Exercises To Help Foot Arch Pain
OverviewOne of those often-painful soft tissue that attaches to heel spurs at the bottom of the foot is called "plantar fascia". Fascia, located throughout the body, is a fibrous connective tissue similar to a ligament. You can see fascia when you handle meat. It is the white, connective tissue separating layers of meat or attaching to bones. The "plantar" fascia in our bodies is that fascia which is seen on the bottom (or plantar portion) of the foot, extending from the heel bone to the ball of the foot. Compared to other fascia around the body, plantar fascia is very thick and very strong. It has to be strong because of the tremendous amount of force it must endure when you walk, run or jump. But while the plantar fascia is a strong structure, it can still get injured, most commonly when it is stretched beyond its normal length over long periods of time. When plantar fascia is injured, the condition is called "plantar fasciitis", which is usualy pronounced either "plan-tar fash-I-tis" or "plan-tar-fash-ee-I-tis." (Adding "-itis" to the end of a word means that structure is inflamed.) It is sometimes known more simply as 'fasciitis'. Plantar fasciitis is the most common type of arch pain.CausesAlso known as pes planus, this is when the arch of the foot collapses completely dropping the whole sole of the foot down to the ground. Flat feet are a common cause of foot arch pain. Babies are born with flat feet and as they grow, the foot arches should gradually form, but in approximately 30% of the population, they never do. They can also develop later in life, due to illness, pregnancy, injury, excessive stress on the feet or as part of the aging process. Many people who have flat feet don?t complain of any accompanying symptoms, but some develop foot arch pain, or problems further up the leg such as knee pain or back pain. They may find their feet tire quickly when they are standing or walking, and that it is difficult to rise up onto their tiptoes. Someone who is experiencing pain on the bottom of the foot or elsewhere due to their flat feet can benefit from exercises and orthotics (specially designed insoles to correct the foot position) as well as walking barefoot rather than in shoes. A quick test to see if you have flat feet is to put your foot in a tray of water and then place it on a smooth level surface e.g. thick paper. Have a look at your footprint, the more of the sole of the foot that you can see, the flatter your foot.SymptomsFlat feet can exhibit a variety of symptoms, from mild to severe. The extent of the flat foto does not always correlate with the extent of symptoms. Patients may complain of arch pain and heel pain. Commonly there is pain on the outside of the foot, where the foot meets the ankle as the collapse foot abuts against the ankle. Muscle cramps within the foot, and onto the leg (shin splints) may occur. In general, patients have pain with activity, such as walking or running. The pain may be deep and focal to a generalized widespread achy feeling. Irritation from shoe gear can cause redness and swelling. Common reasons patients seek treatment are pain, interference with walking or activities, difficulty fitting shoes, swelling, and notice a change in appearance of the foot and/or unsightly appearance.DiagnosisMagnetic 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 TreatmentThere is considerable debate about the best treatment option for plantar fasciitis. Some authors suggest all of the 'mainstream' methods of treatment don't actually help at all and can actually make the symptoms worse! However, on the whole, there are several of the most commonly cited treatment options for plantar fasciitis and these are generally accepted throughout the medical community. I would recommend giving these options a try if you haven't already. Rest. This is mainly applicable to the sports people as rest is possible treatment. (For those who cannot rest e.g. people who work on their feet - skip to the other treatment options below). Rest until it is not painful. This is made more difficult as people need to use their feet to perform daily activities but certainly stop sporting activities that are likely to be putting the fascia under excessive stress. Perform Self Micro-Massage (you can watch this video by clicking the link or scrolling further down the page as it's embedded on this lens!) This massage technique is used to break down fibrous tissue and also to stimulate blood flow to the area, both of which encourage healing and reduce pain. There is also a potentially soothing effect on nerve endings which will contribute to pain relief. Ice Therapy. Particularly useful after spending periods on your feet to reduce the inflammation. Wrap some ice or a bag of frozen peas in a towel and hold against the foot for up to 10 minutes. Repeat until symptoms have resolved. Heat Therapy. Heat therapy can be used (not after activity) to improve blood flow to the area to encourage healing. A heat pack of hot water bottle can be used. 10 minutes is ideal. Careful not to burn yourself! A good taping technique. By taping the foot in a certain way you can limit the movement in the foot and prevent the fascia from over-stretching and gives it a chance to rest and heal. Click on the link for more information on taping techniques. Weight Management. If you are over-weight, any weight you can loose will help to ease the burden on your sore feet and plantar fascia. Orthotic devices (often mis-spelled orthodic) are special insoles that can be used to limit over-pronation (discussed earlier) and control foot function. By preventing the arches flattening excessively, the plantar fascia is not over-stretched to the same extent and this should help with the symptoms and encourage healing. Stretching the calf muscles (again, click this link or scroll to the bottom of the page to watch the embedded video) can help to lengthen these muscles and the Achilles tendon - a risk factor for plantar fasciitis. Stretching of the plantar fascia itself is also encouraged, particularly before getting up the morning (night splints can be used for this effect) and after periods of rest. This can be achieved by placing a towel or band under the ball of the foot and gently pulling upwards until a stretch is felt. Hold for about 15-20 seconds then rest briefly. Repeat 2-3 times. As you can see there are many different treatment options available. Try incorporating some of these in to your daily routine and see what works for you. Regardless of the method the main aim is to prevent the fascia from over-stretching! Medical professionals such as a Podiatrist may decide to make custom orthotics or try ultra-sound therapy. It is likely that anti-inflammatory medications will also be recommended. If you have tried the treatment options and your symptoms persist I'd recommend going to see a medical professional for further advice.Surgical TreatmentAs with most surgeries, patients and physicians should consider the surgery only after other, less invasive treatments have proven unproductive. Indications for surgery include Pain. Inability to function. Failure to improve after a six-month course of specific, directed physical therapy. Failure to improve after using arch supports, orthotics, or ankle and foot bracing. Once patients are at that point, the good news is that the procedure has considerably better outcomes than more traditional flat foot surgery. In the past, surgeons would realign and fuse the three hind joints, which would cause patients to lose motion, leaving them with a significantly stiff hind foot, With these newer procedures, if the foot is still flexible, surgeons can realign it and usually restore a close-to-normal or functional range of motion in the joints.PreventionEarly in the treatment of arch pain, consideration needs to be given to the cause and strategies put in place to prevent it happening again. Advice should be sought on the adequacy of footwear. Stretching exercises should be continued long after the symptoms are gone. Foot orthoses should be used if structural imbalances are present. Activity levels and types of activities (occupational and sporting) need to be considered and modified accordingly.