Ankle and foot pain after dorsiflexion mobilization?

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Could anyone here have some opinion on dorsiflexion mobilization´s safety aspects. I was as a "practise customer" for a physiotherapist trainee in a podiatric clinic. Trainee was supposed to be doing her handlings based on podiatrist´s teachings and estimation.

In my last visit there, trainee did to my both feet what I figure out being "dorsiflexion ankle mobilization". She held my heel and pulled to herself, about three times, and quite vigorously and as tugs, not as smooth and firm longer pulls. Didn´t feel pain when she did this, but didn´t feel good either.

After that, the same day, my other ankle started to hurt somewhat when I was walking, in front of my outer malleolus. And then my lateral instep started to also hurt somewhat and feel sore and deconstructing when walking and when put weight on it. Prickling in both places. Sore aching sensation in my ankle also at rest.

Got to see the podiatrist in charge in two weeks, I was quite tense so I wasn´t in my best cleverness to ask him firmer questions. But he did ask me did the trainee pull my heel as those vigorous tugs or as a longer pull. So I assume now that tugs were a technical fault? He detected my foot manually and said my ankle joint capsule was irritated, and put kinesio tape around my ankle. He also said that prickling sensation would indicate tissue irritation. But he didn´t really say did something go wrong and what sort of mechanism could have caused these sensations.

Now it´s been weeks after the mobilization, and my foot still doesn´t feel the same it was before. Still got soreness and prickling in front of my lateral malleolus and in my lateral instep. And sort of numb feeling in the round-shaped instep, like some band would tighten around it, especially after walking with shoes (got orthotics) and returning to walking without shoes indoors.

 

Does it seem that the trainee´s mobilization technique went clearly wrong? And what mechanism could have triggered my symptoms, could there have been some structural damage? Does this sound nerve damage? I used to have symptoms somewhat like these (but weaker) months ago with my foot and ankle when I originally went to podiatrist. But my foot had already been much better and almost totally symptom-free before this happened.

 

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  • Posted

    Lordel,

    I'm a bit confused by your description of what happened. Dorsiflexion is the act of pulling ankle/foot back towards your shin, and plantarflexion is opposite motion forward (and away from shin). If your trainee pulled foot towards them that would appear to be plantarflexion.

    Anyway, you didn't share why you needed to go through these ankle exercises. I assume you had a healthy foot to begin with and no injury.

    So it would be guesswork to know if the trainee screwed up and hurt your ankle unintentionally. It's possible. As many of us patients know, ankles are ornery things that work flawlessly in health but have an unpredictable and dark side when injured.

    But it seems unlikely to me that any damage, whether to any of tissues that could be involved (ligaments, tendons, nerves, joint capsule, etc) is permanent.

    Your podiatrist should have all the answers. Just be insistent and make sure the doc comes clean on what really is the matter.

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    • Posted

      I didn´t have acute issues anymore with that ankle and foot when I went to the trainee´s. I got some calf rubbing etc. and I trusted that the physio was responsible for the guidance of the trainee´s handlings that she practised. That they would be that type that they wouldn´t hurt me. But of course I regret now that I went.

      The position of my foot was more dorsiflexed than plantarflexed and trainee´s grip was on my heel when she pulled it towards herself.

      Going to see the physio soon and I hope I won´t just face a resistant attitude.

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