Overview
The most common arch problem is the flat foot. This sometimes starts in childhood or may gradually develop in adulthood. In most cases the flat foot is related to a tight calf. The tightness of the calf forces the foot to overpronate (the inside of the foot rolls inwards) and the arch to break down and collapse. The arch collapse leads to abnormal stress on the plantar fascia leading to heel pain, as well as to the main medial tendon (the posterior tibial tendon), leading to tendonitis and even tears of the tendon. The other common symptom in severe flat feet is pain on the outside of the foot as well as calf and Achilles symptoms.
Causes
There are many different factors that can cause arch pain. A structural imbalance or an injury to the foot can often be the direct cause. However, most frequently the cause is a common condition called plantar fasciitis. The plantar fascia is a broad band of fibrous tissue located along the bottom surface of the foot that runs from the heel to the forefoot. Excessive stretching of the plantar fascia, usually due to over-pronation (flat feet), causes plantar fasciitis. The inflammation caused by the plantar fascia being stretched away from the heel often leads to pain in the heel and arch areas. The pain is often extreme in the morning when an individual first gets out of bed or after a prolonged period of rest. If this condition is left untreated and strain on the longitudinal arch continues, a bony protrusion may develop, known as a heel spur. It is important to treat the condition promptly before it worsens.
Symptoms
The most common symptoms of plantar fasciitis include pain on the bottom of the foot near the heel, pain with the first few steps after getting out of bed in the morning, or after a long period of rest, such as after a long car ride. The pain subsides after a few minutes of walking. Greater pain after (not during) exercise or activity.
Diagnosis
Diagnosis of a plantar plate tear can often be challenging due to the complex nature of the anatomy of the foot. Careful history taking and an examination of the area of pain is required to determine the extent and cause of the tear. If necessary, further investigations such as x-rays or diagnostic ultrasound may be ordered by your podiatrist to help evaluate the severity of the problem.
Non Surgical Treatment
Flat feet in a child do not need treatment if they are not causing pain or walking problems. Your child's feet will grow and develop the same, whether special shoes, shoe inserts, heel cups, or wedges are used. Your child may walk barefoot, run or jump, or do any other activity without making the flat feet worse. In older children and adults, flexible flat feet that do not cause pain or walking problems do not need further treatment. If you have pain due to flexible flat feet, the following may help. An arch-support (orthotic) that you put in your shoe. You can buy this at the store or have it custom-made. Special shoes. Rigid or painful flat feet need to be checked by a health care provider. The treatment depends on the cause of the flat feet. For tarsal coalition, treatment starts with rest and possibly a cast. Surgery may be needed if pain does not improve. In more severe cases, surgery may be needed to clean or repair the tendon, fuse joints in the foot into a corrected position. Flat feet in older adults can be treated with pain relievers, orthotics, and sometimes surgery.
Surgical Treatment
The procedure involves cutting and shifting the bone, and then performing a tendon transfer. First, the surgeon performs a calcaneal osteotomy, cutting the heel bone and shifting it into the correct position. Second, the surgeon transfers the tendon. Reroute the flexor digitorum to replace the troublesome posterior tibial tendon. Finally, the surgeon typically performs one or more fine-tuning procedures that address the patient?s specific foot deformity. Often, the surgeon will lengthen the Achilles tendon because it is common for the mispositioned foot to cause the Achilles to tighten. Occasionally, to increase the arch, the surgeon performs another osteotomy of one of the bones of the midfoot. Occasionally, to point the foot in a straightforward direction, the surgeon performs another osteotomy of the outside portion of the calcaneus.
Prevention
It is possible to prevent arch pain by wearing well-fitting shoes while performing any physical activity. Many times doctors will suggest a therapeutic shoe with a higher heel to relieve the pressure on the achilles tendon and also the arch muscle (plantar fasciitis). People with arch pain suffer from regular flare-ups of pain. However there is no risk to others as this is not a contagious condition.
Stretching Exercises
Flexibility is important in preventing injuries. With a simple stretching exercise, you can rehabilitate the muscles of your foot to relieve arch pain and prevent future injuries. This simple exercise by Tammy White and Phyllis Clapis for Relay Health is a good way to strengthen your foot muscles and stretch your plantar fascia. Sit in a chair and cross one foot over your other knee. Grab the base of your toes and pull them back toward your leg until you feel a comfortable stretch. Hold 15 seconds and repeat three times. When you can stand comfortably on your injured foot, you can begin standing to stretch the plantar fascia at the bottom of your foot.
The most common arch problem is the flat foot. This sometimes starts in childhood or may gradually develop in adulthood. In most cases the flat foot is related to a tight calf. The tightness of the calf forces the foot to overpronate (the inside of the foot rolls inwards) and the arch to break down and collapse. The arch collapse leads to abnormal stress on the plantar fascia leading to heel pain, as well as to the main medial tendon (the posterior tibial tendon), leading to tendonitis and even tears of the tendon. The other common symptom in severe flat feet is pain on the outside of the foot as well as calf and Achilles symptoms.
Causes
There are many different factors that can cause arch pain. A structural imbalance or an injury to the foot can often be the direct cause. However, most frequently the cause is a common condition called plantar fasciitis. The plantar fascia is a broad band of fibrous tissue located along the bottom surface of the foot that runs from the heel to the forefoot. Excessive stretching of the plantar fascia, usually due to over-pronation (flat feet), causes plantar fasciitis. The inflammation caused by the plantar fascia being stretched away from the heel often leads to pain in the heel and arch areas. The pain is often extreme in the morning when an individual first gets out of bed or after a prolonged period of rest. If this condition is left untreated and strain on the longitudinal arch continues, a bony protrusion may develop, known as a heel spur. It is important to treat the condition promptly before it worsens.
Symptoms
The most common symptoms of plantar fasciitis include pain on the bottom of the foot near the heel, pain with the first few steps after getting out of bed in the morning, or after a long period of rest, such as after a long car ride. The pain subsides after a few minutes of walking. Greater pain after (not during) exercise or activity.
Diagnosis
Diagnosis of a plantar plate tear can often be challenging due to the complex nature of the anatomy of the foot. Careful history taking and an examination of the area of pain is required to determine the extent and cause of the tear. If necessary, further investigations such as x-rays or diagnostic ultrasound may be ordered by your podiatrist to help evaluate the severity of the problem.
Non Surgical Treatment
Flat feet in a child do not need treatment if they are not causing pain or walking problems. Your child's feet will grow and develop the same, whether special shoes, shoe inserts, heel cups, or wedges are used. Your child may walk barefoot, run or jump, or do any other activity without making the flat feet worse. In older children and adults, flexible flat feet that do not cause pain or walking problems do not need further treatment. If you have pain due to flexible flat feet, the following may help. An arch-support (orthotic) that you put in your shoe. You can buy this at the store or have it custom-made. Special shoes. Rigid or painful flat feet need to be checked by a health care provider. The treatment depends on the cause of the flat feet. For tarsal coalition, treatment starts with rest and possibly a cast. Surgery may be needed if pain does not improve. In more severe cases, surgery may be needed to clean or repair the tendon, fuse joints in the foot into a corrected position. Flat feet in older adults can be treated with pain relievers, orthotics, and sometimes surgery.
Surgical Treatment
The procedure involves cutting and shifting the bone, and then performing a tendon transfer. First, the surgeon performs a calcaneal osteotomy, cutting the heel bone and shifting it into the correct position. Second, the surgeon transfers the tendon. Reroute the flexor digitorum to replace the troublesome posterior tibial tendon. Finally, the surgeon typically performs one or more fine-tuning procedures that address the patient?s specific foot deformity. Often, the surgeon will lengthen the Achilles tendon because it is common for the mispositioned foot to cause the Achilles to tighten. Occasionally, to increase the arch, the surgeon performs another osteotomy of one of the bones of the midfoot. Occasionally, to point the foot in a straightforward direction, the surgeon performs another osteotomy of the outside portion of the calcaneus.
Prevention
It is possible to prevent arch pain by wearing well-fitting shoes while performing any physical activity. Many times doctors will suggest a therapeutic shoe with a higher heel to relieve the pressure on the achilles tendon and also the arch muscle (plantar fasciitis). People with arch pain suffer from regular flare-ups of pain. However there is no risk to others as this is not a contagious condition.
Stretching Exercises
Flexibility is important in preventing injuries. With a simple stretching exercise, you can rehabilitate the muscles of your foot to relieve arch pain and prevent future injuries. This simple exercise by Tammy White and Phyllis Clapis for Relay Health is a good way to strengthen your foot muscles and stretch your plantar fascia. Sit in a chair and cross one foot over your other knee. Grab the base of your toes and pull them back toward your leg until you feel a comfortable stretch. Hold 15 seconds and repeat three times. When you can stand comfortably on your injured foot, you can begin standing to stretch the plantar fascia at the bottom of your foot.