The foot is a complex area of the body that consists of 26 bones, 33 joints and over 100 muscles and ligaments!

It is also divided into three sections:

1. The hindfoot: The talus (ankle bone) and the calcaneus (heel bone) join together to allow for rotation at the ankle
2. The midfoot: Contains five tarsal bones: five cuneiform, navicular and cuboid — and they connect the hindfoot to the forefoot and form the arches of your feet that help generate force and shock absorption; and
3. The forefoot: Made up of phalanges — your toes (three phalanges in each toe, two only in the big toe) — and five metatarsal bones (the long bones in your foot). The big toe is the shortest and thickest and is designed this way to allow many tendons to attach onto it. This feature helps with force production and allows the big toe to withstand significant loads in weight bearing.

So what can make a foot painful?

Biomechanics

Biomechanics is the term describing how the body moves. In the hindfoot and midfoot there are two main movements — inversion (the sole of foot turns inwards) and eversion (the sole of the foot turns outwards). In the forefoot, the toes perform four types of movement: dorsiflexion and plantar flexion (toes move up and down), adduction and abduction (toes move outwards and inwards).

Your biomechanics can influence your risk of injury but that doesn’t necessary mean you will have an injury. For example, those who have a hypermobile foot with reduced/flattened arches will have a lesser ability to shock absorb and to generate foot propulsion as efficiently. This is particularly relevant when performing extended repeated loading activities such as long distance running. It is important to identify potential weaknesses and and then work on a targeted strength program and ensuring you are wearing appropriate footwear to prevent foot structures from being overloaded.

Plantar fasciopathy/plantar fasciitis

Plantar fasciopathy or plantar fasciitis is an overuse condition of the plantar fascia and is one of the most common causes for heel pain. The plantar fascia is a complex piece of connective tissue that runs along the bottom of your foot and attaches to your heel. It’s main function is to shock absorb as well to help maintain the arches in your feet during weight bearing. When the tissue is repeatedly overloaded the tissue can become irritated, painful and sometimes inflamed.

• • Who can get it?
    • The condition is common in the older population, as the joints tend to become stiffer resulting in increased strain onto the fascia
    • People who do a lot of standing or walking
    • Runners who increase training load too quickly

To find out more of how to manage and rehabilitate it, have a read of “Heeling the pain”.

Morton’s Neuroma

This refers to a thickening and irritation of one of the nerves between the toes, most commonly the 3rd and 4th toe. The main cause is not really known but it is linked to things that compress or stretch the nerves, such as wearing tight footwear or repetitive high-impact loading. The condition affects all ages, but tends to affect middle-aged women the most. Symptoms usually begin as tingling in the space between your toes and, if left to worsen, can progress to a sharp shooting pain in the ball of your foot or at the base of your toes.

• Management

There are many things that can be done to conservatively manage Morton’s Neuroma.

• Firstly, symptoms need to be settled and this will need for aggravating activities to be reduced or avoided
• Wearing proper footwear, such as wider shoes to reduce pressure on the nerve, and make sure there is sufficient cushioning!
• Orthotic devices with a pad for the ball of your foot to help relieve the pressure on the nerve
• Manual therapy to ensure sufficient joint movement in the foot and ankle to help dissipate load away from the nerve
  

Stress fractures

Stress fractures are small cracks or bruising in the bone and are caused by overuse, overload and repetitive activities, commonly seen in those who do large amounts of jumping and running long distances. The injury is usually triggered by an increase in load, whether that is in nature of amount or intensity. Pain is felt localised and is worsened with weight bearing and improves significantly when offloaded.

Management

• Time will be required to let the bone settle and heal (ideally six to eight week). It is essential that prior to return to the aggravating activity you are able to load the foot up pain free
• Once pain free, it is important to modify the things that caused it in the first place. This could include poor training technique, inappropriate footwear or insufficient strength resulting in increased load on the bone
• It is important when starting a new program to slowly make changes and progress gradually
• Avoid performing the same heavy repetitive loading activity. Cross train by adding in low impact activities
• Ensure proper nutrition to keep the joints and bones healthy.

Foot pain treatment with Life Ready Physio

For a pain-free foot, you require strong muscles around the joint as well as a good range of motion. With experienced treatment such as joint mobilisation, massage and therapeutic exercises for improved functionality, Life Ready Physio will not only alleviate foot pain — we’ll provide you with the tools to prevent future injuries too.

For an in-depth assessment by one of our skilled physiotherapists, book a consultation here.

We look forward to joining you on this journey to pain-free living.

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