Importance of Foot Rehabilitation and Management in Arthritis

Dr.BhaktiJamdade (PT),Rehabilitation Therapist. Pune.

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Take a step in right direction – To find best management for your foot in Arthritis!!

It was Leonardo da Vinci who stated that “the human foot is a masterpiece of engineering and a work of art.”

Our ankle and foot complex consists of 26 bones and 33 joints and more than 100 muscles, tendons and ligaments and it’s a high precision instruments that connects us to the earth, supports our skeleton and provide balance and stability.

Briefly, in our body spine is connected to hip bone that is connected to the thigh bone and the thigh bone is connected to the knee joint and so on.

Our entire skeleton is interconnected, and foot is the foundation of our body.

“When your feet are supported, it sets stage for the rest of your skeleton to be in better alignment”

That is the reason foot rehabilitation and management is crucial in cases of Arthritis.

Arthritis is an inflammation of the joints which affects multiple joints in body and cause pain, tenderness, swelling and stiffness. Arthritis in foot and ankle can be especially painful and troublesome and can affect the way we walk and our daily functional activities and in turn affect our quality of life.

While there are many types of arthritis, there are three types that most commonly cause foot and ankle pain and deformities. These types are osteoarthritis (wear and tear/ aging arthritis), rheumatoid arthritis (an autoimmune disease), and post traumatic arthritis (caused by an injury or fracture)

Whether you have inflammatory arthritis or osteoarthritis the management of foot and ankle is most important in terms of rehabilitation.

Foot health protocol is crucial to maintain and improve the quality of life in patients with arthritis.

Briefly consisting of - 

-    Foot and ankle Physiotherapy 
-    Splinting and bracing 
-    Footwear selection 
-    Foot care

Foot and Ankle Physiotherapy

Physiotherapy rehabilitation plays a vital role in managing the effects of arthritis to improve the functional capacity of patients

Physiotherapy goals should aim in pain reduction, restore alignment, motion and the load distribution on feet thus improving the strength of joints and bring patient back to their desired level of physical activity.

A good physiotherapy program should focus on strengthening, maintaining flexibility of joints, maintaining mobility to keep patients functionally active. Lifestyle modification and environmental changes as per the patient's requirements and training the individual to adapt to the environment effectively.

Physiotherapy should be focused on the overall fitness and improving the quality of life of the patients and reduce the barriers affecting their involvement in community.

Splinting and bracing are used to immobilize the affected joints in arthritis to treat acute pain and swelling especially when the patient experiences the flare in the condition.

Splinting is also advised for alignment correction in case of correctable deformities. Bracing helps to realign the joints and give additional stability to joints and help ease discomfort and pain, prevent and maintain the deformity and improve the function.

Various splints like Toe alignment splints, bunion splints, Toe spacers are useful for the deformity corrections and prevention.

Customized splinting and bracing is crucial in patients with more severe deformities to reduce pain.

Insoles are important aspect of orthotic foot management that help patients in all the stages of arthritis to maintain the right biomechanical alignment of foot and prevent further damage.

Insole’s correction is required to maintain the arch of foot, manage the pressure points and maintain alignment.

Various types of insoles are available, and the ideal type should be prescribed by the rehabilitation therapist based on foot pressure mapping and analysis.

Footwear Selection

Considering the different types of deformities in arthritis various important points should be considered before selecting the right footwear like – shoe shape (shape should match the shape of your feet)

- Shoe stability
- Consider rocker bottom shoe for easy translation
- Select right type of shoe material 
- Select shoes with removable insoles 
- Aim for easy adjustability

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Foot Care in Arthritis

In arthritis specific foot caresteps should be followed to keep your feet healthy and control the effects of foot and ankle arthritis 

-    Daily foot inspection to check for pressure points, redness 
-    Daily foot wash with lukewarm water 
-    Wearing comfortable and right footwear indoors and in outdoors
-    Nail and nail bed care
-    Avoid cutting, filing corns, calluses or skin protrusions
-    Maintain basic physical activity to main good circulation 

To conclude

We can say arthritis management in foot and ankle requires a holistic approach and a teamwork from different specialists. And self-management in terms of stress management, weight reduction and taking the charge of your health and not being ignorant about the condition is important.