Sore Foot Arch After Running
OverviewThe tibialis posterior runs down the medial (inside) and posterior (back) of the ankle. The tibialis posterior tendon functions to stop the ankle from rolling inwards and the medial arch collapsing. This tendon can either completely rupture or develop tears along the length of it (tendonitis/dysfunction). Symptoms of tibailis posterior dysfunction/tendonitis or rupture include severe pes planus (flat foot deformity), pain on the medial (inside) of the ankle. swelling on the medial side of the ankle. pain on the lateral (outside) of the ankle, inability or difficulty doing a single leg calf raise.CausesA person with flat feet has greater load placed on the posterior tibial tendon which is the main tendon unit supporting up the arch of the foot. Throughout life, aging leads to decreased strength of muscles, tendons and ligaments. The blood supply diminishes to tendons with aging as arteries narrow. Heavier, obese patients have more weight on the arch and have greater narrowing of arteries due to atherosclerosis. In some people, the posterior tibial tendon finally gives out or tears. This is not a sudden event in most cases. Rather, it is a slow, gradual stretching followed by inflammation and degeneration of the tendon. Once the posterior tibial tendon stretches, the ligaments of the arch stretch and tear. The bones of the arch then move out of position with body weight pressing down from above. The foot rotates inward at the ankle in a movement called pronation. The arch appears collapsed, and the heel bone is tilted to the inside. The deformity can progress until the foot literally dislocates outward from under the ankle joint.SymptomsPlantar fasciitis is most often seen in middle-aged men and women, but can be found in all age groups. The condition is diagnosed with the classic symptoms of pain well focused deep in the heel area of the bottom of the foot. Often the pain from plantar fasciitis is most severe when you first stand on your feet in the morning. Pain often subsides quite quickly, but then returns after prolonged standing or walking. Plantar fasciitis is sometimes, but not always, associated with a rapid gain of weight. It is also sometimes seen in recreational athletes, especially runners. In these athletes, it is thought that the repetitive nature of the sports causes the damage to the fibrous tissue that forms the arch of the foot.DiagnosisDiagnosis of a plantar plate tear can often be challenging due to the complex nature of the anatomy of the foot. Careful history taking and an examination of the area of pain is required to determine the extent and cause of the tear. If necessary, further investigations such as x-rays or diagnostic ultrasound may be ordered by your podiatrist to help evaluate the severity of the problem.Non Surgical TreatmentThe initial treatment for arch pain, especially if it is of sudden onset is the use of ice to reduce the swelling. Later heat and anti-inflammatory gels can be a big help. Activity should be modified, if you stand a lot at work, see if you can using seating more, if you run a lot, consider swimming or cycling for a while. Use footwear that is supportive in the midfoot and heel area.Surgical TreatmentAlthough 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.PreventionDrink 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 ExercisesAchilles stretch. Stand with the ball of one foot on a stair. Reach for the step below with your heel until you feel a stretch in the arch of your foot. Hold this position for 15 to 30 seconds and then relax. Repeat 3 times. Balance and reach exercises. Stand next to a chair with your injured leg farther from the chair. The chair will provide support if you need it. Stand on the foot of your injured leg and bend your knee slightly. Try to raise the arch of this foot while keeping your big toe on the floor. Keep your foot in this position. With the hand that is farther away from the chair, reach forward in front of you by bending at the waist. Avoid bending your knee any more as you do this. Repeat this 15 times. To make the exercise more challenging, reach farther in front of you. Do 2 sets of 15. While keeping your arch raised, reach the hand that is farther away from the chair across your body toward the chair. The farther you reach, the more challenging the exercise. Do 2 sets of 15. Towel pickup. With your heel on the ground, pick up a towel with your toes. Release. Repeat 10 to 20 times. When this gets easy, add more resistance by placing a book or small weight on the towel. Resisted ankle plantar flexion. Sit with your injured leg stretched out in front of you. Loop the tubing around the ball of your foot. Hold the ends of the tubing with both hands. Gently press the ball of your foot down and point your toes, stretching the tubing. Return to the starting position. Do 2 sets of 15. Resisted ankle dorsiflexion. Tie a knot in one end of the elastic tubing and shut the knot in a door. Tie a loop in the other end of the tubing and put the foot on your injured side through the loop so that the tubing goes around the top of the foot. Sit facing the door with your injured leg straight out in front of you. Move away from the door until there is tension in the tubing. Keeping your leg straight, pull the top of your foot toward your body, stretching the tubing. Slowly return to the starting position. Do 2 sets of 15. Heel raise. Stand behind a chair or counter with both feet flat on the floor. Using the chair or counter as a support, rise up onto your toes and hold for 5 seconds. Then slowly lower yourself down without holding onto the support. (It's OK to keep holding onto the support if you need to.) When this exercise becomes less painful, try doing this exercise while you are standing on the injured leg only. Repeat 15 times. Do 2 sets of 15. Rest 30 seconds between sets.