The following examples are for information purposes only. We highly recommend seeing a sports injury professional or Doctor to recieve a full assessment of your injury.
In order to thoroughly assess a foot injury, a sound knowledge of the anatomy of the foot is required. This is extremely complex and there are many structures which could be involved in your injury. For this reason a systematic and thorough examination is needed to determine the cause of your foot pain.
Subjective Assessment
During a subjective assessment information is gathered to help the practitioner develop an overall picture of the injury. This should involve a medical history, previous injuries, how the current injury occurred and the symptoms of the injury.
You may be asked the following questions:
- Have you suffered any previous injuries?
This is usually asked to determine if a previous injury may be linked to the current one, if there might be any remaining muscle imbalances or postural issues. Even if you think a previous shoulder injury for example could never be associated with your foot pain, mention it anyway, you never know!
- Do you currently take any medication?
This is usually asked in case the practitioner prescribes or recommends other medication (e.g. anti-inflammatories).
- How did the injury happen?
Describe as accurately as you can, what you were doing at the time the injury occured. This helps the practitioner build a picture of the movement which caused the injury. If your pain came on gradually over a period of time, try to describe how long ago you first felt it & what you were doing at the time.
- Have you recieved any treatment already?
The practitioner will want to know what you did immediately following the injury (rest, ice, compression, bandaging/support, pain killers?) Also if it is a long-standing injury, have you seen any other therapist/specialist about the injury & what treatment did they give you?
It is important to the practitioner to know:
- Exactly where the pain is
- How severe the pain is (they may ask you to rate it 1-10)
- If its constant or intermittant
- If its a sharp pain, dull ache, throbbing pain etc
- What activities/movement aggravate it
- If the pain radiates (moves, or shoots)
- If the pain is worse at certain times of the day
- Do you ever feel tingling, pins and needles or numbness?
These symptoms can often (but not always) indicate involvement of one or more nerves
- Have you felt any other sensations?
Such as clicking, grinding, locking, instability or giving way.
- Have you noticed any swelling or bruising?
If time has passed between the injury first occuring and you seeing a specialist they would need to know if there was any swelling or bruising as this can indicate the severity of the injury.
Objective (Physical) Assessment
The objective assessment involves the practitioner assessing the foot, and probably also the ankle joint to test for tender points, available movement, strength and damage to various structures within the foot.
- Observation & Palpation: The practitioner will look at the foot and ankle is standing as well as at rest to look for a number of things including swelling, bruising and foot/ankle posture. They may also ask you to walk as they observe your foot. As with all assessments they should compaired the injured foot to the other side.
- Range of Motion: The movement available at the ankle joint and toes should be assessed both passively (the practitioner moves the joint) and actively (the patient moves the joint). They will also passively move the small gliding joints within the foot to check for stiffness and pain.
- Resisted Muscle Tests: Depending on the injury the practitioner may get you to push against resistance (usually their hand/arm) in various directions, looking for comparative strength and pain.
Special Tests
For every body part there are a number of tests which help the prectitioner to confirm a suspected injury. The following can be used in the foot and ankle:
- Tinel’s sign: Repeated tapping over the posterior tibial nerve where it branches underneath and to the back of the medial malleolus (bone on the outside of the ankle). Tingling or pain futher down the foot indicates tarsal tunnel syndrome (video).
- Morten’s test: Squeezing together the metatarsal heads often produces a sharp pain in the mid-foot in those with morton’s neuroma (video).
Functional Tests
Depending on the severity of the injury the practitioner may ask you to perform a number of functional tests to look at your posture and foot position, symptoms and muscle imbalances in activites such as squatting, lunging and hopping. |
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