Working With Pain In The Arch

Overview

If you are dealing with chronic pain in the arch of your foot (the area between the ball and heel) it may be diagnosed as arch strain. While there are several potential causes for arch pain, the most common cause is plantar fasciitis. The plantar fascia is the band of ligaments that runs along the sole of the foot, connecting the heel bone to the metatarsals (bones just behind the toes.) Its job is to support the arch of your foot, and to put some ?spring in your step.? But, unfortunately, it?s the sight of an all-to-common inflammation that causes intense pain in the heel and across the bottom of the foot. This inflammation and pain is known as plantar fasciitis.

Pain In Arch




Causes

Arch pain can be caused by several different factors. Tight calf muscles combined with repeated arch collapse on weight bearing, is the most common cause of arch pain.This can then often lead to a condition called plantar fasciitis, which is an inflammation of the connective tissue that connects the heel with the ball of the foot. When the connective tissue in the bottom of the feet gets stretched out too much, plantar fasciitis can result. The inflammation resulting from plantar fasciitis can result in arch pain. Arch pain caused by plantar fasciitis is often worst after long periods of rest, like when you first wake up in the morning. This is because the plantar fascia tightens when you are off your feet. When you wake up in the morning and start walking around, the plantar fascia stretches out again.




Symptoms

The primary symptom is pain or aching in the arch area. This can be accompanied by inflammation and tenderness. If the pain is caused by the plantar fascia, it is likely to be considerably more severe in the mornings due to the muscles being unused.




Diagnosis

Your doctor may order imaging tests to help make sure your heel pain is caused by plantar fasciitis and not another problem. X-rays provide clear images of bones. They are useful in ruling out other causes of heel pain, such as fractures or arthritis. Heel spurs can be seen on an x-ray. Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound, are not routinely used to diagnose plantar fasciitis. They are rarely ordered. An MRI scan may be used if the heel pain is not relieved by initial treatment methods.




Non Surgical Treatment

Consult a doctor to diagnose the condition and determine the cause. If revealed to be plantar fasciitis, please refer to our article on that injury for further information. Generally arch pain is easy to treat, with the most effective method of treatment being the placement of arch supports in the shoes. This counteracts the strain placed on the arches by biomechanical errors, causing them to cease stretching excessively. A specialist can recommend the inserts suitable to your needs, which will depend on the shape of your arches. These supports should lessen your symptoms within days. If pain is severe you should refrain from running activities until it subsides to avoid risking an aggravation of the injury. To maintain fitness, alter your training program temporarily to be focused on low-impact sports like swimming. Applying ice to the affected area should assist in reducing pain and swelling.

Arch Pain




Surgical Treatment

There are two types of bone procedure for flat feet, those where bone cuts and bone grafts are used to alter the alignment by avoiding any joint structures, or joint invasive procedures (called fusions or arthrodeses) that remove a joint to reshape the foot. With joint fusion procedures, there are those procedures that involve non-essential joints of the foot versus those that involve essential joints. All bone procedures have their place in flat foot surgery, and Dr. Blitz carefully evaluates each foot to preserve as much motion and function while obtaining proper and adequate alignment. In many cases a flat foot reconstruction involves both soft tissue procedures and bone procedures to rebuild and restore the arch. There are several joints in the arch of the foot that can collapse - and these joints are non-essential joints of the foot. This does not mean that they do not have a purpose, but rather become inefficient is providing a stable platform for function. As such, locking these non-essential non-functioning joints into place is commonly recommended. These joints are fused together with screws and/or plates. A heel bone that is no longer in proper position and pushed outwards away from the foot can be corrected with a bone cut and realignment procedure, so long as the displacement is not too significant. A benefit of this surgery is that it keeps the back portion of the foot mobile, and helps the surrounding tendons work for efficiently in maintaining the arch. In certain flat feet, the foot is deviated outwards and away from the midline of the body. Sometimes, this is due to the outer portion of the foot being shorter than the inner portion. Here bone graft can be added to the outer edge of the foot to lengthen the foot to swing the foot over into a corrected position. This procedure is most commonly performed in children and young adults. A bone graft is inserted into the top part of the arch to realign a component of the flat foot, medically known as forefoot varus or medial column elevatus. The back part of the foot (called the rearfoot complex) can be the cause (or source) of the flat foot or the simply affected by the flat foot foot. In simple terms, the back part of the foot can be made to flatten out due to arch problems - and vica versa for that matter. Dr. Blitz specifically identifies the cause of the flat foot as this will determine the best treatment plan, as each flat foot needs to be evaluated individually. The rearfoot is made up of three joints, and depending on the extent and most importantly the rigidity of these joints, they may require fusion to restore alignment. When all three joints require fusion - this call is a triple arthrodesis. For completeness, isolated fusion of any of the three joints can be performed (such as subtalar joint arthrodesis, talonavicular arthrodesis, and calcaneaocuboid joint arthrodesis). The medical decision making for isolated fusions is beyond the scope this article, but Dr. Blitz tries to avoid any rearfoot fusion for flexible feet because these are joints are essential joints of the foot, especially in younger people. Those in severe cases, it may be advantageous to provide re-alignment.




Prevention

Strap the arches into the anatomically correct positions with athletic tape and leave them like this for some time. If the fallen arches are an issue with the muscular structure, this may give the muscles an opportunity to strengthen. This is definitely not a fallen arches cure all the time but it can help prevent it more times than not. Ask a doctor or physical therapists to show you how to do this taping. Find shoes that fit. This may require that you get your foot measured and molded to ensure that the shoe will fit. Shoes that are too big, too tight or too short, may not directly cause the fallen arches, but they can assist with the damage to the area. These shoes should have thick cushioning inside and have plenty of room for your toes. Walk without shoes as much as possible. Shoes directly assist with weakening and distorting the arches of the feet so going without shoes can actually help strengthen your arches and prevent fallen arches. Walking on hard and bumpy surfaces barefooted makes the muscles in your feet strengthen in order to prevent injury. It is a coping mechanism by your body. Insert heel cups or insoles into the shoes that you wear the most. Many people wear uncomfortable shoes to work and these are the same shoes that cause their arches the most problems. Inserting the heel cups and insoles into these shoes can prevent fallen arches from occurring. Many people place these inserts into all their shoes to ensure support. Ask a medical professional, either your doctor or a physical therapist, about daily foot exercises that may keep the arches stronger than normal. Many times, you can find exercises and stretches on the Internet on various websites. Curling your toes tightly and rotating your feet will help strengthen your longitudinal arches. Relax your feet and shake them for a minute or so before you do any arch exercises. This will loosen the muscles in your feet that stay tight due to normal daily activities. Wear rigid soled sandals whenever possible to provide a strong support for your arches. Wooden soled sandals are the best ones if available. Walk or jog on concrete as much as you can. This will create a sturdy support for your arches. Running or walking in sandy areas or even on a treadmill, does not give rigid support. Instead, these surfaces absorb the step, offering no support for arches.




Stretching Exercises

You may start exercising the muscles of your foot right away by gently stretching and strengthening them. Frozen can roll. Roll your bare injured foot back and forth from your heel to your mid-arch over a frozen juice can. Repeat for 3 to 5 minutes. This exercise is particularly helpful if it is done first thing in the morning. Towel stretch. Sit on a hard surface with your injured leg stretched out in front of you. Loop a towel around your toes and the ball of your foot and pull the towel toward your body keeping your leg straight. Hold this position for 15 to 30 seconds and then relax. Repeat 3 times. Standing calf stretch. Stand facing a wall with your hands on the wall at about eye level. Keep your injured leg back with your heel on the floor. Keep the other leg forward with the knee bent. Turn your back foot slightly inward (as if you were pigeon-toed). Slowly lean into the wall until you feel a stretch in the back of your calf. Hold the stretch for 15 to 30 seconds. Return to the starting position. Repeat 3 times. Do this exercise several times each day. Seated plantar fascia stretch. Sit in a chair and cross the injured foot over the knee of your other leg. Place your fingers over the base of your toes and pull them back toward your shin until you feel a comfortable stretch in the arch of your foot. Hold 15 seconds and repeat 3 times. Plantar fascia massage. Sit in a chair and cross the injured foot over the knee of your other leg. Place your fingers over the base of the toes of your injured foot and pull your toes toward your shin until you feel a stretch in the arch of your foot. With your other hand, massage the bottom of your foot, moving from the heel toward your toes. Do this for 3 to 5 minutes. Start gently. Press harder on the bottom of your foot as you become able to tolerate more pressure.

Write a comment

Comments: 0