Are Traditional Rehab Methods Failing Your Feet? A Lower-Limb Expert Weighs In [Interview].

It’s no secret that we’ve been hard at work developing resources on foot training, foot and ankle rehabilitation, and preparing for the launch of our Foot Foundations program. Throughout this journey, I’ve had the privilege of connecting with some truly remarkable professionals, including Cass, a physiotherapist with extensive expertise in the lower limb and a special focus on the foot.

Cass is a mountain biker, backcountry skier, volleyball player, and coach, who also dedicates her time as a physiotherapist and an amazing supporter of friends, family, and the greater community. Her insights and experience have been instrumental in shaping Foot Foundations, ensuring it includes vital check-ins for recognizing when professional help is necessary during rehab.

Today, I’m thrilled to share an interview I conducted with Cass. Her expertise is invaluable, and I know you’ll gain a lot from her insights. Let’s dive in!

Carla: Cass, tell us about yourself!

Cass: Hi! My name is Cassandra Downe, and I am a physiotherapist in Calgary, Alberta. My primary practice is with Coalition Performance Care, where I specialize in treating Calgary’s first responders, athletes from various disciplines, and weekend warriors.

I’ve developed a strong interest in the lower limb and general gait/movement dynamics, supported by extensive and ongoing educational courses specializing in lower limb function.

I’m also certified in spinal and peripheral joint manipulation and medical dry needling, which I use daily in practice. Additionally, I’ve completed courses on sensorimotor retraining and motor control techniques that complement my work with gait analysis and retraining cases.

Over the last five years, I’ve worked closely with the Junior Dinos volleyball club, national-level athletes, and members of the Calgary Fire Department and Police Service. My athletic background includes competing in high-level volleyball, skiing, mountain biking, and more, all of which have taught me the importance of moving well to prevent injuries and maximize enjoyment.

Carla: In terms of foot conditions and injuries, are there situations where exercise might be contraindicated?

Cass: A big red flag is uncontrolled pain with certain injuries. While we aim to keep people moving, if pain isn’t controlled or worsens during an exercise, it’s often a sign that the exercise isn’t appropriate at that time.

Carla: Is there a difference between pain you should push through and pain you shouldn’t?

Cass: Instead of relying on subjective pain scales, I encourage people to assess whether their pain is low and consistent during exercise. If it doesn’t change drastically, it’s usually fine to continue. However, if pain increases in severity, it’s a sign to stop and reassess.

Carla: What sensations or symptoms should prompt someone to stop or see a professional?

Cass: If pain progresses despite adjustments or rest, I recommend being assessed by a professional. This helps ensure no underlying condition could worsen with continued exercise.

Carla: Who should people see if their pain persists?

Cass: For new injuries or uncertainty about returning to exercise, consult a medical professional like a physiotherapist, chiropractor, physician, or athletic therapist.

Carla: Can you share some common foot problems and how they might affect assessments?

Cass:

• Plantar fasciitis: Affects toe-off efficiency, redirecting force elsewhere in the foot.
• Calf tears: Limited ankle range can lead to compensatory issues at the foot, knee, or hip.
• Neuromas: Pain with forefoot loading alters force distribution.
• Bunions/tight, weak feet: Weak intrinsic muscles affect load redistribution.
• Flat feet: Reduced ability to absorb and transfer load, causing compensatory shifts.
• Sprains/strains/breaks: Loss of proprioception or range affects force distribution.

Carla: Are there commonalities among foot conditions you treat?

Cass: The biggest commonality is difficulty with load acceptance or transfer. Feet respond to training just like any other body part, so training them is crucial. I also often see weak or unstable hips contributing to foot issues. Proper stability throughout the kinetic chain is essential, so I always assess the entire lower chain when addressing foot pain.

Carla: Would co-managing with a physio be helpful for certain conditions in the Foot Foundations program?

Cass: Absolutely. Having a physiotherapist co-manage your program can optimize results by addressing specific needs and ensuring exercises are effective and safe.

If this interview resonated with you and you’d like to learn more, here’s how you can take action:

• Explore the Foot Foundations program [HERE]
• Book a session with Cass  to get expert advice on your journey to recovery and performance. Reach out via our contact form for instructions on how!

Take the first step toward healthier, stronger feet today!