Pain in the foot?

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Are you getting sharp pain around your heel as soon as you place your foot on the ground? You are most likely suffering from one of two PAINFUL conditions. Painful yes, but are they something to be worried about? Definitely not. I will 1st explain what they are………...Pain under your heel bone or the arch of your foot is known as plantar fasciitis, pain above the heel bone and on the tendon that attaches from the heel bone to the calf muscle is known as Achilles tendinosis.  

With either of these complaints you might have gone to the doctor and prescribed painkillers or anti-inflammatories, these may help in the short term but unfortunately, it won’t solve the issue in the long term. You really need to find out what is causing the pain in the first place.  

With regards to plantar fasciitis, the most common symptom you will feel is pain first thing in the morning when you get out of bed and place your foot on the floor. This pain then tends to dissipate the more you walk on it as the day goes on until you may have to sit again for a couple of hours at your desk, suddenly you go to get up, place your foot on the floor and OUCH ! that piercing pain returns.

The plantar fascia s a tight band of rope like tissue that attaches from your heel to your toes under your foot. So what’s the reason for the pain? it’s usually down to what type of arch you have in your foot. For somebody with a high arch, the plantar fascia is really tight and the foot cannot turn inwards or what we call pronate efficiently. This means the plantar fascia is constantly pulling off the heel bone. So people like this tend to walk on the outside of the heels and feet. These types of people need to stretch the muscles and plantar fascia under the foot.

Other people have a low arch or what some people call flat feet. This is not a bad thing in all cases - look at Usain bolt’s feet for example! But in the general public, a long weak arch means the foot can’t do the opposite of what we mentioned and that is supinated (create an arch). These people need to strengthen the foot muscles under the foot and create a more stable base. So, you need to be able to do both and that is the key. We find in the clinic the people that present with this type of pain cannot do both!  

Similar rules apply to people who have pain in their Achilles. This affects runners a lot but can affect walkers too. They will find the pain is worse when they start to run/walk but it eases off the further as they go. When the tendon is overloaded it gets damaged and you get tiny little micro tears on the tendon, when this tries to heal at rest a lot of scar tissue builds up, then you go out for a run the scar tissue breaks down and the pain eases. So as you can see it becomes a vicious circle. But what you must realize is the tendon is not happy because something elsewhere in the body is not happy. Be that how the foot and heel move as they hit the ground as or a muscle weakness elsewhere.

A key factor in these type of injuries is NOT to stop and rest it fully, you may need to reduce the amount you are doing, but stopping completely might reduce the pain initially but as soon as you resume your activities the pain will come back. You need to strengthen certain muscles gradually

Insoles - Are they the answer?

They can but that depends on your foot type, someone with a high arch will NOT need an insole as it will make a short and tight plantar fascia shorter and tighter. It might give relief for a week or two, why? Because you are changing the position of the foot and avoid stretching the muscle and straining the tendon. If you have a flat arch yes they can be beneficial, but insoles are very powerful and can make changes not only in your feet but all over your body. If you get a pair you should notice a change in the first week, they don't take 3 months to work. Get a good foot assessment first and some physio might get rid of it quicker.


Tommy ConwayComment