Feet, love them or hate them, we all need them. There are so many different things that can go wrong in your feet. There are 26 bones and 33 small joints, with ligaments and muscles and tendons holding them all together and making them work. They need to be strong, stable, flexible and be able to deal with a large variety of terrain or activity.
When you were little and start to toddle you may have flat feet, as you grow older they will develop their arch and their shape. As you get older they will once again broaden and flatten.
Pain in your feet can be frustrating and difficult to live with. It is hard to be in pain with every step you take, and can impact all aspect of your life, from your activity levels to your mood. Don’t ignore foot pain, especially if it persists for more than a couple of days.
Common causes of foot pain.
Your foot is a complex structure of many different moving parts. As a result of all of these structures there are many different things that can cause or result in foot pain.
1) Poor fitting or unsupportive footwear
2) Being overweight
3) Change in activity (new job, change in training schedule etc)
4) Ageing
5) Trauma
6) Other conditions (arthritis, gout etc)
The pain in your feet can also be referred from somewhere else in your body. Or you may feel numbness, tingling or burning. Everyones feet are different and unique, therefore your symptoms and pain can be too.
Common foot conditions and their treatments.
Plantar fasciitis.
The plantar fascia is a strong ligament that runs from the front of the heel bone to the toes. It can become irritated and inflamed. This is usually due to overloading or repetitive loading. This can be anything from long standing, tight calves, changes in your arch, unsupportive shoes or heel pain.
Initially you can try reducing the load and irritation by checking your shoes (they do have a mileage limit!), or making sure that they are supporting your foot correctly if you spend a lot of time standing. This may mean that you need to do specific exercises for your feet, buy better/new shoes or seek professional advice with regards to shoes and or orthotics.
You can also try some ice on your feet (rolling a frozen bottle under your foot) or stretching your arches and calves. If this makes no difference, ask for help from a medical professional.
Physio can help with assessment and advice on foot wear, exercise and stretches. Treatment will involve a detailed assessment of your symptoms followed by treatments to deal with your symptoms as your Physio sees fit. You will be given some homework in the form of stretches and strengthening. The Physio will also asses your foot placement in standing, walking and possibly running, and do a gait analysis to see if any of these may be contributing to your symptoms.
Achilles Tendonosis.
The Achilles tendon is the thick cordlike structure that connects the two big calf muscles (gastrocnemius and soleus) to the heel bone. These together create the heel raising motion for walking and running.
Most injuries to the Achilles tendon are due to overload or over use. Trauma or injury are common causes of Achilles pain. Other possible causes can be poor fitting shoes, calf weakness, ageing or simply the shape of your own feet!
You can try reducing mileage, gentle stretches and foam rolling. If you felt or heard a loud snap or pop, or unable to point your toes please seek medical advice immediately.
If the problem does not settle of gets worse seek help from a professional.
Physiotherapy will once again consist of a full history to understand your mechanism of injury, along with a movement and gait analysis, and your activity levels and exercise expectations. The Physiotherapist will then create a program to regain your strength, balance, speed and flexibility.
Ankle sprains.
It is likely that at some time in your life you have sprained an ankle. Either mildly or severely. This happens when your ankle is either rolled, twisted or turned in a forceful uncontrolled way. This will likely result in soft tissue trauma to both the ligaments and soft tissue in your ankle, anything from a pull to a tear. Usually the ankle will roll inwards, resulting in pain on the outside of your ankle and sometimes up your leg.
Although this may seem like a relatively mild injury it can have far reaching effects and needs to be correctly assessed treated. Sometimes you can just “walk it off” but you may have swelling and bruising, pain on weight bearing, and limited range of movement in more severe sprains.
Immediately after injury apply an ice pack. This should be done for approximately 10 mins, every two to three hours. Never apply ice directly to the skin as you may cause skin damage and be careful not to freeze yourself, and ice burn can be very painful.
You will need to rest your ankle, and prevent the movement that created the injury. This may mean a splint or just a bandage. If the pain is severe you may need to use crutches, but a little weight bearing will usually help to improve swelling and promote healing as long as it is within a tolerable range (less than 3/10 on a pain scale).
You can also do some simple ankle mobility exercises, like ankle pumps or writing the alphabet with your toes to begin regaining mobility.
Some ankle sprains will heal on their own without needing any intervention, some may need to be checked to rule out a fracture, you may need to have extensive rehab to strengthen and regain balance, movement and power.
Your Physiotherapist can assess and see how much rehab you will need to return you to full function.
Some easy, general exercises.
1) Ankle pumps. Point and flex your foot up and down 10 to 15 times.
2) Alphabet writing. Imagine you are writing out the letters of the alphabet with your foot.
3) Calf stretches. Stand on a step, hold on to something for safety. Let your heels hang down over the step while balancing on the balls of your feet. Hold this position for 30 seconds
4) Ice bottle rolling. Roll your foot over a plastic bottle of frozen water.
5) Toe and heel tapping. Sit in a chair with your feet flat on the floor. Alternately tap your toes and then your heels. 15 times each.
6) Single leg stand eyes open and closed. These are more advanced. Try and maintain your single leg stand for 10 seconds.
If any of these help reduce your pain, great, keep doing them. If they make your pain worse stop doing them immediately and seek advice from a medical practitioner. If they no effect at all and you still have sore feet, seek the advice of a medical practitioner.
I hope that we can all have Happy Feet!