Video: Exercises To Reduce Pain In The Bottom Of The Foot
This video shows exercises that can help with pain in the bottom of the foot.
The exercises in this video are suitable for most people. They are general exercises only and are not aimed at treating any specific cause of pain or condition.
Get advice from a GP or health professional before trying it, especially if:
- you have any concerns about your health
- you are not sure if the exercises are suitable
- you have any pre-existing health problems or injuries, or any current symptoms
Stop the exercise immediately and get medical help if you feel any pain or feel unwell.
Treatment Of Mrs X Arch Pain
It was explained to Mrs X that she needed to lose weight in order to help her fatigued feet and reduce this chronic and acute arch pain. She was already aware of this and explained she cant walk for exercise, to burn the calories. She was advised to swim and perform resistance training for her upper body. Mrs X enquired about the use of prescription orthotics. She felt her feet were more unstable since gaining weight. The Sports Podiatristexplained to Mrs X that the orthotics were a valid treatment option, and that the Carbon Fibre material would be the preferred choice. These are a firm material but are streamlined and less bulky, and so fit into more shoes more easily. They would have slow release poron to provide cushioning and the support from these orthotics would reduce the strain on the whole foot, particularly the arch. This would allow the arch pain to resolve over time, as the micro tears and inflammation subsided.
Orthotics For Posterior Tibial Tendonitis
Orthotics for this problem are designed specifically to reduce tension on the posterior tibial tendon. This often requires an orthotic that is deeper than normal around the heel and perfectly matches the arch of the foot .
The correct orthotic can not only help heal the tendon by reducing tension on it but can also help prevent re-occurrence of the problem.
Depending on the level of treatment needed we may use a prefabricated orthotic with modifications to reduce tension on the posterior tibialis or a custom orthotic. Our goal is to use the least expensive therapy that will provide you with optimal pain relief.
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Peroneal Tendonitis Can Cause Arch Pain
Peroneal tendonitis is a tendon condition that causes severe pain on the outside edge and arch of the foot. There are two peroneal tendons on each foot , that run along the outer edge and connect to the muscles in your lower leg. They provide structure to the side of the foot and contribute to ankle stability.
When these tendons become stressed and irritated from pressure and overuse they can cause severe pain, tenderness, and stiffness that often radiates to the arch. This condition can be misidentified as plantar fasciitis so be sure to see your foot doctor since treatment for the two conditions is quite different.
Types Of Tendonitis In The Foot
The most common types of foot tendonitis are:
Achilles tendonitis
The Achilles tendon is the large tendon that attaches the back of your heel to your calf muscle. Achilles tendonitis usually occurs one to four inches above the area where your Achilles attaches to your heel bone. This is the weakest part of the tendon and the location where tendon tears typically occur.
Extensor tendonitis
Extensor tendons run along the top of your foot. Tendonitis in this location is often caused by your foot rubbing against your shoe. It can also be caused by less common inflammatory conditions such as rheumatoid arthritis. If your feet have high arches, they are more vulnerable to the shoe friction that causes this type of tendonitis.
Flexor tendonitis
Flexor Tendonitis usually causes a profound pain deep in the back of your ankle near the inside of your foot. This type of tendonitis is common in dancers or those who are required to do a lot of balancing on their toes.
Peroneal tendinosis
The tendons of the peroneal muscle wrap around the outside of your foot and down towards your ankle. Pain and possibly swelling can occur here and in the area just below and above it.
Posterior tibial tendonitis
This type of tendonitis is usually associated with people who have flat feet. The tendon of your tibialis posterior muscle wraps around the inside of your foot. That area of your foot is where pain and swelling can be felt.
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Symptoms And Characteristics Of Plantar Fasciitis
One of the most common telltale signs of Plantar Fasciitis is foot pain that is worst first thing in the morning and improves somewhat throughout the day as the fascia stretches out. The following are other telltale signs of Plantar Fasciitis:
- Stiffness in the heel and aching arches
- Swelling and redness along the arch and heel
- Pain that is worse in the morning
- Symptoms improve somewhat with rest, stretching the fascia, and icing
- Sharp pain in the fascia and heel, which typically causes limping
Advanced Posterior Tibial Foot Tendonitis
In more advanced stages of posterior tibial foot tendonitis, the arch of the foot has collapsed and a simple tendon debridement may be insufficient to correct the problem. Reconstruction of the posterior tibial tendon is occasionally performed. In a reconstructive procedure, a neighboring tendon is moved to replace the damaged posterior tibial tendon. This procedure is often combined with a bone reconstruction.
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Discover How We Can Help You Find Relief From Tendonitis
Tendonitis refers to any irritation or inflammation of thick tissues called tendons that attach bones to muscles. The condition can be caused by a sudden injury or by repetitive motions that place added stress on tendons and supporting structures. While tendons in any part of the body may become inflamed and irritated, tendonitis is a common source of foot and ankle pain. More common in adults and athletically active individuals, tendonitis can affect anyone. Seek medical care if:
- Symptoms are severe and self-care is not helping
- You cannot move or place weight on the affected foot
How Can You Treat Tendonitis At Home
You can treat some cases of extensor tendonitis at home. Rest the affected foot for two to three days. Use it as little as possible to give the tendons a break.
While you are resting your foot, put ice on it for 20 minutes every two or three hours.
Wrap an elastic bandage around the injured area to reduce inflammation, or use a brace. Make sure the bandage or brace is not too tight and take it off before you go to sleep.
Try loosening your shoelaces or trying different shoes to see if that helps. You can also add some padding under the tongue of your shoe before you return to activity.
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What Causes Plantar Fasciitis
With every step we take, our body weight comes to rest first on the heel and then gradually over the length of the foot. As the foot begins to bear weight, it flattens. This puts pressure on the plantar fascia, which has very little stretch. As we walk, the plantar fascia pulls on its attachment at the heel.
If the foot is properly aligned, this pull causes no problems. If the foot is pronated meaning it rolls outward at the ankle the arch falls too much and there is an abnormal amount of pull on the fairly rigid plantar fascia. This causes an abnormally strong pull on the heel where the plantar fascia attaches.
Something similar happens when the foot has supination, meaning it rolls inward. These type of feet are relatively inflexible, usually have a high arch and a short or unusually tight plantar fascia.
Plantar fasciitis can be caused by:
It’s not always possible to identify the cause. Plantar fasciitis tends to develop as we get older and the fascia become less elastic. Women tend to get this condition more than men.
Early Foot Tendonitis Treatment
The initial treatment of posterior tibial foot tendonitis is focused on resting the tendon to allow for healing. Unfortunately, even eliminating everything but normal walking may not adequately allow for the tendon to rest sufficiently. In these cases, the ankle must be immobilized to allow for sufficient rest so that the foot tendonitis can start to repair itself.
Options for early treatment of foot tendonitis include:
- Shoe inserts and arch supports
- Non-steroidal anti-inflammatory drug pain relievers such as ibuprofen and naproxen
Treating foot tendonitis with surgery is approached cautiously by Midwest Orthopedic Specialty Hospital surgeons. In early stages of posterior tibial foot tendonitis, some surgeons may recommend a procedure to clean up the inflammation called a debridement. During a debridement, the inflamed tissue and abnormal tendon are removed to help allow for healing of the damaged tendon.
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Uneven Weight Distribution From Diabetes
Charcot foot is a rare condition characterized by a large, bony lump that forms on the bottom of the foot. It can develop as a serious complication of diabetes caused by chronic inflammation. A Charcot foot causes pain and swelling at the bottom of the foot and increases your risk of developing diabetic ulcers.
Treatment for a Charcot foot that develops from uneven weight distribution of the feet involves putting the affected foot in a cast and avoiding weight-bearing activities on that foot for several months. During this time, you will have to use crutches or a wheelchair to move around.
Gradual progression to normal weight-bearing with prescription footwear or a CROW will begin when your symptoms decrease. In cases that do not improve, surgery may be performed to remove bone spurs , increase the length of the Achilles tendon to improve the alignment of the foot and ankle, and fuse bones of the foot together for better stability.
Shockwave Therapy For Posterior Tibial Tendonitis
If we dont see rapid improvement in your symptoms by reducing tension on the tendon and standard anti-inflammatory measures, then shockwave therapy is usually the next level of treatment.
Extracorporeal shockwave therapy is a safe and non-invasive therapy for many tendon disorders. The goal of shockwave therapy is to stimulate healing of tendon. It involves 4 5 sessions of shockwave therapy, each about 1 week apart. Treatments are usually not painful or cause only mild discomfort. Sessions take less than 15 minutes.
A number of studies have shown very positive outcomes using shockwave therapy for tendon disorders In a 2018 study of about 400 subjects, for example, Shockwave therapy significantly reduced the pain that accompanies tendinopathies and improves functionality and quality of life. It might be first choice because of its effectiveness and safety.
Shockwave therapy works by stimulating healing of tendon in two ways:
- New Blood Vessel Formation: Shockwave therapy helps create new blood vessels, a process called neo-vascularisation. The improved blood flow helps provide the nutrients that assist with tendon healing.
- Release of growth factors: Growth factors are proteins that stimulate the cells that repair tendon tenocytes).
The British Medical Bulletin in 2015 noted in a systemic review that Extracorporeal shock wave therapy is an effective and safe non-invasive treatment option for tendon and other pathologies of the musculoskeletal system.
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When To See A Healthcare Provider
Sometimes, bottom-of-foot pain goes away on its own in a few days. Other times, it becomes a chronic condition that impacts your quality of life. It’s important to have an accurate diagnosis and begin treatment and any lifestyle changes to relieve pain on the bottom of your foot.
See a healthcare provider if you have:
- New pain that lasts more than a few days
- Loss of sensation or tingling
- Existing chronic foot pain that gets worse
- Pain that makes it uncomfortable and difficult to walk or do other activities
- An injury that causes foot pain
- Dizziness or nausea related to foot pain
- Fever or swelling with foot pain
- Diabetes or another condition that affects your nerves
In general, your primary care provider should be the first person you see for any foot pain, injury, or other condition you are experiencing.
Based on their assessment, they may point you to a podiatrist or orthopedist .
Your PCP may point you to a neurologist if they suspect your foot pain is due to a nerve condition like peripheral neuropathy or Guillain-Barré syndrome.
When Is Surgery Recommended
Surgery for tendonitis is rarely necessary. Itâs an option thatâs only considered if other treatments arenât successful or if there is structural damage to the tendon itself or nearby structures in the foot and/or ankle.
Reduce your risk of developing tendonitis in your feet and ankles by properly stretching first before participating in activities that will involve foot movements. Making an effort to minimize repetitious foot movements, being mindful of proper form while running or jogging, and avoiding processed and fried foods, sugary snacks, and other foods that tend to contribute to inflammation can also keep tendons healthy. Itâs just as important to know when to pay attention to pain and take a break from activities that seem to trigger your discomfort.
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Symptoms Of Posterior Tibial Tendonitis Pain On The Inside Of The Foot
Figure 2 Flattening of your foot causes outward rotation of heel promoting Posterior Tibial Tendonitis
Symptoms of posterior tibial tendonitis include pain and swelling along the inside of the ankle and arch along the course of the tendon.
There is often pain on the inside of the of foot.
Pain is present with walking, exercise or just standing. This discomfort will usually increase over time.
This pain initially is absent when at rest but may progress to the point where pain is present even when not active. In advanced cases the injury to the tendon that started as tendonitis may result in a full or partial tear of the tendon.
Symptoms Of Tendonitis Of The Ankle Or Foot
The most common symptoms of foot or ankle tendonitis are localized pain, swelling, and stiffness.
Pain is the first sign of foot or ankle tendonitis. The pain typically lessens over time but then resurfaces the longer you spend on the foot or ankle.
You should schedule an appointment with your primary care doctor, a podiatrist or an orthopedic specialist if pain and swelling worsen even after resting.
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Use An Arch Support In Your Shoes
An arch support, particularly one that conforms close to the arch of your foot, will act to support the arch and reduce tension on the posterior tibialis tendon. OTC arch supports will not work as well as a quality custom orthotic, but will help. The best ones have a high enough arch to do a good job supporting the arch of the foot. In addition they are firm enough to not collapse under the arch of the foot. The best we have found for inside of ankle pain to fit in athletic and walking shoes is theFootChair Podiatrist Designed Orthotic. It is the only OTC arch support we have found with both an exceptional arch and additional pads that can be used to increase the arch height.
For use in smaller shoes including high heels, flats, soccer cleats FootChair makes a much smaller orthotic that still has the adjustable height arch support. This is theFootChair Slim Orthotic. We also like it because it flexes to fit different heel heights
Use a sandal or slipper with an arch support to wear around the house. This will act to support your arch when you are not wearing shoes. We recommend the Vionic Arch Support Sandals and Slippers for their superior arch support.
Use shoes with excellent support features. You can find a list of Seattle area shoe stores on our Shoe List. If you dont have a good shoe store nearby, these Orthofeet Shoes for Women and Orthofeet Shoes for Men provide great support for flat feet.
Treatment Options For Foot Tendon Problems
Some injuries of the tendon may not require excessive treatment. It will only depend on the conditions severity. Below are some of the treatment options that you can apply.
Treatment option can vary depending on your condition. The doctor will know which choice is right for you.
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Factors Causing The Arch Pain In Mrs X
The increase in body weight was clearly a contributing factor in the onset of Mrs Xs arch pain. The weight gain adds load to the feet and causes stress and strain on muscles and tendons. When the weight gain occurs quickly, the feet dont always cope with the extra stress and the Plantar Fascia can become overloaded. This leads to the micro tearing and inflammation of the Plantar Fascial fibres.
In addition to this, the extra body weight leads to an increase in calf muscle bulk and tightness. This muscle group works harder during stance and push-off in heavier patients. The stiffness in these muscles, which are attached to the back of the heel, causes a stronger pulling action on the back of the foot. This in turn causes a stronger pull through the sole of the foot, which can lead to strain in the Plantar Fascia and result in arch pain.
Theres a fairly good case that would suggest Mrs X would not have developed this acute arch pain had she worn more supportive shoes. Ballet flats, and any shoes that are flat and flexible are likely to cause problems in heavier patients, if used for longer periods.