Many people have pain in the base of their foot. This could be due to overuse of one of many different structures in your foot. Common examples are sesamoiditis (inflammation of structures surrounding two small bones under the big toe joint) and plantar fasciitis (overuse of a ligament-like structure that runs underneath the length of the foot). Pain on standing first thing in the morning is a classic symptom of plantar fasciitis. It is one of the most common problems experienced by runners, accounting for about 10 per cent of running injuries. It is also common among middle-aged people, particularly if they are overweight. It often starts with low-grade pain in the arch or heel of the foot and can get worse over weeks or months.
A common cause of foot arch pain is a stress fracture. They tend to occur from repeated overloading of one of the foot bones from activities such as jumping and running especially if you have suddenly increased your activity level. The breaks in the bone may be small but they can be extremely painful. Stress fractures of the metatarsal bones or the navicular can cause anything from mild to severe foot arch pain. The Tibialis Posterior muscle plays a very important role in supporting the medial arch of the foot. Posterior Tibial Tendonitis can occur either through repetitive use e.g. high impact sports such as soccer or tennis, or from an injury e.g. a fall. This causes the tendon to become inflamed or even torn, resulting in pain on bottom of foot. This pain usually gets worse with activity or when standing for long periods. If the problem persists, the inner side of the foot (known as the medial longitudinal arch of the foot) gradually collapses down, causing flat feet. A simple test for this condition is to stand on one leg and rise up onto your tiptoes. If you cannot, it indicates a problem with the Posterior Tibial tendon. Treatment usually consists of rest, ice, exercises, orthotics and physical therapy.
The majority of children and adults with flexible flatfeet never have symptoms. However, their toes may tend to point outward as they walk, a condition called out-toeing. A person who develops symptoms usually complains of tired, aching feet, especially after prolonged standing or walking. Symptoms of rigid flatfoot vary depending on the cause of the foot problem.
A professional therapist may use tinels test to diagnose tarsal tunnel syndrome. This involves tapping the nerve just behind the medial malleolus or bony bit of the ankle with a rubber hammer. Pain indicates a positive test. Sometimes it is initially mistaken for plantar fasciitis which also causes pain from the inside heel and throughout the arch of the foot. Neural symptoms (such as tingling or numbness) as well as the location of tenderness when touching the area should help to easily distinguish between the conditions.
Non Surgical Treatment
A new ankle foot orthosis known as the Richie Brace, offered by PAL Health Systems, has proven to show significant success in treating Stage II posterior tibial dysfunction and the adult acquired flatfoot. This is a sport-style brace connected to a custom corrected foot orthotic device that fits well into most forms of lace-up footwear, including athletic shoes. The brace is light weight and far more cosmetically appealing than the traditional ankle foot orthosis previously prescribed.
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.
Stretch and strengthen important muscles in your feet, ankles and legs in order to guard against future strain. Make sure to acquire suitable arch supports and inserts if necessary, and that your shoes are shock absorbent and in good condition. Wearing tattered shoes provides no protection, and runners should replace their footwear before exceeding 500 miles of usage. Athletes new to arch supports should gradually build their training routine, allowing their feet to become accustomed to a new stance.