Overview
Discomfort across the bottom of the foot at any point between the heel and the ball of the foot is often referred to as ?arch pain.? Arch pain is a non-specific term. Most arch pain is due to strain or inflammation of the arthritis, deformity, plantar fasciitis. Plantar fasciitis is sometimes associated with a heel spur. In most cases, arch pain develops from overuse, unsupportive shoes, weight gain, or acute injury. If arch pain persists beyond a few days, see a foot and ankle surgeon for treatment to prevent this condition from becoming worse.
Causes
The most common cause of arch pain is plantar fasciitis. Plantar fasciitis is inflammation of the fibrous band of tissue that connects the heel to the toes. Sufferers of plantar fasciitis typically feel pain early in the morning when they first get out of bed. Another common cause of arch pain is fallen arches or flat feet. Fallen arches result in the sole of the foot becoming flat so that the entire sole of the foot touches the ground. Fallen arches can lead to pain in the ankles, knees, feet, and even in the legs. While fallen arches are often inherited, for some it develops as a result of wear and tear on your feet. Wearing shoes without proper metatarsal support, or arch support, can overstretch the tendon that supports the arch causing the arch to flatten out.
Symptoms
Many people have no symptoms, and the condition is discovered only by chance when an X-ray of the foot is obtained for some other problem. When symptoms occur, there is usually foot pain that begins at the outside rear of the foot. The pain tends to spread upward to the outer ankle and to the outside portion of the lower leg. Symptoms usually start during a child's teenage years and are aggravated by playing sports or walking on uneven ground. In some cases, the condition is discovered when a child is evaluated for unusually frequent ankle sprains.
Diagnosis
The doctor will examine your feet for foot flexibility and range of motion and feel for any tenderness or bony abnormalities. Depending on the results of this physical examination, foot X-rays may be recommended. X-rays are always performed in a young child with rigid flatfeet and in an adult with acquired flatfeet due to trauma.
Non Surgical Treatment
Use corrective prophylactic measures. Purchase new shoes or replace the insoles of your current shoes. Athletic shoes lose the elastic properties of the soles through usage and age. A good rule of thumb is to replace your shoes every six months, more often if there is heavier usage. The use of after-market insoles can increase energy absorption and add support to the foot. Custom fabricated orthotics or off-the-shelf orthotics may also improve the biomechanics of the foot. Focus on muscle strengthening and flexibility. You may be given exercises to increase the strength and stability of the affected area and to correct muscles that may not be balanced. Exercises to increase flexibility will maintain or improve the length of a muscle. Flexibility helps to make a stronger muscle that is less likely to be injured.
Surgical Treatment
The soft tissue surgeries usually would include a lengthening of the Achilles tendon, releasing of the plantar fascia as well as tendon transfers. These procedures are usually done in conjunction with bony procedures such as calcaneal osteotomies (to lower the heel bone and get it more under the leg itself), as well as metatarsal osteotomies. These procedures usually involve either cutting or fusion of the bones, and placement of fixation devices to allow the bones to heal. Healing time is usually at least 6-8 weeks and usually the patient must be non-weight bearing during the healing process. These types of surgical corrections are usually reserved for the more difficult, painful and deformed feet. They can require more surgeries down the line. These procedures are usually the last resort after all other modes of treatment have been exhausted (except in children where it is usually best to treat the deformity early). There are many different degrees of high arched feet and these procedures should be left for the more extreme cases. These cases usually require a very high degree of surgical skill and should only be done by those who frequently perform these types of cases.
Prevention
Foot and ankle injuries are common in sports, especially running, tennis and soccer. But sports enthusiasts can decrease the risk of injury by taking some precautions. Lightly stretch or better yet, do a slow jog for two to three minutes to warm up the muscles. Don't force the stretch with a "bouncing motion." The amount of time spent on the activity should be increased gradually over a period of weeks to build both muscle strength and mobility. Cross training by participating in different activities can help build the muscles. People whose feet pronate or who have low arches should choose shoes that provide support in both the front of the shoe and under the arch. The heel and heel counter (back of the shoe) should be very stable. Those with a stiffer foot or high arches should choose shoes with more cushion and a softer platform. Use sport-specific shoes. Cross training shoes are an overall good choice; however, it is best to use shoes designed for the sport.
Stretching Exercises
Below are two simple plantar fasciitis stretching exercises to help improve the flexibility of the muscles and tendons around the foot and ankle. Plantar fasciitis stretch taken from The Stretching Handbook. Kneel on one foot and place your body weight over your knee. Keep your heel on the ground and lean forward. In the photo to the left, the athlete is stretching the arch of her left foot. Kneel on one foot with your hands on the ground. Place your body weight over your knee and slowly move your knee forward. Keep your toes on the ground and arch your foot. In the photo to the right, the athlete is stretching the arch of his right foot.
Discomfort across the bottom of the foot at any point between the heel and the ball of the foot is often referred to as ?arch pain.? Arch pain is a non-specific term. Most arch pain is due to strain or inflammation of the arthritis, deformity, plantar fasciitis. Plantar fasciitis is sometimes associated with a heel spur. In most cases, arch pain develops from overuse, unsupportive shoes, weight gain, or acute injury. If arch pain persists beyond a few days, see a foot and ankle surgeon for treatment to prevent this condition from becoming worse.
Causes
The most common cause of arch pain is plantar fasciitis. Plantar fasciitis is inflammation of the fibrous band of tissue that connects the heel to the toes. Sufferers of plantar fasciitis typically feel pain early in the morning when they first get out of bed. Another common cause of arch pain is fallen arches or flat feet. Fallen arches result in the sole of the foot becoming flat so that the entire sole of the foot touches the ground. Fallen arches can lead to pain in the ankles, knees, feet, and even in the legs. While fallen arches are often inherited, for some it develops as a result of wear and tear on your feet. Wearing shoes without proper metatarsal support, or arch support, can overstretch the tendon that supports the arch causing the arch to flatten out.
Symptoms
Many people have no symptoms, and the condition is discovered only by chance when an X-ray of the foot is obtained for some other problem. When symptoms occur, there is usually foot pain that begins at the outside rear of the foot. The pain tends to spread upward to the outer ankle and to the outside portion of the lower leg. Symptoms usually start during a child's teenage years and are aggravated by playing sports or walking on uneven ground. In some cases, the condition is discovered when a child is evaluated for unusually frequent ankle sprains.
Diagnosis
The doctor will examine your feet for foot flexibility and range of motion and feel for any tenderness or bony abnormalities. Depending on the results of this physical examination, foot X-rays may be recommended. X-rays are always performed in a young child with rigid flatfeet and in an adult with acquired flatfeet due to trauma.
Non Surgical Treatment
Use corrective prophylactic measures. Purchase new shoes or replace the insoles of your current shoes. Athletic shoes lose the elastic properties of the soles through usage and age. A good rule of thumb is to replace your shoes every six months, more often if there is heavier usage. The use of after-market insoles can increase energy absorption and add support to the foot. Custom fabricated orthotics or off-the-shelf orthotics may also improve the biomechanics of the foot. Focus on muscle strengthening and flexibility. You may be given exercises to increase the strength and stability of the affected area and to correct muscles that may not be balanced. Exercises to increase flexibility will maintain or improve the length of a muscle. Flexibility helps to make a stronger muscle that is less likely to be injured.
Surgical Treatment
The soft tissue surgeries usually would include a lengthening of the Achilles tendon, releasing of the plantar fascia as well as tendon transfers. These procedures are usually done in conjunction with bony procedures such as calcaneal osteotomies (to lower the heel bone and get it more under the leg itself), as well as metatarsal osteotomies. These procedures usually involve either cutting or fusion of the bones, and placement of fixation devices to allow the bones to heal. Healing time is usually at least 6-8 weeks and usually the patient must be non-weight bearing during the healing process. These types of surgical corrections are usually reserved for the more difficult, painful and deformed feet. They can require more surgeries down the line. These procedures are usually the last resort after all other modes of treatment have been exhausted (except in children where it is usually best to treat the deformity early). There are many different degrees of high arched feet and these procedures should be left for the more extreme cases. These cases usually require a very high degree of surgical skill and should only be done by those who frequently perform these types of cases.
Prevention
Foot and ankle injuries are common in sports, especially running, tennis and soccer. But sports enthusiasts can decrease the risk of injury by taking some precautions. Lightly stretch or better yet, do a slow jog for two to three minutes to warm up the muscles. Don't force the stretch with a "bouncing motion." The amount of time spent on the activity should be increased gradually over a period of weeks to build both muscle strength and mobility. Cross training by participating in different activities can help build the muscles. People whose feet pronate or who have low arches should choose shoes that provide support in both the front of the shoe and under the arch. The heel and heel counter (back of the shoe) should be very stable. Those with a stiffer foot or high arches should choose shoes with more cushion and a softer platform. Use sport-specific shoes. Cross training shoes are an overall good choice; however, it is best to use shoes designed for the sport.
Stretching Exercises
Below are two simple plantar fasciitis stretching exercises to help improve the flexibility of the muscles and tendons around the foot and ankle. Plantar fasciitis stretch taken from The Stretching Handbook. Kneel on one foot and place your body weight over your knee. Keep your heel on the ground and lean forward. In the photo to the left, the athlete is stretching the arch of her left foot. Kneel on one foot with your hands on the ground. Place your body weight over your knee and slowly move your knee forward. Keep your toes on the ground and arch your foot. In the photo to the right, the athlete is stretching the arch of his right foot.