Aching feet: the hallmark of a busy person. When you’ve been on your feet all day, or cranking out a high-impact workout, or dancing in high-heeled or tight shoes, you probably get the characteristic soreness in the bottom of your feet. Certain medical conditions or continual strain can move foot pain beyond a temporary, mild ache to a debilitating disorder that can make daily tasks unbearable and prevent you from leading a normal, enjoyable lifestyle. Whatever degree your foot pain is, however, physical therapy can do a lot to relieve the hurting, fix the injury or condition, and return foot function to normal. The first step to recovery is identifying the source of the pain.
A common area that can become sore with extended use is the heel, the large fleshy pad that absorbs most of the impact when walking and that provides cushioning between the body’s weight and the ground. Excessive, sharp, or enduring pain in the heel, however, can be a sign of plantar fasciitis. This occurs when the plantar fascia, a thick band of connective tissue that links the heel to the ball of the foot, becomes inflamed from an aggravating injury or continuous strain.
Another common area that can become sore, especially when wearing improper footwear, is the inner arch of the foot. There are several conditions that can lead to pain in this area, including a range of deformities known as “adult acquired flatfoot”. This occurs when the arch of the foot loses its structure due to a variety of injuries. With flatfoot, the foot is unable to flex properly, resulting in stiff and hurting soles. Other causes of pain in this area of the foot include ligament or tendon dysfunctions, and rheumatoid arthritis. Pain in the instep can also be caused by ab accessory navicular, or a small extra bone that can rub nerves or tendons, especially when wearing tight shoes.
The ball of the foot, the round, fleshy pad under the joint of the big toe, provides a lot of the strength and leverage when pushing off the ground to take a step. A number of painful conditions may develop here as a result of the pressure the ball regularly endures. One can be a disorder in the sesamoids - the two small bones that support the big toe joint. These can become inflamed or fractured, aggravated by extra tissue under the joint, or can sometimes partially die off from a deficient blood supply, causing aching, popping, or numbness at the big toe joint, especially when stretching the toe upward or taking a step. Other causes may be hallux rigidus, a degenerative type of arthritis in the big toe joint, or an interdigital neuroma, a painful growth on a nerve in the foot caused by nerve swelling or irritation, such as that caused by wearing tight shoes.
A vague, persistent burning, tingling pain or numbness on the bottom of the foot can be a sign of tarsal tunnel syndrome. As the equivalent of the hand and wrist’s carpal tunnel syndrome, this disorder is caused by abnormal compression of the nerves in the foot/ankle joint. The precise cause of tarsal tunnel can be difficult to identify, but can be due to localized swelling or pressure, and may be especially felt during long periods of standing or walking.
There are many non-surgical means to correct these foot problems and remedy such foot pain. At Blue Hills Sports & Spine Rehabilitation, the first goal is to relieve your symptoms of pain using techniques such as icing, moist heat, ultrasound, soft-tissue massage, or electrical modalities directed to the affected area. The goal of your physical therapist is then to resolve the underlying structural disorder, and typically includes exercises to strengthen your foot and calf muscles, correct positioning, or increase flexibility in your ankle and toes. They will also advise you on activities that will be beneficial for your specific foot problem and those which should be avoided during recovery. For some more severe injuries, temporary foot and ankle immobilization in a cast or splint may be necessary. Finally, a lot of foot pain can be avoided by finding appropriate, comfortable footwear with plenty of space and support, or can be alleviated by using arch supports in your shoes.
Foot pain can keep you from participating in the activities you enjoy, but through physical therapy you can overcome its causes and be back on your feet again in no time!