Arch pain is common in people with a typical structural problem known as flat feet. Arch pain may also occur in people with fallen arches (a fallen arch is one that has collapsed due to bearing weight). Flat feet can lead to extreme stress or inflammation of the plantar fascia, possibly causing severe discomfort and leading to other foot problems. Without properly supported arches, simple movement can pull your body out of alignment and cause stress, strain and fatigue to your lower body.
Tarsal Tunnel Syndrome develops when there is compression on the tibial nerve as it passes through the tarsal tunnel on the inner side of the ankle bone (medial malleolus). It can cause pain on bottom of foot as well as pins and needles. Numbness in the heel can often extend down to the big toe and adjacent three toes. In addition, it may also produce hot and cold sensations along the bottom of the foot. Tarsal Tunnel Syndrome is caused by anything which occupies space in the tarsal tunnel including cysts, ganglions, bone spurs, swelling from ankle injuries or tumours. Treatment aims to reduce the foot arch pain and usually consists of rest, strengthening and stretching exercises, compression bandages and steroid injections. If the pain in bottom of foot persists, surgery may be required.
If you’ve ever seen your footprints in the sand and they looked more like bricks than feet, then you probably have flat feet. Simply stated, a flat foot is a foot that does not have an arch when standing. In the medical world, flat feet are associated with “pronated” feet. Pronated is merely the term used to describe the position of the foot when it is flexed upward (dorsiflexed), turned away from the body (abducted), and the heel is rolled outward (everted), all at the same time. A certain amount of pronation is required for normal walking, but too much pronation is often considered a foot’s “worst enemy.” Over time, excessive pronation can lead to many unpleasant problems including heel pain, bunions, hammertoes, shin splints, and even knee, hip, or back pain. In fact, one orthopedic surgeon discovered that 95% of his total knee replacement patients and 90% of his total hip replacement patients had flat feet. An easy way to tell if you pronate too much is to take a look at your athletic shoes-excessive wearing of the inside heel (arch side of the shoe) as compared to the outside is a classic indication of excessive pronation.
To come to a correct diagnosis, your podiatrist will examine your foot by using his or her fingers to look for a lump or stone bruise in the ball of your foot. He or she will examine your foot to look for deformities such as high or low arches, or to see if you have hammertoes. He or she may use x-rays, MRIs (magnetic resource imaging), and CT scans to rule out fractures and damage to ligaments, tendons, and other surrounding tissues. Your doctor will also inquire about your daily activities, symptoms, medical history, and family history. If you spend a lot of time running or jumping, you may be at a higher risk for pain in the bottom of your foot. These diagnostic tests will help your doctor come to a proper diagnosis and create an appropriate treatment plan.
Non Surgical Treatment
Initial treatment of the tear will focus on symptom relief. This may involve the use of anti-inflammatory medications, strapping of the toe, off-loading padding, altered footwear and activity modification. Following this treatment will focus on the underlying causes of the problem, such as flat feet, bunions and hammer toes. Your podiatrist will perform a thorough biomechanical assessment to determine the best course of action to offload the forefoot and decrease the mechanical stress on the area. This injury usually occurs gradually and is best treated in the early stages. Often a customised soft full length orthotic and footwear modifications can prevent the problem from progressing. Occasionally surgery needs to be performed, either frank repair of the plantar plate or in chronic cases a resection osteotomy may be suggested.
Surgery may be necessary in situations where the symptoms are likely to get worse over time, or when pain and instability cannot be corrected with external orthopedic devices. There are many types of surgical procedures, including cavus foot reconstruction, which can be performed to correct the foot and the ankle and restore function and muscle balance.
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.