Managing With Arch Pain

Overview

A cavus or high-arched foot may have many foot shapes. This may range from an arch that is slightly high to a severe deformity that causes a patient to walk on the outside of the foot. Surgery is occasionally required to realign the foot. There are different causes of a high-arched foot. In many cases, the cause is unknown. In other cases, the cause is a nerve disease, clubfoot or injury. Treatment ranges from changes in shoewear to surgeries, depending on the amount of deformity and related problems.

Foot Arch Pain




Causes

There are many causes for a high arch (cavus) foot. In the United States, the most common cause for a high arch foot is a form of muscular dystrophy called hereditary sensorimotor neuropathy. Most people recognize this by the more commonly used name of Charcot Marie Tooth disease (CMT). This is a disease of the muscles and the nerves of the legs, and occasionally of the hands, in which certain muscles weaken while others retain their strength. The condition is transmitted as an autosomal dominant condition. This means that 50% of the offspring will statistically inherit the disorder. This is, however, just a statistic. In some families, all the children develop the condition while in others, none inherit it.




Symptoms

Many people have no symptoms, and the condition is discovered only by chance when an X-ray of the foot is obtained for some other problem. When symptoms occur, there is usually foot pain that begins at the outside rear of the foot. The pain tends to spread upward to the outer ankle and to the outside portion of the lower leg. Symptoms usually start during a child's teenage years and are aggravated by playing sports or walking on uneven ground. In some cases, the condition is discovered when a child is evaluated for unusually frequent ankle sprains.




Diagnosis

After you describe your symptoms and discuss your concerns, your doctor will examine your foot. Your doctor will look for these signs. A high arch. An area of maximum tenderness on the bottom of your foot, just in front of your heel bone. Pain that gets worse when you flex your foot and the doctor pushes on the plantar fascia. The pain improves when you point your toes down. Limited "up" motion of your ankle.




Non Surgical Treatment

Treatment for a high arch foot or Charcot Marie Tooth disorder depends on the extent of deformity and the amount of disability experienced by the patient. Depending upon the symptoms, treatment may include. Changing the shoes. Special orthotic supports (devices that support, adjust, or accommodate the foot deformity). Cushioning pads. Foot and ankle braces or surgery.

Pain In Arch




Surgical Treatment

With flat feet, there is a tendon on the inside of the foot than can often become weakened, injured, split and/or ruptured. This tendon, is called the posterior tibial tendon, and is the main arch supporting tendon. Obviously damage to this tendon can cause collapse of the arch. Some people have genetically inefficient tendon, and tends to be the case in younger people. In mild cases, such as tendon splits, the posterior tibial tendon can be repaired to restore its strength. Acute incontinuity of the tendon can be primarily repaired. Often the posterior tibial tendon is augmented with a tendon transfer of an adjacent tendon to provide both strength and continuity. In any tendon repair, advanced or retensioning of the tendon is performed. In most flat foot surgery a tendon augmentation is often combined with other boney procedures to restore structure and balance to the foot.




Stretching Exercises

Massage therapy is a great way to loosen muscles and help improve mobility in in your feet. As many people with foot pain have discovered, tight muscles in your legs or back can lead to tense foot muscles. All those muscles are connected, so tension in your back can cause tension in your legs which can pull the tendons in your feet and cause stiffness and pain. Getting acupuncture or a professional full body massage are probably the best ways to deal with this, but there are also some simple tricks you can do at home to help keep muscles limber. These are great for loosening up and improving circulation, both before and after exercise. Place a tennis ball under the arch of your bare foot and roll it around, stretching the muscles in your foot and promoting blood flow. You can also roll the ball under your calves and upper legs to work out stiffness and knots. If you feel the tennis ball is too easy, try a lacrosse ball for deeper massaging. This is also demonstrated in the exercise video above. Use a foam roller, those big overpriced rolls of foam that are now available in every department and sporting goods store are fantastic for self-massage (why a roll of foam costs $30 is beyond us, but they do work wonders-our advice is to not waste money on the more expensive fancy grooved ones because even the simplest rollers work great). The exercises you can do with foam rollers seem to be endless, and there are literally hundreds of free videos online showing how to use them to massage every part of your body. Here's one we picked out that specifically targets foot and leg muscles related to arches and plantar fasciitis.

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