From Foot Pain to 15K: A Chiropractor's Success Story with Shockwave Therapy and Comprehensive Rehabilitation
Introduction
Mr B, like many, had taken up running to help with weight loss which unfortunately led to severe pain on the inside of his foot. He tried to persist but every time he returned to running it would flare up! He tried orthotics, received x-rays and CT scans, and even sought the opinion of an orthopaedic surgeon, all to little avail. With his pain persisting for 3 years by this point and concerns about being able to pass his work annual fitness tests (emergency services) he came to see Ben Goodall, Chiropractor at Proformance Clinics.
After a thorough chat and physical examination, Mr B was diagnosed with tibialis posterior tendinopathy, a condition involving pain, reduced strength, and occasionally swelling on the inner side of the ankle and foot. The involved tendon plays a crucial role in lifting the instep, helping with movements like walking, running, and jumping. Injury often results from changes in activity levels, causing pain after rest or increased activity.
A multi-faceted approach to addressing his symptoms was agreed upon, incorporating shockwave therapy, graded strengthening exercises, and a specialised hopping protocol.
Shockwave therapy
Shockwave therapy for tendinopathy works by inducing controlled microtrauma, promoting growth of new blood vessels, while also reducing the sensitivity of local nerve endings, leading to improved tendon healing and reduced pain. A short course of shockwave therapy lead to a 50% subjective improvement in symptoms and enabled us to get Mr B hopping pain free.
Strengthening exercises
To the surprise of many, tendons like load, even sore ones, so long as you get the intensity and dosage right. Mr B’s strengthening programme began with a variety of bodyweight and weighted calf raise variations from day 1, as well as exercises for the other muscles involved in running, tweaked each week as progress was seen, regressed if pain increased. We began with isometrics (contracting the muscles without moving), before progressing to heavy, slow tempo foot and ankle exercises using weights and machines in the onsite gym at David Lloyd. As Mr B wanted to return to running, we also incorporated alterative cardiovascular work such as rowing and the cross trainer to ensure running fitness didn’t drop during the rehab progress.
Hopping protocol
To help Mr B transfer the new strength and tolerance he’d built in his tendon from the strengthening exercises to the demands of running, it was time to add speed and impact with a hopping programme. Mr B’s hopping programme was based off a study that Chiropractor Ben has used with many of his runners to success, it involves progressing through double and single leg hopping variations, using soft and stiff knees, on and off steps, and jumping forwards and back to improve the resilience of the foot and ankle to the high and fast loading of running. For Mr B, once the single leg hopping phase was reached, graded interval running began and was progressed over time.
End result
In the end Mr B made a fantastic recovery from his foot and ankle pain, he was consistent with the exercise programme, was able to pass the work fitness tests and surprised us both when he managed to beat his pre-injury 5km time with 21m 54s and managed a 15km run with no worsening of symptoms the day after.
If you're dealing with aches and pains, don't let it hold you back! Swing by Proformance Clinics in David Lloyd, let's chat, figure out a game plan that suits you, and get you back to doing what you love. Mr. B's success isn't a one-off – your success story could be next. Don't wait, let's kick those pains to the curb and get you moving!
