Pain across the bottom of the foot at any point between the heel and the ball of the foot is often referred to as "arch pain." Although this description is non-specific, most arch pain is due to strain or inflammation of the plantar fascia (a long ligament on the bottom of the foot). This condition is known as plantar fasciitis and is sometimes associated with a heel spur. In most cases, arch pain develops from overuse, unsupportive shoes, weight gain, or acute injury. If arch pain persists beyond a few days, see a foot and ankle surgeon for treatment to prevent this condition from becoming worse.
Spending a lot of time on your feet. Especially when you are not used to doing so. For example you may have started a new job such as waiting tables where you are on your feet all day and wake up the next day with sore feet. This is a sign of damage and over time could lead to plantar fasciitis. Being Over-Weight. Never an easy topic to discuss but in simple terms, the heavier you are, the greater the burden on your feet. There are times when you're walking when your entire body weight is borne on one leg and therefore one foot, placing great strain on the plantar fascia. Wearing shoes with poor arch support or cushioning. A tight Achilles tendon. This is the big tendon at the bottom of your calf muscles above your heel. If this is excessively tight this can affect your ability to flex
your ankle and make you more likely to damage your plantar fascia. Suddenly changing your exercise routine. Using running as an example if you suddenly run many more miles than your are used to or change to a new running surface
e.g. grass to tarmac - these factors can put excessive strain on the plantar fascia and lead to plantar fasciitis. All of these risk factors ultimately lead to a specific change in foot structure. The term given is over-pronation and this basically describes rolling in of the foot and lowering of the arches. It is this change that excessively elongates the plantar fascia which can lead to plantar fasciitis.
If you've ever seen your footprints in the sand and they looked more like bricks than feet, then you probably have flat
feet. Simply stated, a flat
foot is a foot that does not have an arch when standing. In the medical world, flat
feet are associated with "pronated" feet. Pronated is merely the term used to describe the position of the foot when it is flexed upward (dorsiflexed), turned away from the body (abducted), and the heel is rolled outward (everted), all at the same time. A certain amount of pronation is required for normal walking, but too much pronation is often considered a foot's "worst enemy." Over time, excessive pronation can lead to many unpleasant problems including heel pain, bunions, hammertoes, shin splints, and even knee, hip, or back pain. In fact, one orthopedic surgeon discovered that 95% of his total knee replacement patients and 90% of his total hip replacement patients had flat
feet. An easy way to tell if you pronate too much is to take a look at your athletic shoes-excessive wearing of the inside heel (arch side of the shoe) as compared to the outside is a classic indication of excessive pronation.
feet are easy to identify while standing or walking. When someone with flat
feet stands, their inner foot or arch flattens and their foot may roll over to the inner side. This is known as overpronation. To see whether your foot overpronates, stand on tiptoes or push your big toe
back as far as possible. If the arch of your foot doesn't appear, your foot is likely to overpronate when you walk or run. It can be difficult to tell whether a child has flat
feet because their arches may not fully develop until they're 10 years of age.
Non Surgical Treatment
There are many different causes of and treatments for flat
foot. The most important part of treatment is determining the exact flat
foot type on an individual basis, and doing so early on. The main objective is to become educated on the potential problems, so that you can stop them before they start. Conservative treatment is often successful if initiated early. The old adage "a stitch in time saves nine" definitely applies to the human body, hopefully more figuratively than literally. Do not ignore what your common sense and your body are telling you. Yes, you can live without an arch, but never neglect a symptomatic foot. If you neglect your feet, they will make you pay with every literal step you take.
If you have pain that has not been responsive to other treatments, there is a new non-surgical treatment that was recently approved by the FDA
. ESWT (extracorporeal shockwave
therapy) uses strong electrohydraulic acoustic (sound) energy that triggers the body?s natural repair mechanism. This treatment method is safe, effective and requires a very short recovery period compared to older surgical techniques.
So how do you prevent plantar fasciitis? Factors which can be controlled include training progression
, environmental factors, shoes, and strength and flexibility exercises. A useful guideline for a safe training progression
is ?the 10% rule.? Limit increases in distance or intensity to 10% a week. For example, if a person is running 60 minutes at a session, 4 times a week, or 240 minutes, she or he can probably increase the running time to 264 minutes (240 + 10%), the following week if all else remains the same. Terrain is also an important factor in training. Running 30 minutes on hills is very different from running 30 minutes on flat
surfaces in terms of the forces on the legs and feet. Work up gradually to increase your running time on hills. Also lean forward when running downhill. If you run on a banked or crowned surface
, vary the direction you run in so you alternate which leg is higher and which leg is lower on the bank. If you know concrete or asphalt is causing you discomfort, try running on a cinder or composite
track. If you are going on vacation and are not used to running on sand or grass, don?t spend your whole vacation doing it.
Inchworm. Stand with your weight on one foot. Raise the metatarsal heads of the unweighted foot while you pull its heel closer to your toes. Next, raise your toes toward the ceiling, and then relax your whole foot with it flat
on the floor. Your foot should move like an inchworm across the floor. Reps 6-7 for each foot. Horsepawing. Stand with your weight on one foot and the other foot slightly in front of you. Raise the metatarsal heads on the front foot. Lift your heel ever so slightly off the ground, maintaining the raised metatarsal heads, and pull your foot toward you so that it ends up behind you. Return this foot to the starting position in front of you. You should really feel this one in your arch. Reps. 6-7 for each foot. Toe
pushups. Sit in a chair with your feet resting on the floor. Raise your heel as high as you can while keeping your toes flat
on the floor. This is the starting position. Using your toe
muscles, roll your foot upward until the weight of your foot is resting on the ends of your toes, like a dancer standing on point in toe
shoes. Roll back down to the starting position. Reps. 10-20 for each foot. Sand scraping. Pretend you are at the beach standing in loose sand. Use your big toe
to pull sand inward toward your body, with your little toe
off the ground. Then use your little toe
to push it away, with your big toe
off the ground. Reps. 10 for each foot. Now reverse the exercise: pull the sand inward with your little toe
and push it away with your big toe
. Reps. 10 for each foot.