Your feet are full of bits and pieces that can cause plenty of pain. 26 bones, 33 joints and over 100 ligaments, nerves, muscles and tendons that are all capable of causing varying degrees of feeling from ooh that tickles to CALL THE AMBULANCE!!! Each foot is intricately designed to absorb the forces of walking, running and jumping, morphing to the shape of the ground and transmitting these forces through the ankle to the legs. When everything is going smoothly, this process is seamless and unnoticeable, when it’s not, it can affect your day to day life. According to the 2017 Healthy Feet Survey[1] around half of Australians experience heel/arch pain and 6% of people surveyed wake up every morning with foot pain. The same study also showed that despite having expert knowledge, musculoskeletal physiotherapists are only consulted by 5% of people suffering foot pain, with 80% heading to the GP for advice. GP’s commonly refer clients to musculoskeletal physios for foot and ankle pain, physios are really just doctors to manage and prevent pain.
So, what are the most common types of foot pain, and what do they mean?
Ball of the foot pain or Metatarsalgia
Pain and inflammation in the ball of the foot is referred to by physiotherapists as Metatarsalgia . Good news for people who are more active, you’re more likely to experience ball of foot pain due to your activities that involve a lot of running and jumping. It is also common for people to suffer Metatarsalgia due to the over-usage of improper fitting shoes.
Musculoskeletal physiotherapists recommend a number of conservative treatment methods for ball of the foot pain such as rest and ice therapy. It is also important to take an in depth look at your shoes. Ideally you participate in sports with shock absorbing arch supports or insoles to minimise future complications or recurrences of metatarsalgia. Signs and symptoms of ball of foot pain include:
- Burning or aching pain in the ball of the foot
- Pain around the big toe only
- Worsening pain with weight bearing activities such as standing, running or walking
- Numbness or tingling in the toes of the foot
- The pain improves with rest
Plantar Fasciosis aka Plantar Fasciitis
“Plantar fasciitis” (a common misnomer as there is rarely any inflammation!) is one of the most common causes of heel pain characterised by pain in the plantar fascia, a thick fibrous band of connective tissue running from the bottom surface of the heel bone extending along the sole of the foot towards the toes. Have you ever jumped out of bed in the morning only to feel a stabbing pain in your heel with each step? That’s probably plantar fasciitis. Plantar fasciitis is most commonly found in impact and running sports but can sometimes feel like it just popped out randomly out of nowhere. People with poor foot biomechanics and those with flat feet or weak foot arch control muscles are more likely to suffer heel pain.
One of the most important aspects of treating and preventing a recurrence of plantar fasciitis is assessing and correcting any issues in your foot and leg biomechanics, sporting technique and your shoes. Not all Dee why physio clinics are experts in foot control assessment and its dynamic biomechanical correction. After an initial in depth physiological assessment, your physiotherapist will likely prescribe manual therapy techniques such as joint mobilisations, soft tissue massage or release, muscle stretches for flexibility, foot taping and lower limb strengthening exercises.
Achilles Tendinopathy
Characterised by pain in the Achilles tendon or its covering, Achilles Tendonitis is an overuse injury that is most common in joggers, jumpers and other activities that require repetitive actions. Tendons are tough fibres that connect your muscle to bone but they are susceptible to overuse and injuries are usually caused by a number of micro tears occurring over a period of time. Common causes of Achilles tendonitis include:
- Tight hamstrings and calf muscles
- Walking on your toes (or excessive high heel wearing)
- Overtraining and failing to warm up or down
- Poorly supportive footwear
Foot pain is a common issue for Australians to put off until recovery includes being totally laid off your feet. It can be easy to write off foot pain as simple pain but it can also be caused by fractures, nerve compressions, loss of blood supply to the bone and even problems stemming from the lower back. The best way to pinpoint and treat foot pain is to undergo a full body analysis with your local physio. The good news if you are suffering foot pain is that research has shown that physiotherapy is effective management and will get you back to playing the sports and doing the activities you enjoy, free from pain.
[1] https://www.myfootdr.com.au/wp-content/uploads/2017-Healthy-Feet-Survey-by-My-FootDr-Balance-Podiatry_web.pdf
