Arch pain is common – way too common – and affects a lot of people. The main reason is that the arch is basically your foot’s shock absorber. The arch and the underlying, supporting plantar fascia take the brunt of the force in weight bearing and shock absorption. And contributing to the frequency of arch pain is the complexity of this mid-foot structure.
Your Arch Explained
Actually, your foot has two arches: the longitudinal arch and the transverse arch. These two arches are made up of five irregularly shaped bones called tarsal bones. This assembly of bones maintains its shape because of the shape of the individual bones and the way they fit together—much the way a stone arch stands because the stones have been carefully shaped and precisely fitted together.
Additional support to the arch comes from muscles and an underlying ligament called the planter fascia. Obviosuly, then, your arches are very complex structures. And that means there’s a lot that can go wrong in that array of interrelated parts and functions.
Causes of Arch Pain
Arch pain can have one or more of several causes: trauma, sprained ligaments, strained muscles, bruises, poor foot alignment, overuse, joint tightness, arthritis, and stress fractures. Generally, though, plain old sprains and strains from hard and excessive use, stress fractures, and injury to the plantar fascia are the usual culprits for most people. An injured and inflamed plantar fascia, a condition called plantar fasciitis, is probably the most common.
Plantar fasciitis is a source of arch pain typically caused by repetitive micro-trauma. When the plantar fascia—the bundle of ligaments connecting the heel to the toes and thus supporting the arch—is subjected to excessive loads or stress, it suffers micro-trauma from overstretching. Then, it becomes inflamed and loses some of its elasticity. And then, when you walk or run or jump, the plantar fascia is unable to stretch as it should – and pain is the result.
Because the pain is the product of a plantar fascia (and occasionally the related muscles) being stretched too tight, it is usually at its worst first thing in the morning or after long periods of rest. After some activity, though, things tend to “loosen up,” and the pain lessens.
What to Do About Arch Pain
Arch pain that occurs as a result of plantar fasciitis or similar conditions can often be reduced with certain exercises, such as:
All variations of calf stretches – Useful for stretching out the inflamed plantar fascia and the surrounding musculature, which should help with much of the pain when you walk.
Exercises to strengthen surrounding muscles – Aids in taking the load off the affected area and allowing healing to begin.
Any exercise, even just walking, that flushes the area with blood – Helps promote healing as long as it doesn’t exacerbate the condition causing the pain
The best initial treatment for the early onset of arch pain (usually a burning sensation in the arch) is application of ice to reduce swelling and inflammation. Later, heat and anti-inflammatory gels, coupled with anti-inflammatory medications such as ibuprofen or acetaminophen, can be effective. In addition, rest and eliminating the activities that have contributed to the problem can be a big help. Massage and foot rollers also have their place in the treatment arsenal.
When arch pain is caused by hyper-pronation and plantar fasciitis, arch supports can do wonders for the pain. Just remember, though, that run-of-the-mill arch supports work by immobilizing the arch, and if used for long periods, can lead to weakening of the surrounding muscles. They should, therefore, be used only for relatively short periods until the pain subsides and healing begins.
There are, however, specially designed orthotic insoles on the market that prevent pronation and provide good arch support by working with your muscles to alleviate the pain and build the needed strength. These orthotic insoles/arch supports also stretch the Achilles tendon and calf muscles to take stress off the plantar fascia. Anyone suffering from arch pain would do well to consider these.
Of all the conditions that cause foot and heel pain, from the merely annoying to the nearly debilitating, plantar fasciitis is by far the most common. People nearing or in middle age are most often afflicted by this painful condition (although those in other age groups are also susceptible). And understanding the condition—symptoms, causes, risks, and treatments—is the best way to be armed against it.
Plantar fasciitis is a painful condition that occurs when the plantar fascia—the long, fibrous bundle of ligaments that connects the heel to the toes on the underside of the foot—undergoes repeated, prolonged, unaccustomed, or inordinatesevere stress. This vulnerable strand of connective tissue suffers tiny tears as a result of overstretching produced by increased loads or activity or even abnormal foot mechanics. Then, inflammation sets in. When the plantar fascia then loses some of its elasticity, heel pain is the result.
Symptoms and Causes of Plantar Fasciitis
The symptoms range from mild pain in the heel, which soon subsides after you’ve taken your first few steps early in the morning, to a sharp and persistent pain. Another plantar fasciitis symptom is piercing heel pain that returns after a period of rest. The pain is often exacerbated when you climb stairs or stand on your toes. Further, this condition may lead to tightness in the calf or Achilles tendon, which makes dorsiflexion (flexing the ankle so that the toes are brought toward the shin) difficult.
Often called policeman’s heel, plantar fasciitis is commonly associated with prolonged periods of weight bearing, an occupational hazard for policemen, factory workers, and others who have to stand for hours. Sudden weight gain (pregnancy, for example) or chronic obesity, can also lead to the condition. Other plantar fasciitis causes include athletic activity (usually jogging), abnormal foot mechanics (flat feet or excessively high arches), and the degeneration that comes with age.
Why You Should NOT Ignore Plantar Fasciitis Pain
Beyond the obvious risks of nagging (and occasionally excruciating) pain and limited activity, untreated plantar fasciitis can lead to several
other related conditions. For runners especially, there’s the possibility of developing chronic knee pain. Sfferers sometimes develop an abnormal gait in an unconscious effort to walk with less pain, which in turn puts undue and sometimes damaging stress on other joints and muscles, including the back.
Typically, plantar fasciitis lasts only as long as the stress on the plantar fascia and the inflammation do. Depending on how long the condition has persisted and remained untreated, the pain can last from a period of months to years. When the pain first begins, most people just ignore or put up with it, hoping it will eventually go away.
People who are overweight, have both feet affected, or delay seeing a doctor are usually suffer for the longest periods. The key is to begin treatment as soon as the condition has been properly diagnosed.
What to Do About Plantar Fasciitis
Treatment for plantar fasciitis, depending on its severity, ranges from simple lifestyle changes to home and self-remedies to medication and injections to surgery. Overweight people simply need to lose a little weight, and many others just need to reduce their activity levels to take the load and stress off their feet.
Ice, massage, and various calf-stretching exercises can be beneficial as well.
And something as simple as getting a better-fitting pair of shoes can be a huge help.
If these conservative treatments prove ineffective, the nest step is to consider taking NSAIDs such as ibuprofen and, for more severe cases, corticosteroid injections.
For people with abnormal foot mechanics, orthotic shoe inserts may be in order.
As a last resort, there is surgery, particularly a procedure called Endoscopic Plantar Fasciotomy. Just be aware that surgery carries with it the risk of nerve damage.
Arm yourself with information, and half the battle is over. Begin treatment as soon as possible, and much more of the battle has been won. There really is no need to suffer unnecessarily from the pain of plantar fasciitis.