Are you struggling with foot pain, knee pain, hip pain or lower back pain, BUT not keen to wear foot orthotics (insoles, arch supports) – perhaps Foot Mobilisation Therapy (FMT) could be a solution for you!
Foot Mobilisation Technique (FMT) is relatively new within the podiatry profession, however mobilisation in general has been used by Chiropractors and Osteopaths for decades, however it has never been used exclusively to treat chronic foot conditions, which is what makes FMT so unique with only a few clinics practising FMT in the UK currently.
Foot Mobilisation Techniques ‘FMT’ are a proven treatment solution, that uses the ‘hands-on’ techniques of joint mobilisation and manipulation, combined with corrective exercises, to fix the cause of foot, heel, ankle, leg, knee, hip & back pain and without the need for shoe inserts (orthotics), surgery or medication. The focus of foot manipulation techniques is to provide long lasting improvements to foot and leg problems. This gentle and painless technique stimulates the body’s inherent desire to repair & restore itself. Foot Mobilisation has its roots in manipulative therapy, which is a long established technique widely used by the physiotherapy, chiropractic and osteopathic professions. Even if you currently use orthotics or insoles FMT can improve overall foot function. For some women, wearing an orthotic device is not an option, because of their footwear, so FMT is a perfect treatment alternative to orthotics.
Podiatrists at Leyton Foot Clinic are qualified in a specific foot mobilisation technique which works to put the bones of the foot and lower leg back to their ‘right’ position and allow the foot to work as nature intended.
As we continually load the foot over the years, the bones of our feet move into different positions, this places different demands on the tendons that attach into these bones, and subsequently alters the activity of muscles. This imbalance of muscle, tendon and joint activity is why injuries happen, and why some struggle to rehab after an injury. This foot mobilisation technique positions the bones back to their correct positions and allows everything else to work better, reducing injury risk, reducing pain and improving performance.
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 podiatrist 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 podiatrist 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 podiatrist 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.
The treatment then consists of the podiatrist 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 podiatrist 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. Your feet may be strapped after treatment, and exercises given to do at home.
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.
OUTCOME OF FMT:
Hands-on healing through joint mobilisation and corrective exercises stimulate your body’s natural repair systems. Each visit will promote the following restoration processes:
- Improve mobility by breaking up adhesions and restrictions around the joints
- Improve postural stability by stimulating the body’s proprioceptive (balancing) system
- Improve muscle strength by invigorating the nerve messages sent from the brain to the relevant muscles
- Reduce the ‘pain messages’ sent to the brain by stimulating the joint
While the treatment only takes a few minutes, the above listed effects last for 48-72 hours. Repeated consistently, the effects will continue to last longer and longer.
CONDITIONS TREATABLE WITH FMT:
Foot Mobilisation treats the following common foot problems along with many others:
- Heel Pain
- Arch Pain
- Numbness in your toes
- Ankle Pain
- Shin Splints
- Achilles tendonitis
- Cuboid Syndrome
- Ankle sprains and instability
- Flat feet
- Morton’s neuroma
- Musculoskeletal injuries
- Improving orthotic therapy outcomes
It’s important to know that FMT is not a ‘quick fix’ treatment option, even though most patients do report feeling much better after their first treatment. This euphoric feeling occurs because FMT releases pressure that has built up within the small joints of the foot and ankle, therefore giving an immediate feeling of relief. Proper FMT treatment involves a number of treatment sessions over a couple of weeks and then additional ongoing care based on the symptoms of the patient.
The practice of FMT is a specifically developed form of manual therapy aimed at improving your foot and leg functionality. FMT targets joints of your foot and ankle, which may be stiff, poorly aligned or dysfunctional, and aims to restore the way they work gradually. This is achieved via a series of hands-on treatment sessions in conjunction with a specific exercise regime that we prescribe for you.
Where did FMT originate?
Used extensively in the areas of physiotherapy, chiropractic and osteopathy, FMT originated from a type of treatment called manipulative therapy.
Foot mobilisation techniques have evolved from combining the podiatric biomechanical understanding of foot and leg function with the manual therapeutic experience of physiotherapy and chiropractic.
Dr John Martin Hiss from North America was the pioneer of manipulative techniques for feet and ankles. With the help of a collaborative team of MDs, osteopaths, podiatrists and chiropractors, Dr Hiss set up clinics across the US in the 1920s to treat foot pain.
A student of Dr Hiss, Dr Harvey Lampell further refined the technique and taught the improved version to Ted Jedynak. Jedynak worked extensively with Lampell before refining the technique still further and introducing FMT to Australia.
At Leyton Foot Clinic, our podiatrists have been taught by Ted Jedynak to learn these techniques.