Common Foot Problems
Plantar fasciitis, is a painful inflammatory condition caused by excessive stress to the plantar fascia of the foot or biomechanical faults that cause abnormal pronation of the foot. The pain usually is felt on the underside of the heel, and can extend into the arch, this condition is often most intense with the first steps of the day or moving about after periods of rest. It is commonly associated with long periods of weight bearing or sudden changes in weight bearing or activity. Obesity, weight gain, jobs that require standing/walking on hard surfaces, shoes with little or no arch support and inactivity, are also associated with the condition.
This condition often results in a heel spur on the calcaneus, in which case it is the underlying condition, and not the spur itself, which produces the pain. In cases of chronic plantar fasciitis of at least 10 months duration, one recent study has shown high success rates with a stretching program of the plantar fascia, in conjunction with orthotic use. Pain with first steps of the day can be markedly reduced by stretching the plantar fascia and Achilles tendon before getting out of bed.
Metatarsalgia (literally metatarsal pain, colloquially known as stone bruise) is a general term used to refer to any painful foot condition affecting the metatarsal region of the foot. This is a common problem that can affect the joints and bones of the metatarsals. Metatarsalgia is most often localized to the the first metatarsal head (the ball of the foot just behind the big toe). There are two small sesamoid bones under the first metatarsal head. The next most frequent site of metatarsal head pain is under the second metatarsal. This can be due to either, too short a first metatarsal bone or to "hypermobility of the first ray" (metatarsal bone + medial cuneiform bone behind it), both of which result in excess pressure being transmitted into the second metatarsal head. Orthotics with metatarsal support often help.
Morton's Neuroma (also known as Morton's metatarsalgia, Morton's neuralgia, plantar neuroma and intermetatarsal neuroma) is a benign neuroma of the interdigital plantar nerve. (fibrous tissue formation around nerve tissue). This problem is characterised by numbness and sharp pain, relieved by removing footwear.
Symptoms include: pain on weight bearing, frequently after only a short time; the pain is felt as a shooting pain. Burning, numbness and parasthesia may also be experienced. Classically occurring between the 2nd and 3rd or between the 3rd and 4th interdigital space, which may also involve the toes. The pain is caused by pressure on the enlarged section of nerve where it passes between the metatarsal heads, and is squeezed between them. The first toe is usually not involved. Neuroma in the 4th/5th interdigital space is described, but is rare. Over pronation of the foot can often effect the metatarsals alignment, and the nerve can be impinged. Orthotic use can often help with symptoms.
KNEE PAIN (Patello-Femoral pain)
Knee pain around the knee cap, is usually associated with excessive internal rotation of the legs and knee (inward rotation), and over pronation of the feet (rolling inwards). These actions effect the alignment of the patella (kneecap) and with an associated weakness of the surrounding muscles causes knee pain. Use of orthotics can help control this condition, along with muscle strengthening programs.
KNEE PAIN (Osgood Schlatter’s condition)
Pain, swelling and inflammation, that occurs on the bony prominence below the knee cap on the front of the Tibia bone, called the Tibial Tuberosity. This condition mainly occurs in children, especially those involved in sports, and usually between the ages of 8-15 years. Control of any excessive pronation of the foot (rolling in) or excessive internal rotation of the legs and knees, using orthotics can usually help with this pain.
Pain at the back of the heel bone or Achilles tendonitis is usually associated with over pronation of the feet (rolling in of the feet).
The achilles tendon undergoes stretching forces, which creates an inflammatory response with in the tendon. By aligning the heel bone and reducing the pronation action of the foot, the achilles pain settles down. A good stretching program should also be used.
Over pronation of the feet (rolling inwards) can cause over stretching or over use of the Tibialis Anterior and Tibialis Posterior muscles, which attach to the front and inside of the lower leg. These two muscles help control the arch. Pain and inflammation could result in an over use situation. Reducing the rolling in of the feet, using orthotics, should result in pain relief.
Poor foot alignment over time can result in the formation of bunions, a bony lump at the joint behind the big toe. When the feet over pronate (feet rolling inwards), this creates muscle imbalances, these can result in the big toes alignment changing and moving towards the second toe. Controlling the over pronation with orthotics, can relieve pain experienced in the bunion joint. Although the bony prominence will remain