Foot Pain: How To Prevent And Treat It

Foot pain is a major source of pain and discomfort for millions of people. And while statistics are hard to pinpoint, foot pain affects all of us at some point in our lives. The reason for this is simple: no other part of the body absorbs as much shock and force as our feet! Also, the foot is a very complex anatomic structure. On the one hand, your feet need a certain amount of shock absorption built-in to cushion your body when walking or running. On the other hand, your feet must also be rigid in order to provide support. But - if your feet have too much cushioning, you won’t be able to generate force for walking. In contrast, if your feet are too rigid, that can also create problems. Imagine walking on a ‘peg leg’: forces shoot right up the body, creating stress on the entire body. So, your feet have to maintain a delicate balance: cushioned yet rigid. Here is why the foot is so complex. Your foot is made up of 19 muscles, 26 bones, 33 joints and 107 ligaments. Amazing, isn’t it? Your feet can be afflicted with over 300 different ailments and a 135 pound person absorbs more than 2.5 million pounds of pressure while stepping throughout a typical day! No wonder there are foot and ankle specialists among doctors! The foot’s extraordinary complexity is a function of the many joints and ligaments involved. Every joint requires at least two to three ligaments — and sometimes more — depending on the orientation of the joint. Ligaments (which connect bone to bone) form the supportive structure of the joint. They create what is considered your primary source of stability…along with the orientation (or direction) of the joints themselves. Unlike tendons (which connect muscle to bone), ligaments need to be tight. Without rigidity, there is no support. And since ligaments and tendons are made of different types of connective tissue, once a ligament is stretched out, it’s very difficult (if not impossible) for it to regain its rigidity. Tendons and muscles form the secondary supportive structure for your feet. Tendons are more elastic than ligaments and once stretched, slowly regain their rigidity (when you stretch before exercising, you’re mostly stretching tendons and muscles).

Foot Pain: What Actually Causes It?

Pain in the foot is typically due to an abnormality of any of the structures of the foot.Although some occur as a result of traumatic injuries (such as accidents, broken bones, stress fractures, sports injuries and crushing injuries) most foot pain is attributed to degenerative changes that occur over a long period of time. The most common causes of foot pain include …

• Calcaneal spurs - These are pointed bony outgrowths on the heel. Calcaneal spurs are most often attributed to local inflammation at the insertion of the soft tissue tendons. Spurs can also be located on the sole of the foot or at the back of the heel. If located at the back of the heel, spurs are frequently associated with Achilles tendonitis.
• Plantar Fasciitis - This is a condition where the flat band of connective tissue underneath your foot becomes weak, swollen and irritated. This, in turn, causes the bottom of your foot to hurt when you stand or walk. Although Plantar Fasciitis is seen most in middle-aged people, it also occurs in younger age groups. People who spend a great deal of time on their feet - such as athletes and soldiers - frequently develop this condition. Untreated, it can eventually cause problems with your ankles, your knees and your hips. It usually develops as a result of extremely tight Achilles tendons or calf muscles. Staying flexible is important in avoiding this painful condition.
• Arthritis - This is a very common cause of foot pain. If you have rheumatoid arthritis, it can cause a deformity of the toes and breakdown of the joints. With the loss of rigidity, ligaments tend to break down and the entire foot starts to collapse; it’s a vicious cycle of degenerative changes. Rheumatoid arthritis is most often seen in the hands and feet.
• Improper or Poor Footwear - Believe it nor not, improper footwear is the root cause of nearly 80% of all foot problems. Bunions are a common malady. This is where your first toe turns inwards and creates pain in the foot. It usually occurs in both feet with one foot worse than the other, and gets progressively worse. Women are stricken with bunions at a far greater rate than men. Can you guess why? Right: because of the types of shoes women wear. Also, people who tend walk flat-footed tend to suffer from bunion deformity at an increased rate.
• Neuroma - This is an inflammation of one of the nerves that run between the bones of the toes of the foot. Basically, it’s nerve “entrapment” where a nerve (or nerves) become compressed between the bones of the foot and become enlarged and inflamed. The primary cause is from twisting the foot when walking. Neuroma is also associated with flattening of the foot and can result in a “burning” type of pain and intermittent numbness in the legs and feet.
• Diabetes - This disease has potentially disastrous consequences for your feet. With diabetes, your blood vessels’ ability to deliver oxygenated blood is impaired. As a result, many who suffer from diabetes experience loss of sensation in the legs and feet. People who suffer from diabetes can have very tight shoes or a rock or pebble in their shoe, and not even feel it!This compression alone can damage the soft tissues of the feet. Also, since blood flow is impaired, tissue in the feet cannot heal and ulcers start to form. This only compounds the problem. This is why I recommend that diabetics check their feet on a daily basis and look for irritation and/or red spots.
• Tendonitis - Tendonitis is inflammation of tendons. In feet, tendonitis most often manifests itself as tightness of the heel cord. If you have a history of ankle sprains or sports injuries to the foot, the ligaments in your feet will be looser and susceptible to further injury. Those are the most common causes of foot pain. Now let’s talk about how to prevent foot pain from happening in the first place.

How To Stop Foot Pain Before It Begins

• Tip No. 1: Don’t ignore your pain. Foot pain is NOT normal. As with any type of pain, foot pain is a signal something is wrong with the body. See your physical therapist or your doctor and get it checked out. This is always the first step.
• Tip No. 2: Wear the right shoes for your particular foot type. See my “Questions and Answers” section this month (p. 4) for in-depth tips on selecting the right shoes for your feet!
• Tip No. 3: Check your shoe size every three years. Your feet continue to grow longer and wider as your age. Some conditions (such as pregnancy) can also increase the size of the feet. With age, fatty layers of padding on the bottom of the feet also start to diminish. As this cushioning slowly disappears, it can lead to greater injury and stress over time. People with less padding can be more susceptible to bone spurs and other types of ailments as discussed earlier.
• Tip No. 4: Lose a little weight. Since your feet and ankles are your body’s primary shock absorbers, the less weight (and therefore force) placed on your feet, the better. Even losing 5 or 10 pounds can make a difference. Remember: people’s feet sustain an incredible amount of pressure each and every day. Losing weight is one of the best ways to relieve pressure on your feet.
• Tip No. 5: Ditch the high heels. Wearing high heels changes all the forces in the foot. So instead of distributing these forces across your entire foot, they’re focused exclusively on the “ball” of the foot. This added stress can lead to many different foot ailments. Excessively high heels are an open invitation for foot problems. What are some treatment options for foot pain? Easy. Physical therapy can be a great relief to many. See your physical therapist to help attack the root problems behind your foot pain. In the meantime, you can alleviate the symptoms with ice. Some of my patients find if they freeze a bottle of water, they can roll the bottle over the bottom of their foot and relieve much of the pain associated with certain ailments. You can also try calf stretches (see me for examples), arch stretches and self-massage. You need to maintain the health of your feet because they’re the only ones you have. Losing weight, getting the correct shoe support, doing the right exercises (such as flexibility and strengthening exercises) are crucial. Physical therapy is also a great answer for the most common foot ailments and abnormalities.