Working With Pain In The Foot's Arch

Overview

Plantar fasciitis can be a real pain in the foot. Plantar fasciitis is the medical term for inflammation of the plantar fascia, which is the connective tissue that runs along the bottom of your foot. If you?ve ever had pain in the bottom of your foot with the first few steps out of bed in the morning, you?ve probably had some experience with this painful condition. In active populations, plantar fasciitis is often associated with overuse or a sudden change in activity, and temporarily easing off of activity can be part of the solution. In more sedentary populations, weight gain is usually a major contributor to plantar fasciitis and a weight-loss plan could be of benefit. Whether you?re active or sedentary, however, previous foot injuries, poor arch support, or tight muscles around the foot can all predispose you to plantar fasciitis.

Foot Arch Pain

Causes

At the other end of the spectrum, yet within the same category of congenital flat foot, exist several rare, more severe forms of flat foot. These severe conditions include Vertical Talus, Congenital Calcaneal Valgus, and Tarsal Coalitions - all of which are more rigid (no arch with or without weight on the foot) and definitely symptomatic. Luckily, these are much less common, but can usually be identified by specialists at the time of presentation and treated appropriately. The second category, acquired flat foot, develops over time, rather than at birth. Many different factors can contribute to the development of flat feet. These include the types of shoes a child wears, a child's sitting or sleeping positions, compensation for other abnormalities further up the leg, or more severe factors such as rupture of ligaments or tendons in the foot. Very commonly, the reason for flat feet is that the foot is compensating for a tight Achilles tendon. If the Achilles tendon is tight, then it causes the foot to point down, or to plantarflex (as occurs when stepping on the accelerator of your car). Even minimal amounts of plantarflexion can simulate a longer leg on that particular side, assuming that the other foot is in the normal position. The body therefore tries to compensate by pronating, or flattening out the arch, thereby making up for the perceived extra length on the affected side.

Symptoms

Many people have no symptoms, and the condition is discovered only by chance when an X-ray of the foot is obtained for some other problem. When symptoms occur, there is usually foot pain that begins at the outside rear of the foot. The pain tends to spread upward to the outer ankle and to the outside portion of the lower leg. Symptoms usually start during a child's teenage years and are aggravated by playing sports or walking on uneven ground. In some cases, the condition is discovered when a child is evaluated for unusually frequent ankle sprains.

Diagnosis

Magnetic Resonance Imaging (MRI) can show tendon injury and inflammation but cannot be relied on with 100% accuracy and confidence. The technique and skill of the radiologist in properly positioning the foot with the MRI beam are critical in demonstrating the sometimes obscure findings of tendon injury around the ankle. Magnetic Resonance Imaging (MRI) is expensive and is not necessary in most cases to diagnose posterior tibial tendon injury. Ultrasound has also been used in some cases to diagnose tendon injury, but this test again is usually not required to make the initial diagnosis.

Non Surgical Treatment

The adult acquired flatfoot is best treated early. There is no recommended home treatment other than the general avoidance of prolonged weightbearing in non-supportive footwear until the patient can be seen in the office of the foot and ankle specialist. In Stage I, the inflammation and tendon injury will respond to rest, protected ambulation in a cast, as well as anti-inflammatory therapy. Follow-up treatment with custom-molded foot orthoses and properly designed athletic or orthopedic footwear are critical to maintain stability of the foot and ankle after initial symptoms have been calmed. Once the tendon has been stretched, the foot will become deformed and visibly rolled into a pronated position at the ankle. Non-surgical treatment has a significantly lower chance of success. Total immobilization in a cast or Camwalker may calm down symptoms and arrest progression of the deformity in a smaller percentage of patients. Usually, long-term use of a brace known as an ankle foot orthosis is required to stop progression of the deformity without surgery.

Pain In Arch

Surgical Treatment

Although most patients with plantar fasciitis respond to non- surgical treatment, a small percentage of patients may require surgery. If, after several months of non-surgical treatment, you continue to have heel pain, surgery will be considered. Your foot and ankle surgeon will discuss the surgical options with you and determine which approach would be most beneficial. No matter what kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventive measures. Wearing supportive shoes, stretching, and using custom orthotic devices are the mainstays of long-term treatment for plantar fasciitis.

Prevention

Drink plenty of water before, during and after your workout. Dehydration is a common cause of muscle cramps, according to MayoClinic.com. If your workouts are long and strenuous, drink a carbohydrate-based electrolyte beverage too. Warm up the muscles of your feet before you work out. A simple exercise is to write the letters of the alphabet with your toes. Perform the warm up with bare feet and exaggerate the movements to challenge your muscles. Wear properly fitted shoes. Visit a sporting goods store and get your feet and arches measured. Ask for help selecting a pair of shoes to fit your workout. For instance, if you play soccer, you need cleats, not running shoes. Take a break. Cramps can be your body's way of telling you you're exercising too much, according to MayoClinic.com. Rest for a few days, then resume exercise and see if you can complete a workout without arch cramps. Stretch. At the end of your workout, perform a few stretching exercises to keep your muscles from tightening and cramping. Sit down, lean over and grasp your toes. Pull the toes toward your body until you feel tension in the arch of your foot. Hold the stretch for 20 to 30 seconds, then repeat on the opposite side. Another easy way to stretch your arch is to put a towel on the floor, curl your toes around it and pull it toward your body.

Stretching Exercises

Plantar Fasciitis stretches should always be gentle and pain free, if discomfort occurs with or after stretching decrease the intensity and duration of stretches. Stretches can usually be gradually progressed in intensity and duration over time according to individual tolerance. Plantar Fasciitis Stretch 1. Stretch for the right calf muscle (gastrocnemius) and the arch of the right foot (plantar fascia and muscles under the arches). Take your right heel close to the wall and ball of the foot upright against the wall. Move your hips forwards to the wall. Try to keep your right leg straight. Push down through your right heel to increase the stretch. Maintain for 30 seconds, repeat 2-3 times. Plantar Fasciitis Stretch 2. Stretch for the outside belly of the right calf muscle and the arch of the right foot. Take your right heel close to the wall. Turn the ball of your right foot outwards to 2 o?clock position upright against the wall. Move your hips forwards to the wall. Turn your trunk in the opposite direction (i.e. to the left). Try to keep your right leg straight. Push down through your right heel to increase the stretch. Maintain for 30 seconds, repeat 2-3 times. Plantar Fasciitis Stretch 3. Stretch for the inside belly of the right calf muscle and the arch of the right foot. Take your right heel close to the wall. Turn the ball of your right foot inwards to 10 o?clock position upright against the wall. Move your hips forwards to the wall. Turn your trunk in the opposite direction (i.e. to the right). Try to keep your right leg straight. Push down through your right heel to increase the stretch. Maintain for 30 seconds, repeat 2-3 times. Plantar Fasciitis Stretch 4. Stretch for the right achilles tendon and the arch of the right foot. Take your right heel close to the wall and ball of the foot upright against the wall (as for stretch 1). Move your hips forwards to the wall. Bend your right knee forwards into the wall keeping the ball of your foot upright against the wall. Push down through your right heel to increase the stretch. Maintain for 30 seconds, repeat 2-3 times.

Write a comment

Comments: 0