Foot Pain and How You Can Reduce it Yourself
November 1, 2019
Do you have foot pain, or heel pain? Do you wake up with pain in the mornings? Are those first few steps agony? This is just the news you need – read on!
As physiotherapists, we see people with foot, ankle and heel pain each and every day. Plantar fasciitis, heel spurs, Achilles tendon problems are all common conditions people will come and see us here at Instinct Health. A Google search on foot pain, or any of the conditions listed previously will explain myriad of options as to how best manage your foot pain. Sure, plantar fasciitis is common, but there may be other causes for your foot pain. Below, we will discuss some of the anatomy of these conditions, and importantly, how you can help yourself to get moving again.
Plantar fasciitis is the irritation of the plantar fascia – the thick connective tissue on the soles of our feet that helps to maintain the arch of your foot. The size of the arch in your foot will vary slightly from person to person and can simply be defined as “flat” feet or “high arch” feet. Unfortunately, having either flat or high arched feet does not predict whether or not you will get irritation to your plantar fascia.
The onset of plantar fascia pain is usually as a result of a change of physical loads or demands on your body. This can be a very minor change, like an increase in running or training loads, the surface you regularly walk on, the shoes you have (either new OR old shoes) or even an increase or decrease in your body weight. Sometimes it can be hard to track down exactly what they change has been, but usually there is something.
What does it feel like?
- You can’t put your full weight onto the affected leg
- Sore first thing in the morning, with the first few steps very painful
- Sore after sitting for an extended period of time, and then go to stand up
- Painful at the start of exercise, and after you’ve cooled down
How do you get it better?
Because plantar fasciitis is the result of a change of load or exercise, the first step is to modify this slightly. Complete rest is not the answer, because this can be as harmful as continuing to do too much. Beyond modifying exercise frequency or duration or type, the calf muscle often is tightened and weak. Our team of physios here at Instinct in Camberwell can help to relieve that muscle tightness through massage, dry needling or stretching techniques (certain yoga poses can help). If you can’t come in to see us, try using a foam roller to release the tension in your tight calf. Other helpful ideas may include supporting the foot through orthotics or taping, a change in footwear or in some cases, a referral off for further investigation from a podiatrist.
Heel spurs are usually identified after an ultrasound or x-ray, and usually on the back of heel pain or pain around the Achilles tendon. These develop over time, and are a result of regular pulling of a muscle or tendon on a bone. Our body responds to this pulling by laying down new bone to compensate for the increased stress. The spurs themselves can be painful to touch and may feel like a lump under the skin.
The treatment for heel spurs is similar to plantar fasciitis – load management is vital, and a period of “relative” rest is usually indicated. Over time, the spurs may shrink partly or remain the same. Whatever the outcome of the lump itself, with good management the pain of the lump should reduce.
Again similarly to plantar fasciitis, Achilles tendon injuries are a result of over, or under-training. These can happen to people young or older, and are typically caused by an increase of high intensity or impact exercise. One simple test to see if there is irritation of your Achilles tendon, is sit with your sore leg across the opposite knee so you can see and feel your Achilles. Using your thumb and index finger, gently squeeze the opposite sides of your Achilles and feel for an increase in pain. To check how sore it is, compare it to the opposite side. That might be the sign that you have some level of irritation in the tendon.
Achilles tendon issues can be slow to resolve (in some cases several months) but will gradually improve. To manage an injured Achilles, you will need to strengthen through the calf muscle to reduce the load on the tendon itself. This can be achieved by gradually progressing through static (isometric) strength exercises and then through moving (concentric and eccentric) exercises. The static exercise should be held for at least 30 seconds, with the same work-to-rest ratio. If that starts to get too easy, hold on to a 5kg weight for additional loading.
Our physios in Camberwell at Instinct Health will work with you to gradually and safely progress this regime to get you back to your running, walking or any other sport of choice!
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