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Common Problems Associated With Feet

Plantar Fasciitis:
One of the most common overuse injuries a pedorthist will see is Plantar Fasciitis.  The most common symptom associated with this injury is heel pain, especially in the morning with the first few steps out of bed.  The plantar fascia is a fibrous connective tissue that spans the entire bottom of the foot, originating on the inside of the heel bone and inserting just behind the ball of the foot.  The tissues weakest attachment site is the origin on the heel bone.  With repeated stress throughout the day, the plantar fascia develops small micro tears at the attachment site, leading to pain and inflammation.  With the use of a custom made orthotic, undue stresses are relieved which prevents further irritation of the tissue and promotes healing.  Of important note with regards to plantar fascia: supportive footwear in the house, especially right out of bed in the morning, is crucial to a quick recovery.  

Metatarsalgia is a general term relating to pain at the ball of the foot.  There are a number of specific disorders that fall under this category, with a variety of treatment options available.  Metatarsalgia is most commonly associated with a dropped transverse/metatarsal arch.  This is the arch that runs across the front of the foot from the big toe to the little toe.  When this arch drops, the ball of the foot, specifically the 2nd, 3rd and 4th metatarsal heads, bear the majority of the pressure.  As these bones are not designed to bear excessive pressure, pain and inflammation may arise.  Another common symptom associated with a dropped transverse/metatarsal arch is numbing and tingling felt in the ball of the foot as well as the toes.  There are nerves in the foot that run in-between the metatarsal bones, when the transverse/metatarsal arch is dropped, the space that these nerves lie within is decreased; friction on the nerves from the now closely spaced metatarsals can lead to numbing and tingling.  Decreasing friction on the nerves, and increasing the space in which the nerves lie will reduce, if not eliminate numbness and tingling experienced within the ball of the foot and the toes.  Each treatment is dependent on the specific condition.   

Bunions can be caused by a number of factors, improper fitting footwear, poor biomechanics, muscle imbalances, anatomical predisposition, as well as genetic and hereditary factors.  Bunions generally result when patients experience a condition called Hallux Valgus, movement of the big toe towards the second toe.  As this occurs the first metatarsal head becomes enlarged and painful, and the development of bunion occurs.  Arthritis can accompany this deformity, in which case walking becomes painful (specifically at toe-off), as the range of motion that was once available in the joint is now limited.  Pedorthic intervention is often required to aid in the reduction of pain.

By Krystal Lavechia B.A. Kin., C. Ped. (C)

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