How many times have you gotten out of bed in the morning, or up from a chair that you’ve been sitting in for a while to find that one or both of your feet are really painful. Painful to the point where you have to limp for the next few minutes in the hopes that you can “walk it off”, or the pain resolves. If you are like me, WAY TOO MANY TIMES.
Why does that happen? Why do our feet become so painful? In the absence of trauma, the vast majority of us develop that pain as a result of our BIOMECHANICS. That is a big and scary word. What is the definition of biomechanics? The word biomechanics means “The study of structure, function and motion of the mechanical aspects of our bodies”. In simple terms it means the way that our body moves during activity. In this context it means the study of how our feet and legs move when we are standing, walking and running. This context takes me back to the nursery rhyme when I was a child that went something like “the foot bone is connected to the leg bone; the leg bone is connected to the hip bone etc”. Each of those segments of the body function independently, but also function as a unit which is what allows us to move forward.
What does all of this have to do with aching feet? As a podiatrist examining feet all day, there are primarily two-foot types. Those with high arches, and those with low arches or flat feet. Generally, it is this group that has more foot problems and more sore aching feet. The medical term for flat feet is pronation. It is the pronated foot type that is flatter, and more flaccid as compared to the high arched foot type. In the majority of patients, it is the pronated flat foot
that develops more foot deformity such as bunions and hammertoes, as well as heel pain.
Without getting into too much anatomy, there is a structure on the bottom of the foot called the plantar fascia. This is a soft tissue structure that attaches to the bottom of the heel bone and connects to the ball of the foot. One of the functions of the plantar fascia is to assist in supporting the arch but when the biomechanics (which are hereditary) are such that you have flat feet, the plantar fascia is placed into a position of being taught and stretched. When this goes on for a long enough period of time (which is different for each of us) the fascia responds by becoming inflamed, which is called plantar fasciitis. This is the cause of the heel pain that we so frequently see when first getting out of bed, or after rising from a chair after sitting for a while. If this goes on for a long enough period of time, and the fasciitis becomes chronic, the body tries to compensate for that by developing a bone spur on the heel, called a heel spur.
The good news is that in the majority of these cases, both plantar fasciitis and heel spur syndrome, treatment is very successful without the need for surgery. That is restricted to only the most severe and unresponsive cases. Conservative non-surgical management for plantar fasciitis and heel spurs usually includes a combination of things; oral anti-inflammatory medications, ice, arch supports- over the counter or custom molded are likely to be the most effective non-operative management for this condition. In addition, cortisone injections and laser therapy have been found to be VERY effective in eliminating the inflammation and pain, and then followed up with arch supports to control the biomechanics and eliminate the flat foot condition. In the vast majority of patients, it is this combination of treatment modalities that will eliminate the pain and prevent it from recurring. When none of these non-operative conservative measure works, then surgery may be an option.
If you are someone suffering from aching feet, sore arches, or heel pain act on it sooner rather than later. You will be glad you did.