Ankle/Foot Pain

The foot is composed of 26 bones, 4 arches, and countless muscles, veins, arteries, nerves, joints, and fascia. Beyond that, we rely on the foot repeatedly throughout the day to walk, run and stand. The feet take a lot of abuse; it's easy to understand why they're so prone to injury. We've outlined some of the most common injuries we see and treat in our clinic.

Achilles Tendonitis/Tendonosis: The Achilles tendon is made up of the tendons from two muscles in the lower leg, the gastrocnemius and the soleus. It attaches onto the top/back portion of the calcaneus (heel bone) and is the largest tendon in the body, being able to withstand over 1,000 lbs. of pressure. Although it is strong, it is also the most commonly ruptured tendon. Micro tears occur in the tendon causing inflammation in the area. The patient feels pain at the back of the heel, typically after periods of rest or during jumping, and starting/stopping activities. Inflexible lower leg muscles, over pronation of the feet, and changes in footwear and training schedules are all causes of this condition.

Bunions: Bunions are seen at the side of the base of the big toe. It looks like an enlargement of the joint. They form when the big toe bends laterally towards the other toes, a condition also known as Hallux Abducto Valgus. Bunions can result from abnormal bone formation in the first metatarsalphalangeal joint. Poor foot mechanics are often genetic and can lead to this problem. Other things such as injuries to the foot and 1st toe, flat/pronated feet, and poor footwear can also be a cause. People with bunions complain of pain from the pressure of their footwear, redness and swelling in and around the joint, the motion of the first toe is very restricted, and their other toes are affected either by hammer toes, calluses or corns.

Acute Compartment Syndrome:

- Can take several hours to develop
- When the pressure exceeds the blood pressure within the compartment, the blood vessels collapse
- Without nutrients the tissues can die within hours
- Common causes of ACS include badly bruised muscles, complications after surgery, circulation blockage, crushed foot, and major changes in activity level

Chronic Compartment Syndrome:

- Pain and swelling typically due to exercise
- Improves with rest
- Numbness and difficulty moving foot
- Muscles feel "tight" or "full"
- The pain stops relatively quickly after ending activity but the pressure can remain elevated for some time

Corns: The formation of dead skin cells that develop on the top, sides and tips of the toes. The core of the corn is usually cone shaped with the point facing down. With pressure, the tip can press onto a nerve, making it even more painful. Corns may also become inflamed due to friction from footwear.

Gout: Gout occurs most often in the big toe but can affect any joint of t he body. It usually occurs overnight (within 12-24 hours). It involves painful swelling of one joint at a time, sometimes two. After the first attack a person may go anywhere from one week to years without having another, growing more frequent and more severe with every attack. Without treatment, gout may cause chronic or continuous joint problems and damage.

Uric acid is a natural chemical produced by the kidneys and is key in breaking down and building up food and body tissues. It is normally dissolved in the blood, but in the case of gout, crystal deposits form in the joint causing an inflammatory response.

Genetics play a role in this disease as well as obesity, sudden weight gain, abnormal kidney function, excessive alcohol consumption, and some cancers. The relationship between uric acid levels in the blood stream and gout is unclear. People with high levels of uric acid in their blood do not always have gout and visa versa.

Hammer Toes: Hammertoes can affect any of the toes except the big toe and is most commonly seen in the second toe. It happens when the ligaments and tendons tighten and pull the toe downwards. The bend occurs in the proximal inter phalangeal joint (PIP) with the base of the toe pointing up and the bottom of the toe pointing down. Most people will not notice the initial signs of a hammertoe until a corn appears on the top of the bend in the toe. The corn develops due to the pressure and friction on the joint, typically from footwear. It will be noticeably painful while wearing tight fitting shoes.

There are two separate types of Hammer Toes;

a) Flexible - can move actively and straighten passively (with help from fingers) and
b) Rigid - movement in this case would be limited and painful. Hammer Toes can be hereditary but tight shoes are mostly the cause. Weak muscles in the foot and ankle can also be a factor.

Morton's Neuroma: A condition where nerve(s) are being "squeezed" by the toes and surrounding tissues of the foot, typically between the 3rd and 4th toe. Symptoms of this condition include sharp pain, burning, and even a lack of feeling in the affected area. Morton's Neuroma may also cause numbness, tingling, or cramping in the forefoot. You may experience this after prolonged walking or standing.

Metatarsalgia: A painful condition in the metatarsal area of the foot (the ball of the foot). Pain is typically located under the 2nd, 3rd and 4th toes and is most prominent under the 1st toe (big toe). One or more of the metatarsal heads become inflamed due to extended pressure on the forefoot. Improper fitting shoes are a common cause.

Plantar Fasciitis: The plantar fascia is a band of connective tissue running from the heel into the toes and serves to support the bottom of the foot. It takes a bulk of the load when you are weight bearing. When the fascia and surrounding tissues aren't stretched/used regularly there are allowed to shorten. A shortened plantar fascia is more likely to tear when asked to stretch past its capacity (sometimes all it takes is weight bearing). The most common symptom of this condition is pain in the heel on 1st step, in the morning or after a period of rest.

The calcaneus is the largest bone in your foot and takes the most pressure when weight bearing. A heel spur can develop at the lower frontal area of the calcaneus, where the plantar fascia attaches. When under stress, the plantar fascia pulls away from the bone causing your body to lay down calcium (building block for bone) in an attempt to strengthen the area.

Many people have a spur and don't know it because a spur alone does not cause pain. Rarely are there cases of the spur "poking" into tissue resulting in pain. A spur is mainly just evidence that you may have plantar fasciitis.

Shin Splints: Characterized by inflammation of the sheath of the periosteum (bone) of the tibia (shin bone). This may happen on the outer side (lateral) or the inside/back of the tibia. Most describe the onset of pain as gradual, starting as a dull ache after walking or running. The area of pain is typically localized, being 4-6 inches in length on the mid region of the bone. The muscles that attach to the tibia (soleus, flexor digitorum longus, tibialis anterior, tibialis posterior) often feel sore as well. Causes may include overuse, running on hard surfaces, tip toe running, high arches, and bad shoes and arch support. There is an increased risk of stress fractures occurring if this condition is left untreated.

Sprains: An overstretching or tearing of a ligament. The most commonly damaged ligament is the anterior talo-fibular ligament of the ankle. Risks of injury include poor rehabilitation of a previous sprain, poor proprioception of a previously sprained ankle, and weak ankle muscles. There are three different types of sprains:

1. 1st Degree Sprain: There is some overstretching and tearing of the ligament and little or no functional loss of the ankle. There is mild pain on weight bearing and some swelling and stiffness.
2. 2nd Degree Sprain: There is more tearing than a first degree sprain, moderate instability, moderate to severe pain on rest and severe pain on weight bearing. Swelling and stiffness are also present.
3. 3rd Degree Sprain: The ligament is completely ruptured; there is functional loss and gross instability. Many times there is severe pain right after the injury followed by no pain at all. Swelling is typically severe. 

Tarsal Tunnel Syndrome: Signified by the entrapment of the tibial nerve inside the ankle. Patient has tingling and numbness in the sole of the foot that worsens throughout the day. Rest and elevation lessen the symptoms. The tibial nerve bends around behind the medial malleolus, making it more prone to injury. Surrounding structures can also impinge the nerve if they are swollen or inflamed. Things like flat pronated feet, a cyst or lesion in the area, Rheumatoid Arthritis, fractures or other misalignments to a joint can cause this condition.

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Dr. Brendan Carney Kilian

Chiropractor | Clinic Director

Dr. Brendan Carney Kilian graduated from the University of Waterloo with an Honours Bachelor of Science (Kinesiology – Pre-health Professions Option) in 2002 and from the Canadian Memorial Chiropractic College in June 2006, Magna Cum Laude with Clinic Honours. Dr. Carney Kilian is also a Certified Strength and Conditioning Specialist and has been working in the fitness industry for over a decade. He has special interests in musculoskeletal injury rehabilitation, weight management, and individualized program design. Dr. Carney Kilian has additional certifications as a Certified Golf Performance Therapist, and a Spine certified Active Release Techniques® (ART) Provider. From his small town roots, Dr. Carney Kilian emphasizes a patient-centered approach that stresses patient education and long-term successes. 

Dr. Carney Kilian opened In Motion: Health – Wellness – Fitness to provide an innovative Pain Management, Rehabilitation and Injury Prevention solutions for the residents of Sarnia-Lambton.

Dr. Luke Winegard

Chiropractor | Clinic Director

Dr. Luke Winegard graduated from the University of Guelph with an Honours Bachelor of Science (Human Kinetics) in 2001 and from the Canadian Memorial Chiropractic College in June 2006. Over and above his professional training, Dr. Winegard has studied to become Full Body Certified in Active Release Technique® (ART), as well as received a Diploma of Clinical Acupuncture and is a Certified Strength and Conditioning Specialist. Dr. Winegard’s professional focus is to help an active clientele to reach their potential through active therapies, patient education and the promotion of an active lifestyle.

Actively involved with the Sarnia Seaway Kiwanas Club, the Rapids Family Health Team and the Health Professional Advisory Committee of the LHIN, Dr. Winegard is committed to developing strong ties to the community of Sarnia.

Dr. Winegard decided to open In Motion: Health – Wellness – Fitness to provide an innovative Pain Management, Rehabilitation and Injury Prevention solutions for the residents of Sarnia-Lambton.

 

Dr. Jane Pilkey

Chiropractor

Dr. Jane received her Honours Bachelor of Kinesiology from McMaster University and went on to graduate from the Canadian Memorial Chiropractic College in 2011. She furthered her education by becoming a Contemporary Medical Acupuncture Provider in 2013. Dr. Jane takes special interest in prenatal and pediatric care and is working towards obtaining a residency in pediatrics through the ICPA.

Dr. Jane is an evidence based practitioner that focuses on a patient-centered approach to care; she emphasizes patient education and promotes an active lifestyle to help keep patients both pain free and fully functional. She maintains professional affiliations with the Canadian Chiropractic Association and the Ontario Chiropractic Association in addition to being a registered service provider for the Department of Veterans Affairs, RCMP, and WSIB. 

Originally from Sarnia, Jane was born into an active family and grew up a competitive figure skater, swimmer, soccer player, and golfer. Her love of sport and volunteer work as a coach and athletic trainer with various teams has resulted in immense experience dealing with athletic injuries. She looks forward to her future with In Motion and helping her clients to remain active.

Amanda Sargent

Registered Massage Therapist

A local girl, Amanda Sargent was born and raised in Sarnia and attended Lambton College. Prior to becoming a Registered Massage Therapist in 2003, Amanda spent time in the healthcare setting as a nursing student and a personal support worker. Amanda has gained experience working as part of a multi-disciplinary healthcare team, at Canada’s leading facility for comprehensive healthcare assessments, and in a small family chiropractic office. Amanda has additional training in fascial release, advanced lumbar spine techniques, and Neuromuscular Integration and Structural Alignment (NISA). Amanda has special interests in pregnancy and deep tissue massage. She is excited to be back home to serve her local community as a member of In Motion’s Health Team.

Jamey Mihalich

Registered Massage Therapist / Personal Trainer

Born and raised in Sarnia, Jamey attended and graduated from St. Patrick’s High School.  Already being aware of her love of anatomy and physiology, Jamey soon decided to apply herself to the healthcare field.  After attending the three year Massage Therapy program at Lambton College, Jamey graduated in 2011 with honours.  During her three year course at Lambton College, Jamey developed an interest in the rehabilitative element of Massage Therapy as well as pain management; when indicated she regularly likes to integrate homecare, along with hydrotherapy in her treatments. 

Having had grown up in a very active family with a great love for competitive sports, Jamey takes a special interest in athletics and athletes, whether pertaining to sports injuries or further enhancing physical performance.  She has taken additional training for performing sports massage therapy, as well as therapeutic ultrasound.

She continues to maintain an active lifestyle through participation in the sports of hockey and volleyball, as well as regular workouts. Jamey has attained her certification as a personal trainer through the National Strength and Conditioning Association. She looks forward to training clients and helping them reach their goals to a healthy lifestyle.  

 

Jenn Van Horne

Registered Massage Therapist

Born in Sarnia, Jenn was raised and currently resides in Corunna.  She graduated from SCITS high school and then from the 3 year massage therapy program at Lambton College in 2007.  During that time she took special interest in treating those with chronic pain.  Jenn has taken courses in soft tissue release and deep tissue massage.  She is experienced in treating MVA injuries, clients in severe, chronic pain, pregnant and elderly clients as well as repetitive strain and sports injuries.  She incorporates the use of hydrotherapy into treatments whenever indicated to aide in fully releasing the tissue.

Sarah Burke

Registered Massage Therapist

Born and raised in Sarnia, Sarah first continued her post-secondary education at the University of Guelph in a Bachelor of Science Program. After deciding to pursue a career in health, Sarah transferred into the Athletic Therapy program at Sheridan College where she obtained her degree in Applied Health Sciences. Having a passion for travelling, Sarah was able to spend her internship abroad in Ireland gaining experience working with a variety of cultural sports.  

Sarah decided to extend her career into Massage Therapy and graduated from the Ontario College of Health and Technology in 2013.  By combining both Athletic Therapy and Massage Therapy, Sarah is able to offer a unique skill set into her treatments.  

After working with several different sports teams including University of Guelph Men's Hockey and the Sarnia Saints Rugby club, Sarah has gained an extensive knowledge of various musculoskeletal conditions and sports injuries.  Sarah specialized in rehabilitation techniques, sports massage, joint play, remedial exercise, myofascial release, trigger point work, lymphatic drainage, relaxation and deep tissue massage.

Adam Gray

Chiropodist

Adam was born and raised in Sarnia.  He attended the University of Waterloo for his 4 year B.A, and after completing his studies, completed a 3½ year Podiatric Medicine program, at the Michener Institute of Applied Health Sciences/ University of Toronto Campus.  In addition, he has completed 3 years of internship in the Greater Toronto Area in various hospitals and private clinics. 

As a registered Chiropodist, his specialization includes, but is not limited to: lower limb, foot, and ankle injuries (sports medicine); dermatological and nail care; soft-tissue surgeries; nail surgeries; arch pain; biomechanical assessments, footwear, and orthotics; diabetic consultation/treatment; prescriptions for NSAID’s, antibiotics, and/or antifungals; pharmacological care and injections; compression stockings; and treatment using therapeutic modalities (TENS, ultrasound. Etc.)

Stefanie Senior

Registered Dietitian & Sports Nutritionist

Stefanie Senior is one of the leading registered dietitians and sports nutritionists in Toronto. She specializes in weight management, eating for exercise and athletic performance, and corporate wellness.Stefanie Senior, RD offers registered dietitian and sports nutrition services in the GTA and runs a private practice at Athletic Edge Sports Medicine and online via Skype for In Motion. Stefanie offers nutrition counselling, weight management programs and support groups and creates customized meal plans based on food preferences, lifestyle and goals.  Stefanie is also a professor in food and nutrition at the Centre for Hospitality and Culinary Arts at George Brown College and the in-house dietitian and spokesperson for the CBC Live Right Now campaign.Stefanie is a professional speaker who uses dynamic and interactive seminars to teach simple, powerful and sustainable strategies for achieving optimal health, energy and wellbeing. The energetic nutrition guru has appeared on CP24, CTV, Rogers Live, CBC television and radio, Canada AM and has interviewed for articles published in the Toronto Star, Canadian Living, Best Health Magazine, Chatelaine, the Huffington Post, and the Toronto Observer. Stefanie studied dietetics at the University of British Columbia and completed a post-graduate dietetic internship program at Mount Sinai Hospital in Toronto. Previous to entering the field of dietetics, she did a Bachelor of Science degree, with a major in Psychology at the University of Guelph and worked as a Personal Trainer in Vancouver, British Columbia.Stefanie has a unique approach to her practice and provides advice that is realistic, easy to follow and emphasizes stepwise change, balance and flexibility. She is a firm believer that small, gradual changes to an individual’s eating and exercising regimen coupled with patience, commitment and a positive attitude can lead to permanent lifestyle change and a happier, healthier and more fulfilling life.In her spare time, Stefanie enjoys being active, cooking, travelling and experiencing the newest restaurants and food trends in Toronto and across the globe. Stefanie is excited to join the In Motion Team to offer high quality nutrition and weight loss couseling via Skype.

Adrienne Passingham

Physiotherapist

Adrienne was born and raised in Sarnia before leaving the area to pursue her post-secondary education. She graduated from the University of Ottawa with a Bachelor's Degree in Health Sciences (French Immersion) where she completed her course work in both English and French. Adrienne continued her post-secondary education at the University of Western Ontario and graduated from the Master of Physical Therapy program.

Adrienne is a Registered Physiotherapist in the province of Ontario. She believes in lifelong learning and is currently completing courses through the Orthopaedic Division of the Canadian Physiotherapy Association to further develop her manual therapy skills.

Adrienne spent a year working as a physiotherapist at an outpatient physiotherapy clinic in Guelph. In her free time, she enjoys traveling, reading, skiing and watching hockey. Adrienne is excited to return home and to give back to her community as a member of the multi-disciplinary team at In Motion.

Cassandra Rapaich

Physiotherapist

Cassandra was born and raised in Sarnia where she attended Bright’s Grove Elementary School and Northern Collegiate High School.  In 2003, Cassandra was recruited on a full-ride soccer scholarship to Clayton State University (NCAA DII) in Atlanta, Georgia where she captained the Lady Lakers Soccer Team for 3 of the 4 attending years and was awarded a Bachelor’s of Science Degree majoring in Biology with an emphasis in Biomedical Applications. 

Cassandra then pursued her Bachelor of Physiotherapy in the athletic hotbed of Australia, at The University of Queensland. With an international reputation for clinical research, the University’s Physiotherapy division is recognized as a national and international leader in physiotherapy research. The University of Queensland’s active and collaborative research teams specialize in areas of, Musculoskeletal Pain and Injury, Neck Pain and Whiplash, Pain Management, and Joint Stability. Cassandra’s main area of concentration will continue in this direction as it relates to the injured athlete. Cassandra’s clinical training has been centered on a multi disciplinary musculoskeletal rehabilitation team and she is excited to put her training into practice at Sarnia’s In Motion.

Cassandra graduated from the University of Queensland in December 2011 and is now registered in Canada.

Kristi Kleinsmith

Personal Trainer

In 2000 Kristi earned herself a full tennis scholarship to Northern Illinois University where she spent 4 years playing tennis for the Huskies and earning her Bachelor's of Science Degree, with Honours, in Preventative and Rehabilitative Exercise Science. A minor in Exercise Gerontology was also achieved. She continued her education for two years on graduate assistantship and received her Master's of Science in Education focusing on Exercise Physiology and Fitness Leadership. Kristi has also obtained an American College of Sports Medicine certification (Certified Health and Fitness Specialist).

Kristi has experience working with people of all ages and fitness levels. She has experience working in different fitness industries such as corporate fitness, commercial fitness, and exercise gerontology. Kristi was a university professor at Northern Illinois University and Lambton college where she taught health and fitness, weight training and conditioning, tennis, volleyball, and badminton classes.

Her interests include teaching tennis, participating in volleyball leagues and tournaments, playing hockey, and spending time with her English Mastiff.

Get ready to be motivated, encouraged, and challenged to your full potential. Let her ambitious and uplifting attitude guide you through various workouts and classes.

Jodi Rawcliffe

Office Manager

I was born in Michigan, raised in Corunna, ON.  I have more than 20 years of client relation experience and more than 10 years of managerial experience working for NCO.  In 2012 when NCO closed I was lucky enough to have the opportunity to go back to school.  I enrolled in the Medical Office Administration Program at Lambton College and graduated in 2014 at the top of my class.  While attending Lambton College I was the Campus Program Coordinator for the Ministry of Health campaign - Leave the Pack Behind, which focuses on Smoking Cessation for students.  I also gained experience working in a medical office environment as a work study and co-op student in the Lambton College Wellness Centre.I am married to my husband, Steve and we have 2 children – Alexis and Jaxon.  Alexis is currently attending the University of Ottawa and hopes to become a dentist.  Jaxon is an avid lacrosse and football player. I also have 2 furbabies – Chihuahuas, Martini and Skye.We love travelling, playing with our dogs, and watching Jaxon play lacrosse and football.

Heather Noble

Client Relations

Raised in a small town and currently residing in Sarnia, Heather graduated with her Social Service Worker diploma in 2005. She has since contributed 10 years of municiple program creation, evaluation and counselling services to youth and their families. Heather is practiced in crisis management and prides herself in being an advocate and present force for her clients. In her spare time she enjoys reading, friends, family and being engaged in the great outdoors. Heather looks forward to expanding her skill set and feels that In Motion's mission statement fits perfectly with her personal goals. 

Leah Boire

Client Relations

Leah was born and raised in Chatham, ON and is a recent transplant to Sarnia.  Leah has more than 14 years’ experience in customer service, office administration and management.  Leah graduated with honours in 2002 from St. Clair College (Thames Campus) with an Office Administration – Executive diploma.  After graduation she continued her involvement with the college by teaching night classes and tutoring students.  Leah and her husband Kyle decided to move back to his hometown of Sarnia.  In her spare time Leah likes to spend time with her family, friends and fur babies.  She likes exploring her new hometown and surrounding communities and taking advantage of all the festivals and events in the area.  She also enjoys reading, travelling, attending concerts, watching the Detroit Tigers and the Toronto Maple Leafs.  Leah is excited about her opportunity to be a part of the In Motion Team both professionally and personally. 

Mary Beth Purdy

Client Relations

Born and raised in Sarnia, Mary Beth attended Lambton College and graduated with a Sports and Recreation Administration Diploma in 2013 and a Medical Office Administration Diploma in 2015. With 8 years of customer service experience, Mary Beth loves working with people. She gained experience working in a medical office environment during her co-op placement at Bluewater Health in the Pharmacy department. Since graduation, Mary Beth has gained further experience while working as a chiropractic health assistant. Mary Beth has always been enthusiastic about health and wellness and is especially enthusiastic about cardiovascular and weight training. In her spare time she enjoys going to the gym, horseback riding, watching the Toronto Blue Jays / Toronto Maple leafs, and spending time with her family, friends and fur baby Haalie – a 4 year old husky lab. Mary Beth looks forward to expanding her skill set and is excited to be a part of the In Motion Team.      

Kelsey Johnston

Client Relations

Born and raised in a small town, and recently moved to Sarnia. I studied Business – Marketing and Dental Assisting at Fanshawe College. After college I worked chairside for a dental office before switching to more office administration work. I have always loved working with people and enjoy that working reception has allowed me to spend lots of time talking to clients. Since switching to more office administration work I have gained experience while working as the office manager for a chiropractic office. In my spare time I enjoy spending time with family and friends by the pool, going camping, cheering on the Toronto Blue Jays/Toronto Maple Leafs, as well as spending time with my fur babies Jasmine, Sammy, and Roxy. I am looking forward to expanding my health and wellness knowledge, and I am excited to be part of the In Motion Team.