small movements of joints within the foot that the therapists finds during examination. The stiffness come from soft tissue (tendons, ligaments, joint capsule and other connecting tissues) restrictions that can occur due to the foot being held (by function) into a certain position. The joint restriction can feel as if it is a bony block but this is rarely the case. There are often ‘adhesions’ which are soft tissues that become stuck down or bound together and so do not move easily by or over each other but become fixed. The joint becomes poorly aligned and the soft tissues that support the joint change and adapt to this new position. Soft tissues always adapt to their shortest functional length – and this can happen very quickly. Therefore if the foot is functioning by continuing to pronate and so stays flat during the whole of the stance phase then the bones and soft tissues will adapt to this position. This will then become the ‘normal’ position of the foot with regards to position and function.
When would you benefit from a session or course of FMT?
Pain is the most usual presentation. This pain is often hard to diagnose and there can be a sporadic nature of the presentation – it is ok one day and not the next, etc. There is often no real cause or sometimes pain will linger long after a trauma, such as an ankle sprain that should have healed. Often the pain is difficult to describe and can vary from a sharp acute pain for a brief period to a dull ache that is a bit annoying.
Sometimes patients present with a sensation that something just does not feel right, feet feel flat or they do not seem to function as they used to. There may be a sensation of stiffness or heaviness when walking or running, a restriction of movement or a pain at a certain point in the stance phase of your gait cycle. During activity you may be ok but a discomfort comes on following increased activity levels. People often comment that they seem to have lost the spring in their step.
What happens at the assessment?
The therapist will take a full history of the problem you are presenting with and ask you various questions to get an understanding of the nature of your problem and any other information that may be of use. On examination the therapist will palpate (press) into certain areas of your feet and move the small individual joints that are in the feet. They may find painful areas when pressed or a restriction or poor alignment of a joint. The joint may be painful when examined and when the therapist tries to move the joint can become increasingly painful. Sometimes the movement is painful when the joint is moved in a certain direction but not in another direction. This will sometimes indicate the direction the treatment will need to take.
The therapist would aim to identify which structures are causing the pain and try to establish a cause why this has happened. They may examine other areas of your feet, to check alignment, the way the foot moves, what happens you stand on it and what happens when you walk on it. We also offer a more in depth assessment of your running style and function and use both high speed video and in-shoe pressure analysis to evaluate how you move and how you move over your stance foot during gait. Please go to the other sections of our website for more information on these assessments.
The treatment then consists of the therapist addressing the movement in the joints in your feet and ankles. This will involve you either sitting or lying on your front to enable the therapist to address the problems found. Some of the movements can be uncomfortable and there may be popping or cracking of the joint. This is a change in joint pressure rather than bone moving on bone and is not damaging to the joints.
We may use strapping on your feet following treatment and give you some exercises to do at home. We shall discuss with you your current level of activities and may advise on a short term change to this.
FMT works best with a short intensive course of treatment and we would usually see you for 3-4 weeks and then look at extending treatments as your foot becomes used to working in a new alignment. There may be a case of using orthoses to support your feet and function in its new alignment. There may also be ongoing exercises to reinforce a new movement pattern.
There may also be a muscle weakness associated with muscles that may cross the joint or when muscle tendons attach into one of the bones that make up the joint. The therapist may test these muscles before and after treatment and you may experience a large change in muscle function.
If you would like any more information on foot mobilisation techniques then please contact us.