Foot and Toe Degenerative Joint Disease: find out why physical therapy is a must

Published: 24th August 2010
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There are many different types of therapists who could be called physical therapists, including physiotherapists, chiropractors, osteopaths, masseurs and some areas of occupational therapy. They all work to try and affect the joints, muscles, tendons and ligaments but have different philosophies and techniques to do this. However they do all have the same aim for patients with foot and toe degenerative joint disease and that is to restore function by improving mobility and so relieving pain and stiffness. This is all directed at the muscles, tendons and ligaments (the soft tissue) around the foot and toe joint as there is nothing that can be done for the actual joint itself in foot and toe degenerative joint disease (unless you count a joint replacement!).

To do this a physical therapist will use different techniques, depending on their profession. Chiropractors, osteopaths and some physiotherapists use manipulation where they 'crack' the foot and toe, stretching the soft tissue around it and so improving mobility. Many physiotherapists and occupational therapists give exercise programmes, as do some chiropractors and osteopaths, including stretching to improve mobility and strengthening to improve the structure of the soft tissue around the foot and toes and so support the joints better. This is vital to the long term stability of the foot and toe degenerative joint disease sufferer.

I have worked with many different types of therapists over the years and what type you go to and what works for you is very much up to the individual. At my clinic some foot and toe degenerative joint disease patients did better with a Chiropractor who 'cracked' them and did massage, others with the physiotherapist who would use mobilization and massage and others were better with just the masseur who obviously used massage only. All were given an exercise programme no matter who they saw.

WHAT SORT OF EXERCISE PROGRAMME SHOULD YOU DO FOR FOOT AND TOE DEGENERATIVE JOINT DISEASE?

This is what I recommend. You do need to do these three types of exercises.


1. Stretching- to increase the length of the muscles again and improve flexibility.

2. Isometric strengthening- these are exercises that strengthen the muscle but don't move the joint and irritate your worn joint surface.

3. Isotonic strengthening- these are exercises that strengthen the muscle by moving the joint as you progress.

If you visit a therapist with foot and toe degenerative joint disease they should also do some massage as well or electrical therapy such as Interferential or TENS. Being a Chiropractor (Chiro means 'by hand') I still believe doing the work by hand is better. Why? Because a good therapist will be able to feel exactly which soft tissues are being affected and work exactly on the bad bit. It's harder work for the therapist so is probably why a lot choose to use machines! (That was a bit bitchy wasn't it?!)

How each exercise is done and how many repetitions you do will depend on the level of foot and toe degenerative joint disease you have and the type of therapist you visit.

N.B. Do not be tempted to just get a few exercises off You Tube or a catch all exercise DVD as the programme needs to be set for YOUR level of foot and toe degenerative joint disease and a programme should build up and then drop back to a maintenance level which most of those don't.

ARE THERE ANY PROBLEMS WITH DOING PHYSICAL THERAPY FOR FOOT AND TOE DEGENERATIVE JOINT DISEASE?
The main problem is that exercises are not a cure and must be done for life. Once you have your foot and toe degenerative joint disease reasonably controlled you can usually do them about three times per week to keep your condition maintained.

If I had a patient who moaned about that they usually got told that if they could not find 20 minutes three times a week then they can't really be in much pain. All my programmes could be done at home with no special equipment so there were no excuses!

Really there should be very little problems with a physical therapy programme as long as you are doing a programme that is designed for foot and toe degenerative joint disease sufferers and for your level of DJD.

Anyway the long and the short of it is that if you have foot and toe degenerative joint disease you must do some type of physical therapy programme to keep your joint moving and to strengthen the soft tissue in order to support your foot and toe joint.


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