Overview
Flat feet is the most common foot deformity known. In fact, sixty million Americans or 25% of the U.S. population have flat feet. Some of these people may experience problems that limit their activities, while others can run marathons or play in the NBA.
Causes
Poor quality footwear. Excess weight. Commonly occurs in people over 50. Overuse or strain by athletes, especially runners. Plantar fasciitis can be caused by overuse of the plantar fascia due to walking or running in poorly supported footwear. It?s not surprising to note that healthy, active adults are the most common victims of plantar fasciitis: runners, joggers, basketball players, tennis and racquetball players? basically any sport that requires quick or repetitive movements combined with impact on the heel and arch of the foot can lead to plantar fasciitis. Seniors are also at risk due to the ligament and bone issues common to those of older years. Another leading cause of plantar fasciitis is being overweight or obese. In this case, while a sports-related injury may not be to blame, just the daily stress of walking with too much excess weight straining the plantar fascia ligaments can lead to inflammation and painful heel pain. Anyone whose job requires long periods of standing or walking is prone to develop plantar fasciitis as well. For those who develop arch strain or arch pain as a result of structural problems like flat feet, they require arch support that will accommodate their individual needs.
Symptoms
Repetitive exertive activity arch pain is usually sharp, and localized to a specific area, rather than the entire arch. Usually the pain occurs in the area just in front of the heel. It is present when first standing on the foot in the morning, but may decrease once you start walking around, but will, gradually becomes worse with continued walking or running. Swelling may be present. The pain subsides with rest, but stretching the arch while resting may cause the pain to return. Injury pain is constantly present, but worse when standing on the foot. This pain is localized to a specific area, but may radiate out from this area to the entire foot. The pain is sharp, and usually accompanied by swelling and occasionally "black and blue" discolorations. The pain due to the natural aging process is usually dull and aching, or stiff, and can be felt throughout the entire arch area, rather then in just one spot. This pain is present whenever weight bearing, and usually becomes worse with continued walking. The pain gradually subsides when resting, and usually does not return with stretching. Biomechanical defect pain is usually localized to a section of the arch, such as the inner, middle, outer, front, or back of the arch. This pain may be sharp or dull, but is always worse with continued walking.
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
An orthotic arch support, specially molded to fit your foot, may be part of your treatment. These supports can be particularly helpful if you have flat feet or high arches. You can tell if that is what is needed when short-term taping decreases your heel pain.
Surgical Treatment
Surgery may be necessary in situations where the symptoms are likely to get worse over time, or when pain and instability cannot be corrected with external orthopedic devices. There are many types of surgical procedures, including cavus foot reconstruction, which can be performed to correct the foot and the ankle and restore function and muscle balance.
Prevention
It is possible to prevent arch pain by wearing well-fitting shoes while performing any physical activity. Many times doctors will suggest a therapeutic shoe with a higher heel to relieve the pressure on the achilles tendon and also the arch muscle (plantar fasciitis). People with arch pain suffer from regular flare-ups of pain. However there is no risk to others as this is not a contagious condition.
Stretching Exercises
Achilles 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.
Flat feet is the most common foot deformity known. In fact, sixty million Americans or 25% of the U.S. population have flat feet. Some of these people may experience problems that limit their activities, while others can run marathons or play in the NBA.
Causes
Poor quality footwear. Excess weight. Commonly occurs in people over 50. Overuse or strain by athletes, especially runners. Plantar fasciitis can be caused by overuse of the plantar fascia due to walking or running in poorly supported footwear. It?s not surprising to note that healthy, active adults are the most common victims of plantar fasciitis: runners, joggers, basketball players, tennis and racquetball players? basically any sport that requires quick or repetitive movements combined with impact on the heel and arch of the foot can lead to plantar fasciitis. Seniors are also at risk due to the ligament and bone issues common to those of older years. Another leading cause of plantar fasciitis is being overweight or obese. In this case, while a sports-related injury may not be to blame, just the daily stress of walking with too much excess weight straining the plantar fascia ligaments can lead to inflammation and painful heel pain. Anyone whose job requires long periods of standing or walking is prone to develop plantar fasciitis as well. For those who develop arch strain or arch pain as a result of structural problems like flat feet, they require arch support that will accommodate their individual needs.
Symptoms
Repetitive exertive activity arch pain is usually sharp, and localized to a specific area, rather than the entire arch. Usually the pain occurs in the area just in front of the heel. It is present when first standing on the foot in the morning, but may decrease once you start walking around, but will, gradually becomes worse with continued walking or running. Swelling may be present. The pain subsides with rest, but stretching the arch while resting may cause the pain to return. Injury pain is constantly present, but worse when standing on the foot. This pain is localized to a specific area, but may radiate out from this area to the entire foot. The pain is sharp, and usually accompanied by swelling and occasionally "black and blue" discolorations. The pain due to the natural aging process is usually dull and aching, or stiff, and can be felt throughout the entire arch area, rather then in just one spot. This pain is present whenever weight bearing, and usually becomes worse with continued walking. The pain gradually subsides when resting, and usually does not return with stretching. Biomechanical defect pain is usually localized to a section of the arch, such as the inner, middle, outer, front, or back of the arch. This pain may be sharp or dull, but is always worse with continued walking.
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
An orthotic arch support, specially molded to fit your foot, may be part of your treatment. These supports can be particularly helpful if you have flat feet or high arches. You can tell if that is what is needed when short-term taping decreases your heel pain.
Surgical Treatment
Surgery may be necessary in situations where the symptoms are likely to get worse over time, or when pain and instability cannot be corrected with external orthopedic devices. There are many types of surgical procedures, including cavus foot reconstruction, which can be performed to correct the foot and the ankle and restore function and muscle balance.
Prevention
It is possible to prevent arch pain by wearing well-fitting shoes while performing any physical activity. Many times doctors will suggest a therapeutic shoe with a higher heel to relieve the pressure on the achilles tendon and also the arch muscle (plantar fasciitis). People with arch pain suffer from regular flare-ups of pain. However there is no risk to others as this is not a contagious condition.
Stretching Exercises
Achilles 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.