30 Oct Painful Feet – Heel pain and Arch pain
Many people think they have to live with painful feet, I hear it a lot; “I just thought it was part of getting old”, or “I thought my problem was hereditary”. Sometimes that is the case, but many times it is not! There is treatment that can a/ slow the progress of change and b/ teach you how to manage it yourself and live painfree.
Simple treatments for painful feet …mobilise a tight muscle or a stiff joint and enable the foot to function normally again pain free. Treating feet requires specific knowledge of foot biomechanics and the relationship of the feet to the whole body.
One example of this relationship is;
Achillies tendinosis – If the knee is tracking inward, and the hips are dropping from side to side when you run, the achillies will be twisted simultaneously to being stretched, and this injures it over time. In this instance lack of control of your body above the foot causes heel pain. Treatment is ‘core’ muscular retraining and gait reeducation, among other specific exercises and modalities.
Arch Pain is not just plantar fasciitis– it can be caused by tight abductor hallucis , a muscle that runs along the inside length of the foot. It can trap nerves that travel under the muscle and cause pain to spread along the arch. This is a common runners complaint. Tension in this muscle can also limit the bend in the ankle.
Heel Pain: Pain under the heel can originate from:
- plantar fascia itself
- nerve entrapment (eg. calcaneal or plantar nerves)
- irritable trigger points in calves or foot muscles (trigger points are irritable areas of muscle)
- referred from the spinal nerves esp L5 or S1
- inflamed fat pad under the heel
For proper diagnosis, all these structures must be assessed.
Treatment for plantar fasciitis may include calf stretches, taping to support the arch, correction of any biomechanical issues (of the whole body), massage, and correct footwear . If pain is 8/10 or more when walking you may have a tear. An MRI or ultrasound is indicated. For tears a walking boot may be prescribed to completely rest the foot for 4-6 weeks until the pain is only 1-2/10. After wearing a boot the foot needs to be strengthened, strength and function is not returned by just walking on it. The foot is a complex structure with many joints and muscles to work as a functional unit.
Heel and Arch Pain is not always plantar fascia pain. There are many different causes for heel and arch pain.
“Plantar fasciitis” is a commonly overused diagnosis. Pain in this region of the foot can be effectively treated by diagnosing and treating the correct structure involved; nerve, fascia, muscle, the body above.
It is helpful to have guidance from a foot and ankle physiotherapist, here at Physio Body and sole in North Sydney for effective treatment.