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 has completed certification training in the area of strength and conditioning with the NSCA and has over twenty years experience in the fitness industry. He has special interests in musculoskeletal injury rehabilitation, weight management, and individualized program design. Dr. Carney Kilian has taken additional training as a Certified Golf Performance Therapist, a Spine certified Active Release Techniques® (ART) Provider and has completed the Contemporary Medical Acupuncture Course through McMaster University.. 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. 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.

Dr. Joel Simpson

Chiropractor

Dr. Joel Simpson was born and raised in Corunna. He attended Western University where he received an Honours Specialization Bachelor of Arts (Kinesiology) in 2010. From there he graduated from the Canadian Memorial Chiropractic College in 2016.

Dr. Joel has completed his certification as a strength and conditioning professional with the NSCA, Functional Movement Systems and Selective Functional Movement Analysis. Dr. Joel focuses on patient centred care utilizing short term and long term goals. This is done through a variety of treatment techniques in order to keep patients pain free but also maintain an active lifestyle in the future.

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.

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.

Shelley Dixon

Registered Massage Therapist

I am a new resident of Sarnia as of August 2023. I grew up in Ingersoll, then made London my home in the early 90's. The youngest of 6 children, my parents were always encouraging us to be active and live healthy lives. I attended Fanshawe College after high school for Fitness & Health Promotion and worked at the YMCA for many years teaching Aerobic Classes and Personal Training. In my mid 20's I ran two marathons and competed in several Triathlons. Nowadays, I enjoy Yoga, walking, cycling and lifting weights.

It wasn't until I was in my 30's that I decided to go back to school for Massage Therapy at D'Arcy Lane. During my 18 plus years as an RMT, I've had the opportunity to expand my knowledge by taking such courses as: Acupressure, Ultrasound Therapy, Deep Tissue Manipulation and Thai Massage.

I have a daughter and son, and a granddaughter. My partner has two daughters and a son. Family is very important to us. I never visited Sarnia until I met my partner who was born and raised here. Over the years, and our many trips to Sarnia for family functions and outings with friends, I came to love the area. Being so close to the water is truly a perk. Now, I find myself saying "I can't believe I actually live here".

As soon as I stepped through the doors of In Motion, I knew I found my new work home. Such a comfortable environment, and a group of talented individuals who truly love what they do was evident. As part of the In Motion Team I am excited to be working alongside other like-minded Healthcare Professionals. I am eager to learn some new skills and help my clients attain their optimal health goals. I also look forward to meeting you soon.

Vanessa Macedo

Registered Massage Therapist | Physiotherapist Assistant

Vanessa Macedo was born and raised in Sarnia. She attended and graduated from the two-year Massage Therapy program at Lambton College in 2023. Prior to becoming a Registered Massage Therapist, Vanessa attended and graduated from the two-year Occupational Therapist Assistant and Physiotherapist Assistant program at Lambton College in 2021.

As an Occupational Therapist Assistant and Physiotherapist Assistant student, Vanessa has gained knowledge in human movement and therapeutic exercise. As a Registered Massage Therapist, Vanessa has experience in the treatment of traumatic brain injuries, motor vehicle accidents, individuals with developmental and physical disabilities, and a variety of soft tissue dysfunctions. Vanessa utilizes General Swedish and Non-Swedish techniques, specialized massage techniques, hydrotherapy, and therapeutic exercise in the treatment of a variety of conditions and ailments when indicated.

Vanessa is registered with the College of Massage Therapists of Ontario (CMTO) and the Registered Massage Therapists Association of Ontario (RMTAO). Vanessa is excited to be starting her career and helping our local community as a member of the In Motion health team.

Kristi Kleinsmith

Personal Trainer | Physiotherapist Assistant

In 2000 Kristi earned herself a full tennis scholarship to Northern Illinois University where she spent four 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.

In 2018, Kristi became a Functional Patterns, Human Foundation Practitioner. This new system of personal training develops the human body as a whole organism. Learn how to correct your dysfunctions by assessing your current posture and gait cycle. Correct your biomechanics and bring the body into a state homeostasis and have it remain there for a lifetime.

Her interests include spending time with her family outdoors, whether it is hiking, biking, swimming, kayaking, or skating. Her family likes to visit the local fruit, vegetable, and animal farms in the area. Discovering the Pinery Park and other parks in the area create new adventures and experiences. She is constantly learning more about how to be a healthy human for a lifetime and wants to share this knowledge with her family, friends, and clients.

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.

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.)

Erika Vasconcelos

Registered Physiotherapist

Erika earned her Bachelor’s Degree in Physical Therapy in Brazil in 2008 and completed her Bridging Program at the University of Toronto in 2016. During her journey to become a registered Physiotherapist in Canada, she had the opportunity to shadow an expert in the Myofascial Release Approach by John Barnes, which sparked her passion for this technique.

In 2017, Erika began taking specialized courses in Myofascial Release, which she now uses as her primary treatment strategy, along with Neurodevelopmental Therapy (NDT), orthopedic injury management, and manual therapy. This integrated approach allows her to address a wide range of issues, drawing on her diverse training to provide comprehensive care for her patients. With experience in both acute care and rehabilitation settings, Erika has witnessed significant improvements in her patients’ chronic pain, posture, movement patterns, muscle activation, and overall functionality.

Erika takes a holistic view of her patients, believing that understanding the whole person is key to effective treatment. Her goal is to empower individuals to transform their lives and guide them on their healing journeys. She begins with a thorough assessment to identify the root causes of symptoms related to the fascial system, which are unique to each individual. From there, she employs targeted hands-on techniques to address these issues and teaches self-care strategies for managing symptoms between visits. She also introduces specific exercises to enhance strength and mobility, helping patients regain movement and overcome limitations. Finally, Erika provides personalized education to help patients learn how to use their bodies correctly, reducing pain and enabling them to participate fully in their activities.

In her free time, Erika enjoys spending time with her family, exploring the outdoors, and staying active. She has a strong interest in neuroscience and emotional intelligence, fascinated by how the brain functions and its impact on the body’s interpretation to signals, judgement, behavior, movement, and overall well-being. Additionally, Erika is passionate about women's health and is eager to explore this area further in her career.

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.

Erica Verberne

Client Relations

I was born and raised half in London, and the other half on a farm in Strathroy. I have worked in the administrative/customer service industry for 15+ years. In recent years, I have enjoyed the financial/accounting side to administration, but overall enjoy meeting new people and building on my customer service expertise.

Among COVID downtime, I decided to become a First Aid/CPR instructor, and enjoy teaching to help build a safer community.

I love travelling, and have spent a year backpacking through New Zealand, as well as numerous trips to Key West. I have visited 16 countries so far and hope to continue exploring with my spouse, Adam, and my 3 children.

Alexis Rosandich

Client Relations

I was born in Sarnia, raised in Corunna. After graduating from SCITS highschool in 2013, I enrolled at the University of Ottawa. There, I received my Bachelor of Health Sciences and graduated in 2017.
I have two children, Scarlett, 3, and Sebastian, 2, who I have stayed home with since they were born.
In my free time I enjoy cooking and baking, especially experimenting with new recipes. I also love to read and I aim to read at least one book a week for the entire year!

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.

Akhy Bhushan

Registered Physiotherapist

Akhy completed his undergraduate degree in Health Sciences at UOttawa and went on to complete his masters degree in physiotherapy at McMaster University. He has taken further education and is certified in concussion management and is currently developing his skills further in the McMaster contemporary Neurofunctional Acupuncture course.

Akhy has a background in playing many competitive sports, namely soccer and martial arts. Akhy has a huge passion in helping others heal as his own injuries through life have motivated him to be a physical therapist. Akhy prioritizes finding a diagnosis and using his knowledge of anatomy and physiology to develop evidence based exercise care plans to help patients overcome obstacles to mobility. By understanding that everyone is a unique individual, with unique anatomical abilities and levels, Akhy works with each patient to ensure a plan is best suited for you. Akhy is an virtual practitioner at this location and only provides sessions via zoom online.