Foot Health Blog
Find expert articles from physical therapists and podiatrists to help understand, diagnose, and treat different foot health issues such as plantar fasciitis, bunions, flat feet, and more.
Foot painBaxter’s Nerve Entrapment: Symptoms, Causes and TreatmentAs the name implies, Baxter’s nerve entrapment is the entrapment of the Baxter’s nerve, otherwise known as the inferior calcaneal nerve. This nerve runs from the inside of the heel through the foot arch to the outer heel. Generally, entrapment happens when there is a limitation in the movement of the ankle joint, flat feet, and pressure from a heel spur or plantar fasciitis.
When the nerve is entrapped, it causes symptoms similar to that of plantar fasciitis, which is why the two are often mistaken for each other. However, studies suggest that Baxter’s nerve entrapment may be responsible for as much as 20% of medial heel pain.
This article looks at the symptoms and causes of Baxter's nerve entrapment, how to distinguish it from plantar fasciitis, and some common treatment options.
Symptoms of Baxter’s Nerve Entrapment
Baxter’s nerve entrapment is often misdiagnosed because its symptoms are similar to plantar fasciitis symptoms. Apart from starting gradually without trauma or injury, both cause pain in the inner heel and affect all genders and ages.
However, Baxter’s nerve entrapment pain is more common on the heel and the medial aspect of the foot that is usually worse after a period of rest. When left untreated, it can result in numbness at the lateral part of the heel.
Causes of Baxter’s Nerve Entrapment
Baxter’s nerve entrapment is due to either compression, impingement, or entrapment of the inferior calcaneal nerve as it travels between the quadratus plantae and the abductor hallucis. Its possible causes include the following:
Poor gait mechanics, like overpronationCompression from poorly fitting footwearHeel pad atrophy due to untreated heel spursRepetitive strain to the nerve during trauma
Apart from these causes, several factors predispose individuals to Baxter’s nerve entrapment, including:
ObesityPlantar fasciitisHeel spursFlat feetEnlargement of lower limb muscles
How to Distinguish Baxter’s Nerve Entrapment From Plantar Fasciitis
As noted earlier, in Baxter’s nerve entrapment, doctors often make the mistake of diagnosing plantar fasciitis instead of Baxter’s nerve entrapment. To differentiate them, watch out for the location and type of pain experienced.
Pain due to plantar fasciitis is sharp and aching under the heel, while Baxter’s nerve entrapment causes sharp, burning pain and numbness at the inner heel. Baxter's nerve entrapment also causes tenderness on the inner heel and heightened pain after periods of rest.
Can You Treat Baxter’s Nerve Entrapment?
Thankfully, Baxter’s nerve entrapment can be treated if the diagnosis is made early enough. The primary goal of treatment at the initial stage is to remove any compression, which should naturally resolve any pain. At home, the first line of treatment you should follow when managing Baxter’s nerve entrapment includes the use of non-steroidal anti-inflammatory drugs (NSAIDs), rest, ice, and activity modification.
Other treatments include:
Proper Footwear
Using proper footwear can reduce the pressure on the heel and relieve the symptoms.
Stretching and Strengthening Exercises
Stretching and strengthening programs can place the foot in a better position to adapt to the demands placed on it by the activities.
Orthotics
Orthotics are ideal for managing the symptoms of Baxter's nerve entrapment and relieving any pressure causing nerve compression. When appropriate orthotics are used, they can also help improve foot mechanics. Understand that the wrong orthotic inserts can worsen the condition. For example, using orthotics meant for plantar fasciitis can increase the pressure on the heel and the compression of the inferior calcaneal nerve.
Consequently, custom orthotics designed by professionals are best for handling Baxter’s nerve entrapment. Upstep provides the relevant kind of orthotics to relieve pain and any other symptoms as our team of podiatrists consider the exact conditions of your unique feet. As such, the orthotics are custom-designed based on the foot impressions you send us.
Use of Cortisone injections
When the symptoms defy these conservative approaches, you can try more aggressive methods like the use of cortisone injections. This is done with ultrasound monitoring to ensure the steroid is delivered to the exact location but can have the unintended effect of weakening the bone and fascia. Hence, it is only used in certain circumstances when the potential gain far outweighs the side effects.
Surgery
As always, surgery is used as a last resort. Surgical intervention could be to remove any bony spurs causing compression or to surgically release the compressed nerve.
Understanding the Cause of Your Pain
Proper diagnosis remains the main thing when it comes to managing foot pain. As such, you must ensure you accurately determine the cause of the pain before choosing an intervention.
Once you’ve determined the cause, you can go ahead to select a treatment modality or consult a podiatrist to find the best treatment method for you. Just be sure to monitor the process to see if the treatment is working, as you may need to incorporate a few of the listed treatment methods.
Achilles tendonitisAchilles Tendonitis: Symptoms, Causes, Treatments, and MoreThe Achilles tendon is the band of tissue that connects the calf muscles in the lower limb to your heel bone. When this tissue becomes inflamed, the result is Achilles tendonitis, an overuse injury associated with pain above the heel that is common with athletes.
This article looks at the symptoms and causes of Achilles tendonitis, different treatment options, and what you can do to reduce the risk of developing it.
Symptoms of Achilles Tendonitis
Achilles tendonitis usually causes pain at the back of the leg but can also present with pain above the heel during activities like running. It becomes more severe with high-impact activities like exercising, climbing, and sprinting. This pain is usually worse in the morning and after rest from activity.
Other symptoms include:
Difficulty walkingAnkle stiffnessTightness in the tendonSwellingHeat around the tendon
Causes of Achilles Tendonitis
While the primary cause of Achilles tendonitis is overuse, several risk factors can predispose you to the injury. Some of the most are:
Gender
Achilles tendonitis is more common in men than women.
Age
Degenerative changes occur to the Achilles tendon with age, making older people more likely to develop Achilles tendonitis.
Anatomical problem
A flat arch and tight calf muscles can predispose you to Achilles tendonitis, as well as obesity.
Footwear
Running with worn-out shoes or shoes that provide little support can increase the chances of developing Achilles tendonitis.
Exercise surface
Uneven surfaces can cause inflammation and lead to pain, tenderness, and swelling of the Achilles tendon.
Medical conditions
Conditions like psoriasis or high blood pressure put you at a greater risk of developing Achilles tendonitis.
Medications
Quinolones and Fluoroquinolones (antibiotic medications) have been associated with incidences of Achilles tendon ruptures in the past.
Treatment of Achilles Tendonitis
Treatment must be administered to the ankle as soon as possible once Achilles tendonitis is observed. The treatment aims to reduce the tension on the tendon, which is usually done in the following ways:
The RICE Method (Rest, Ice, Compression, Elevation)
An initial period of rest is necessary for healing to take place. Where this is not possible, limit activity so that only the minimum load possible is transmitted through the leg. Applying ice will help deal with inflammation in the acute phase. With compression stockings, you can increase blood flow to the area and speed up tendon healing. Lastly, elevation also encourages decreased inflammation.
Pain Medication
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can be used to decrease pain and inflammation. Unlike posterior tibial tendonitis (PTTD), corticosteroid injections are not recommended for Achilles tendonitis as they can cause the tendon to rupture.
Exercises
Strengthening and stretching exercises for the Achilles tendon are useful exercises to treat Achilles tendonitis. The stronger the muscles are, the less work the tendon will have to do. The less the load it bears, the lesser the pain that may result.
Some basic stretches are the Achilles tendon stretch, calf stretch, and plantar fascia stretch. The strengthening exercises will mostly be eccentric exercises of the Achilles tendon, gastrocnemius, and soleus muscles, thereby reducing any further risk of calf strain or worsening tendonitis.
Orthotics
Orthotics can help redistribute the pressure in the foot and consequently the amount of tension in the Achilles tendon. Likewise, heel lifts can be used temporarily to take some load off the Achilles tendon. Where it is used for a prolonged period, it can cause a shortening of the tendon.
Surgery
Surgery is considered a last resort when the non-invasive methods have been tried without commensurate results. However, where it is a total rupture, surgical repair is necessary within a few days of the injury.
How to Reduce the Risk of Achilles Tendonitis
While total prevention may be impossible, you can limit the risk of Achilles tendonitis by:
Using appropriate footwear
Footwear that is properly fitted, cushioned, and provides adequate support.
Warm up properly before exercise
Do not increase the duration or intensity of your exercise without a proper warm-up. Once done, avoid stopping the exercise abruptly too.
Maintain a healthy body weight
Excess weight increases the load on the Achilles tendon.
Be aware of acute symptoms
If you notice any sudden pain around your heel, rest from exercise, and seek the expert opinion of a podiatrist as soon as possible.
Achilles Tendonitis Management
It takes time to recover from any injury to the Achilles tendon. The actual length of recovery is dependent on the severity of the injury and the promptness/compliance with treatment. Where intervention is prompt and strictly adhered to, return to pre-tendonitis state is possible within 12-16 weeks.
MetatarsalgiaMetatarsalgia: Causes for Swelling and 10 Ways to Reduce ItMetatarsalgia is a condition in which pain occurs in the sole or ball of the foot. Usually, this pain is aching by nature, worsened by activity, and occurs with other symptoms like swelling and bruising at the metatarsals. Metatarsalgia can lead to joint stiffness, limited range of motion (ROM), and pain in the lower back and hip due to altered body mechanics.
Causes of Metatarsalgia
Generally, metatarsalgia is due to repetitive loading of the foot and is caused by:
Intense training
During running, jumping, and climbing activities, the front of the foot absorbs more force than usual. Without proper shoes to absorb some of this force, pain can result at the head of the metatarsals.
High arch
A high foot arch places extra pressure on the foot around the metatarsals. This is especially true around the second metatarsal head. This redistribution of weight can lead to metatarsalgia.
Poorly fitting shoes
High-heeled shoes and shoes with a narrow toe box can contribute to the development of metatarsalgia.
Foot deformities
Hammertoes, claw toes, bunions, or any bumps in the foot due to foot deformities can lead to metatarsalgia.
Stress fracture
Repetitive loading can cause small breaks in the metatarsals due to advancing age. These fractures can make the toe bone more painful.
Obesity
The more you weigh, the more pressure on the ball of the foot.
11 Methods for Treating Metatarsalgia Swelling
Thankfully, the symptoms of metatarsalgia, including swelling, can be managed using any of the following methods;
6 Home Management Techniques
Rest
Between periods of intense activity like running or standing for long, keep the feet rested.
Elevation
When you’re not standing, ensure the foot is kept elevated above the heart.
Ice
You can apply ice to the ball of your foot for up to 20 minutes. By stimulating vasoconstriction, ice can help reduce inflammation and blood flow, resulting in less swelling.
Weight reduction
You can reduce pressure on the ball of your feet by performing a weight loss program.
Non-steroidal anti-inflammatory medications (NSAIDs)
NSAIDs help address the pain and swelling that results from metatarsalgia and also give room for other treatment methods.
Activity modification
There may be a need to change the activities you engage in daily. Where this is impossible, you may consider reducing the intensity and duration of the activities.
5 Other Non-conservative Management Techniques
Physical therapy
Working with a physical therapist may reduce swelling due to metatarsalgia. The physiotherapist will encourage normal foot biomechanics through gait retraining. Consequently, this will relieve the pressure on the ball of the foot and the resultant symptoms.
Proper footwear
Invest in high-quality footwear that has spacious toe room, is well cushioned, and provides adequate support for the arch, heel, and ball of the foot. Shoes with a stiff sole and a rocker bottom contour can reduce the pressure on the forefoot.
Splinting
You can ease the pressure temporarily on a joint by splinting the affected joint, which means strapping a piece of rigid material to the area to prevent movement.
Custom orthotics: Orthotic inserts provide extra cushion and padding for the feet while absorbing pressure. This reduces the impact on the muscles, ligaments, and bones. Orthotics can be arch supports, metatarsal pads, or hammertoe crest pads.
i. Metatarsal pads: If your shoes are already good, metatarsal pads can provide additional comfort. They cushion the metatarsal bones and will help bear the redirect some of the pressure off the affected metatarsal.
ii. Taping/hammertoe crest pads: You can use taping to bring the toe back into its normal position. Similarly, you can use a hammertoe crest pad when there is a claw toe deformity that needs pushing back into position.
iii. Arch supports: These reduce stress on the metatarsal heads and encourage roper biomechanics when walking.
Corticosteroid injections
Corticosteroids can temporarily improve the quality of life when injected into the affected joint. The relief can continue for up to 3 months in some cases.
Surgical Approach
When non-conservative treatment fails, surgery becomes an option. Since the goal of surgery is to remove the primary cause, the surgical approach will depend on the cause of the condition, its severity, and any complications it may have caused.
Factors That Increase the Risk of Metatarsalgia
Anyone can develop metatarsalgia, and the following factors can increase your chances:
High-impact activitiesObesityFoot conditionsInflammatory arthritis (rheumatoid arthritis or gout)Wearing high-heeled shoes
Can Metatarsalgia Be Cured?
Metatarsalgia can be easily managed. With management, one can expect a full recovery, especially when intervention is prompt and early. One factor that cannot be overstressed is the need for correctly fitted shoes. Whether for sports or daily activities, ensure you wear proper shoes with shock-absorbing insoles or arch supports, as these can prevent or minimize future episodes of metatarsalgia.
Foot painNatural Treatments for General Foot Pain: CBD and OrthoticsOver the last few years, CBD has grown in popularity as a treatment option for several conditions ranging from anxiety to pain. Evidence from research suggests that CBD helps treat arthritic pain, control pain transmission, and manage chronic pain conditions. Specifically, there are suggestions that CBD is useful in treating foot pain.
Common Causes and Symptoms of Foot Pain
Pain, in any form, isn’t a good thing. It’s even worse when it occurs in the foot as it can keep you grounded and unable to move around freely. This, in turn, reduces your quality of life.
Unfortunately, foot pain is a common cause of clinic visits especially among seniors and sports-oriented individuals. With 25% of the body’s bones and several other important structures in the feet, there are just too many structures that can be injured.
The skin, nerves, bones, blood vessels, and soft tissues of the foot can all be affected and cause foot pain. You must evaluate the foot and the surrounding ankle, leg, knee, and hip when trying to identify the cause of foot pain.
Some of the more common locations, causes, and types of foot pain are listed below:
Bottom of the Foot
Plantar fasciitis
Inflammation of the plantar fascia which causes dull and stabbing pain.
Heel spurs
A bony-like growth under the heel bone that results in sharp pain.
Heel fracture
A common injury that causes a crack in your heel bone and results in sharp and severe pain.
Arch of the Foot
Posterior tibial tendonitis
Inflammation of the posterior tibial tendon due to overuse injury. It presents with localized pain that worsens with activity.
Tarsal tunnel syndrome
Sharp, shooting pain in the ankle that results because of tibial nerve compression.
Achilles tendon injuries
This is an injury to the Achilles tendon that causes discomfort, ranging from a slight ache and stiffness to severe pain.
Ball of the Foot
Metatarsalgia
Characterized by sharp, aching, or burning pain in the ball of the foot.
Morton’s neuroma
A painful condition caused by thickening of nerve tissue at the ball of the foot, especially at the third or fourth toes. Pain is typically burning in nature.
Toes
Psoriatic arthritis
This kind of arthritis affects people who have psoriasis and causes dull, aching pain.
Gout
It is a form of inflammatory arthritis that affects mainly big toes. Pain starts as a dull ache but worsens considerably over time.
Turf toes
Turf toes are an injury in the big toe joint when ligaments, tendons, and soft tissues stretch or tear. Causes pain and tenderness as you bend your big toe upwards
Apart from these categories, some pains can occur anywhere and everywhere, such as those caused by tendonitis, osteoarthritis, neuropathy, rheumatoid arthritis, etc.
The cause of foot pain must be identified because treatment often depends on the cause, severity, time of intervention, and possible presence of further complications.
Treating Foot Pain Naturally
There are several approaches to the management of foot pain. From rest to NSAIDs to acupuncture, the approaches are as diverse as the causes. However, when it comes to treating chronic foot pain, there’s no single approach that will produce the required result.
Thus, complete pain relief is only achievable when you combine different methods. Natural treatment methods rank among the top approaches for alleviating foot pain. The two most popular ones, CBD and orthotics, are discussed below:
Cannabidiol (CBD)
CBD is the short form of Cannabidiol, a non-psychoactive cannabinoid found in the Cannabis plant. Research has shown that CBD is effective in bringing pain relief by controlling pain transmission and managing chronic pain conditions.
CBD achieves pain relief by interacting with and modulating the endocannabinoid, inflammatory, and nociceptive (pain reception) systems. It also has anti-bacterial properties which make it a deal in cases where foot pain is due to blisters.
CBD oil can also reduce pain through its anti-inflammatory properties and without the side effects associated with non-steroidal anti-inflammatory drugs.
Custom Orthotics
Custom orthotics are inserts specifically designed to address an individual’s need which depends on the individual’s foot condition. Unlike over-the-counter (OTC) orthotics, custom orthotics are designed using the specifications of a particular foot. Consequently, they fit comfortably into the footwear while providing the support needed to reduce pain and injury. This makes custom orthotics the ideal treatment for foot conditions that cause pain.
Custom orthotics address pain by targeting the cause of the foot pain directly. To get one, you can simply make an order online with Upstep. Our orthotics are designed by the best podiatrists from across the world by utilizing your personal foot impressions. The design factors in the shape of your feet, age, lifestyle, and type of preferred physical activity.
Alternative Foot Pain Relief Methods
Foot pain is a common condition that needs to be addressed early. When it comes to the management of foot pain, orthotics and CBD are both good options. The primary difference is that while orthotics address and correct the cause, CBD’s focus relieves the symptoms without dealing with the cause. Again, while CBD’s anti-inflammatory and analgesic properties make it fantastic for short-term symptom relief, orthotics are often used over a longer period to correct the underlying condition.
Beyond these, alternative methods for relieving foot pain include the use of rest, contrast baths, Epsom salt, ice, massage, exercises (stretching and strengthening), and activity modification. Surgery is also indicated many times when conservative management has failed. In the end, it is the cause that determines the approach of treatment to embrace.
Posterior tibial tendonitis4 Stages of Posterior Tibial Tendon Dysfunction and Their DiagnosesPosterior Tibial Tendon Dysfunction (PTTD) is a common cause of flat foot deformity in adults. It occurs due to damage to the posterior tibial tendon. The posterior tibial tendon connects the calf muscles to bones on the inside of your foot and is responsible for supporting the arches. When it is affected, the arch collapses, causing pain in the ankle and foot.
Along with the pain, PTTD is also associated with foot and ankle swelling, warmth, redness and pain that worsens during activity, an inward rolling of the ankle, and turning out of the toes and foot. PTTD is progressive in nature, meaning that the symptoms get worse as the condition progresses.
There are four distinct stages with varying levels of symptoms.
Stage 1
Stage 1 is often missed because it comes with little or no symptoms, even though the tibial tendon is injured. A radiological examination will also show nothing. However, it is sensitive to the single-toe raise test.
To perform the test. You’ll begin in a standing position and lift the unaffected foot off the ground. Afterward, attempt to lift onto the toes of the affected foot, which you will be unable to do if you suffer from PTTD. There can also be associated tenosynovitis (inflammation of the tissue surrounding a tendon).
Stage 2
At Stage 2 PTTD, there is a torn tendon that affects regular functioning. Stage 2 can be further divided into Stage 2A and 2B.
In stage 2A, there is a flat foot deformity, a flexible hindfoot but an otherwise normal forefoot. A radiological investigation will reveal an arch collapse deformity. Also during physical examination, the single-leg heel raise test will be negative but there will be mild sinus tarsi (center ankle) pain.
In stage 2B, there is an associated abduction of the forefoot but otherwise remains the same as stage 2A.
Stage 3
This stage is characterized by significant deformation of the entire foot as well as degenerative changes to the connective tissue in the hindfoot. Physical examination at this stage will reveal severe sinus tarsi pain while a radiological exam will reveal subtalar arthritis and arch collapse deformity.
Stage 4
By stage 4, the deltoid ligament is compromised and there are degenerative changes at the ankle joint. Consequently, the flatfoot deformity is worse, usually a rigid forefoot abduction and a rigid hindfoot valgus. A physical examination will reveal ankle pain and severe sinus tarsi pain. As for radiography, it will show an arch collapse deformity, subtalar arthritis, and talar tilt on the mortise view.
When Is Surgery Necessary for PTTD?
In treating flatfoot deformity, conservative means are usually the first line of intervention. Rest, use of custom orthotics, immobilization, ice, medication, and exercises can all help to relieve pain, strengthen tendons, and aid healing. However, if the pain persists even after six months of treatment or there is no improvement, surgery may be necessary.
The surgical approach will depend on the severity of the condition and the level of deformity in the foot. Debridement, reconstruction, and fusion are three common approaches to the surgical management of PTTD when it is deemed necessary.
KneeKnee Pain When Squatting: Causes and How to Fix ItStep after step, the leg carries the body from place to place. To perform this function, the hip, knee, and ankle joints work together to transmit the weight from the back and pelvis to the floor. The knee is the largest and most complex joint in the lower limb and plays a huge role in this arrangement.
Whenever the knee is affected by discomfort or pain, it immediately impacts the body's natural movement. This can be caused by different conditions and can occur in several positions of the knee.
This article looks at the different causes of sore knees after squatting as well as some home remedies and what you can do to prevent it from occurring.
Identifying the Position and Causes of the Knee Pain When Squatting
As earlier stated, pain, pressure, or discomfort in the knees when squatting can occur in different parts of the knee and for different reasons, such as the following:
Inner knee pain
This can result from an injury sustained while exercising or performing sports, such as a meniscal tear while running, by trauma to the knee, or from a medical condition like knee osteoarthritis.
Posterior knee pain
Pain behind the knee can be caused by Baker's cyst, arthritis, infection, injury, tumor, or deep vein thrombosis.
Pain at the top of the knee
This may be caused due to repetitive strain, overuse, quadriceps or hamstring tendonitis, patellar tendonitis, arthritis, and knee bursitis.
General knee pain may also occur due to compensatory mechanisms caused by weak hips or limited ankle mobility, poor or improperly fitted shoes, and incorrect techniques when exercising.
Home Remedies for Knee Pain Caused by Squatting
Proper Exercise Form
Using proper form and posture when squatting will help you to minimize knee pain. To perform a proper squat, follow the steps below:
Stand shoulder-width apart with your knees in line with your heels.Take a deep breath.Bend your knees, going down as far as you can without allowing your bottom to drop below your knees.Return to your standing position by pushing from your heels instead of the balls of your feet.
In addition, reducing the range of motion during squatting can take some pressure off your knees and eliminate any possible pain. Research suggests that a mean hip range-of-motion (ROM) of 95.4 ±26.6° of flexion is needed to reach a maximal squat.
Low-Impact Exercises
Since knee pain while squatting can be due to loss of balance when carrying heavy weights, avoiding weights can help avoid pain. In their place, you can use resistance bands for strength training. Also, in place of squatting, consider low-impact aerobic exercises that do not have as much impact on the knee as squatting, such as swimming.
The RICE Method
Another home remedy for knee pain is the R.I.C.E method. You can relieve pain and combat inflammation with RICE—Rest, Ice, Compression, and Elevation:
Rest
Limit activities involving the knee to the barest minimum.
Ice
Applying an ice pack to the knee regularly can help minimize swelling and inflammation.
Compression
Wrapping the knee with an elastic bandage can also decrease swelling.
Elevation
Also ensure you keep the knee elevated at or above the level of your heart to decrease blood flow to the area and help prevent swelling.
Medically Assisted Treatment of Knee Pain
If the condition does not improve with home management, you can consider physical therapy. Upon examination of the knee, the physical therapist will design a holistic program to reduce inflammation, relieve pain, improve flexibility and mobility of the knee joints, and strengthen the muscles around the knee joints to prevent future episodes of pain.
Custom orthotics are also helpful in managing knee pain due to squatting. For example, when you use Upstep orthotics, beyond relieving pain, they aid proper alignment of the knee in the kinetic chain to provide support and restore balance and stability.
Surgical intervention can also be considered as a last resort when all conservative approaches have been exhausted with no improvement in the condition. Arthroscopy and knee replacement are two of the most common surgical interventions for knee pain.
Prevention and Rehabilitation of Knee Pain
It is best to never have had pain in the knee, which is why you should always take the necessary steps to achieve this, such as wearing proper footwear and ensuring you follow the correct form when exercising. However, once knee pain occurs, the goal of treatment is to relieve pain and avoid surgery since recovery from knee surgery usually takes a much longer time.
Orthotics for knee pain provided by Upstep can be of great assistance as a way to both prevent and rehabilitate future knee pain.
HeelWhy Do Your Heels Hurt?Heels Aching?
They seem so innocent, sitting there at the back of our feet. But our heels take on a lot of stress as we stand, walk or run. And that also means they're prone to pain and injury.
Do Your Heels Hurt?
Are you getting sharp pain when you try to stand or walk? Does it go away when you start moving but come back after you've been resting again?
This means you may have plantar fasciitis - a fancy Latin word for an inflammation of the fibers running from your heel to your toes. It's one of the most common causes of heel pain, and like millions of other Americans, you can have it for months before you start feeling pain.
Why Does it Happen?
Your plantar fascia - those fibers we mentioned earlier - absorbs shock while you walk. If it's not getting enough support from proper shoes, or if you don't allow your feet to rest, small tears start forming. The more stress you apply, the more likely those tears are to inflame and become painful.
What Can You Do?
Making sure your feet are supported is the first - and the most important - way to heal your heel. Support takes the pressure and stress off your plantar fascia. Your heels rest, but you can still stand, walk and move around. Orthotics, especially custom ones, are ideal for this as they fit the exact shape of your feet and spread the load much better.
There are also exercises you can do to stretch and strengthen muscles and ligaments around your heel. When they're stronger, they can take some of the load off your plantar fascia and prevent further damage.
Whichever way you choose to go, know that dealing with plantar fasciitis takes patience. Full recovery can take 3-12 months, depending on the severity and what you do to minimize further damage.
Ready to Step up and Take Action?
Give your heels the support they need with a fully customized solution that's twice more effective than other custom orthotics.
TreatmentsTreatments for Plantar Plate TearsThe plantar plate is the fibrocartilaginous ligament in the ball of your foot that supports the toe joints and keeps them in place. When there is repetitive overloading of the head of the metatarsal, a plantar plate injury can occur.
What Is a Plantar Plate Tear?
A plantar plate tear is a common injury that affects the forefoot. It refers to the tear of the plantar plate ligament and is most common at the second toe. Sometimes, it may be confused with a plantar fascia tear which is direct damage to the small fibers of the plantar fascia. However, the two affect different structures though they may cause similar symptoms.
The repeated trauma causes the connective tissue running across the toes to stretch or tear. These plate tears can cause pain and swelling in the ball of the foot, dislocation, and even toe deformity, making walking difficult.
In this article, we'll discuss various causes and risk factors of plantar plate tears, their symptoms, treatment, and duration of recovery, depending on the treatment.
Symptoms of a Plantar Plate Tear
A plantar plate tear is a common cause of forefoot pain in athletes, yet, it's often misdiagnosed. To receive prompt treatment, it's essential to recognize the symptoms. Aside from causing forefoot pain, it may also cause a burning, tingling, or numb sensation between the toes and on the ball of the foot after standing for a long time. Shortly after the tear, there may also be swelling and redness at the top of the foot.
Causes and Risk Factors of Plantar Plate Tears
Any action that places the ball of the foot under considerable strain repeatedly can cause a plantar plate tear. Some of these factors include:
Ill-fitting shoes or high-heel shoes.Having a long second metatarsal bonePresence of a bunion or a hammertoeBarefoot walkingHigh-impact activities like dancing, running, and jumping.Gait abnormality (e.g. rolling feet inwards while walking)Repeated bending of the toesCortisone injection
What Happens if a Plantar Plate Tear Goes Untreated?
Plantar plate tears can be a significant source of foot pain. Unfortunately, it's unlikely to recover without intervention because it occurs in degenerate tissue. Correct diagnosis and treatment are essential to managing forefoot pain.
While conservative treatment will cause full recovery in patients with mild tears, a surgical procedure may be necessary for more advanced tears. Without treatment, plantar plate tears could cause significant pain and deformity of the foot. It could also cause midfoot pain, hammertoes, crossover toe deformity, arthritis, and other debilitating foot conditions.
Home Treatments for Plantar Plate Tears
When a plantar plate tear occurs, treatment is necessary to guarantee a good prognosis. In the acute phase, conservative treatment is very effective.
The home treatments include rest, ice, taping, splinting, orthotics, and padding. Generally, the goal of intervention at this point is to relieve pain, promote healing, and remove any activity or force that can lead to deformation. Approaches can include:
Medication
Non-steroidal anti-inflammatory drugs (NSAIDs) can help in managing pain. However, these are not as effective in the acute phase of plantar plate tears.
Toe Splints or Pads
A toe splint keeps the toe in its proper position while healing occurs after partial tears. You can splint the toe in a basket weave fashion. While toe splints maintain the alignment of the toes and prevent deformity, toe pads reduce physical irritation and pressure on the ball of the toes, easing pain and discomfort.
Toe Taping
Taping is the initial treatment for plantar plate tears. The aim is to keep the toe in a plantarflexed position while limiting dorsiflexion during walking. To do this, tape the affected toe downwards in a basket weave fashion.
Shoe Modification
Ideally, you should be deliberate about the type of shoe you wear as it can impact the healing process. The best shoes for plantar plate tears should have a strong metatarsal pad, a deep toe box, a cushioned sole, and a supportive arch. These components will help to immobilize the plantar plate and relieve any pressure and pain from plantar plate tears.
Custom Orthotics
A metatarsal dome or bar can be designed to support the front of the foot and assist in preventing deformity. More specifically, custom orthotics redistribute body weight, redirecting the weight away from the ball of the foot to the foot arch. As such, they keep the pressure off the injury when walking, allowing healing to occur.
» Still deciding if custom orthotics are right for you? Check out our review of Custom Orthotics for Plantar Fasciitis and order a pair today.
Immobilize in a Moon Boot
A moon boot, otherwise known as a Controlled Ankle Motion (CAM) boot is an orthopedic boot for treating and stabilizing sprains, fractures, and tears in the ankle or foot. It can be used to immobilize the feet after a plantar plate tear to allow healing. Unlike casts, Moon Boots can be adjusted, reused, and even removed. In some cases, it may be used for as long as 6-8 weeks.
Running with a Plantar Plate Tear
Running overloads the plantar plate. As such, it may worsen a plantar plate tear, leading to permanent damage and making it more painful. However, it may be impossible to stay away from running completely as an athlete. In that case, orthotics may be used to cushion the effect and redistribute the body weight to the foot arch.
Also, exercises like lunges, calf raise, and box jumps must be avoided as they can worsen a plantar plate tear.
Exercises for Treating Plantar Plate Tears
While there are dangerous exercises for plantar plate tears, there are also exercises that may be performed for treating the tears. These exercises will aid in the healing of the plantar plate and promote faster recovery from foot injuries.
However, exercises can only commence after the initial pain has resolved. The goal of the exercises is to strengthen the intrinsic muscles of the foot. Some of the exercises that are effective for plantar plate tears are:
Toe Push-Ups
This exercise will strengthen the intrinsic foot muscles. To carry it out:
While in a standing position, place your feet flat on the floor.Slowly glide up your greater toes, increasing your medial foot arch in the process.Repeat as much as 200-300 times daily.
Lesser Toes Flexion Exercise
Like the toe push-up, the lesser toe flexion exercises strengthen the intrinsic foot muscles too.
Place a resistance band around your lesser toes keeping your hand firmly at 90 degrees.Slowly flex your lesser toes against the resistance band while keeping the force from the band constant.Once lowered, hold and then slowly lift the toes back up.Repeat 10-15 times for the foot. If the foot lowering becomes too easy, increase the resistance by pulling the band tighter.
Balance Exercises Using a Wobble Board
Begin by standing on the wobble board with your feet hip distance apart.Stand upright and maintain a neutral spine, focusing straight ahead.Shift your weight so the board edges can’t touch the floor.Hold that position for 30 seconds.
Calf Raises
Calf raises may be considered if the pain has subsided in the ball of the foot, and you can use the highest resistance band on toe flexion. Perform calf raises for plantar plate tear as follows:
Stand with the balls of your feet on the edge of a stair or step.Push your heels up as far as you can.Slowly lower the heels until your heels are just below the top of the step or stair. Return to the starting position once you feel a stretch in your calf muscles.
What Is the Plantar Plate Tear Recovery Time?
The healing time depends on the severity of the tear and how prompt treatment begins. Generally, you can expect that you should have returned to normal activities after 3 months. However, sometimes it may take up to 6 months for swelling to resolve.
When to Consider Plantar Plate Surgery
Surgery may be considered in both chronic and severe cases of plantar plate tears. For example, a stiff toe or a toe that remains painful and deformed after non-conservative treatment are both indications for surgery. There may also be a need to realign the toe and stabilize the joint.
Depending on the aim, the doctor may employ different surgical techniques to repair the plantar plate tear, correct the toe deformity, and relieve pain. The method depends on the extent of injury to the plantar plate ligament, cause of tear, time from onset of injury, presence of a toe deformity, and general structure of the foot.
Your medical provider will advise you on the best course of action
Plantar Plate Surgery Recovery Time
Following surgery, the patient will not be allowed to bear weight on their foot for a recommended period of 4-6 weeks. The foot must be allowed adequate time to heal.
If you start weight-bearing on your foot too early, it may increase the chances of re-injury. Additionally, changes in your foot structure may require you to get new orthotics to reduce the impact of activities on your foot.
Foot painWhat Causes Middle Foot Pain and How to Get Rid of ItBefore knowing the causes of middle foot pain, let's first understand what is considered to be the midfoot.
The midfoot is a pyramid-like combination of bones (metatarsals), tendons, and ligaments that form the middle part and arch of your foot.
Causes of Middle Foot Pain
Pain in the middle of the right or left foot is less likely due to a direct impact on the center of the foot, but more so due to the structures - more specifically, the bones, joints, muscles, ligaments, and nerves - composing the middle foot extension to the front part of the toes and the back portion of the heel and ankle.
Causes of Pain in the Arches
Foot arch pain can commonly be a result of a few conditions, such as:
Plantar fasciitis
Inflammation of the plantar fascia, the thin band of tissue that runs under your foot and connects the heel bone to the toes.Tendonitis
Inflammation of surrounding tendons.Fallen arches (flat feet)
The entirety of the sole touches the floor.
The reasons for these conditions, and others, are usually the result of any of the following occurrences:
Ligament sprainsImproper footwearStress fractures Staying on your feet for long hours without any rest breakMuscle tightness or weakness
Could Your Weight Be Causing Foot Pain?
Being overweight can certainly cause foot pain as it places more stress on your bones, joints, and muscles, altering their biomechanics. This could be directly related to discomfort and pain in the middle and bottom of the foot.
What Diseases Cause Foot Pain?
Foot pain can either be directly caused by underlying diseases of the foot or a secondary result of diseases of the knee and back. All three of these bodily regions function in one chain and are interrelated in their biomechanics.
Some of the conditions causing foot pain are:
Osteoarthritis of the knees
Wear and tear of the natural cushioning between joints.Plantar fasciitisMetatarsalgia
Painful inflammation in the balls of your feet.Posterior Tibial Tendonitis
Inflammation or damage to the posterior tibial tendon, resulting in pain on the inner side of the foot.Altered knee and foot posture
How Do You Get Rid of Midfoot Pain?
The first step in treating midfoot pain is getting yourself diagnosed by a physiotherapist or podiatrist. They can provide a conservative treatment plan that might involve taking care of your posture, regular exercising, using the correct footwear with a pair of custom-made orthotics.
Some of the prescribed remedies could be:
Icing the area three times a day for 7-10mins using a frozen water bottle and simply rolling under your feet. Wearing a custom-made orthotic.Insoles for added support that makes your footwear fit properly.Taking frequent breaks if you are on your feet for long hours, especially if you suffer from plantar fasciitis.Stretching and strengthening exercises.Balancing rest and activity.Stabilizing the arches with proper footwear or insoles.
How to Stretch the Inside of Your Foot
For some immediate relief from midfoot pain, you can stretch the insides of your feet by carrying out the following steps:
Sit comfortably on a bed with your legs straightPull your foot towards you with a towel wrapped around the first half of your feet. Hold the pull for 30 seconds
Repeat the procedure for 3 sets, 3 times a day.
How to Know if Your Foot Pain Is Serious?
Look for the following signs and symptoms:
Excessive swellingInability to put any pressure on your feetInability to do any movementsExtreme temperature variations in your feet Unbearable painLoss of sensation in the feet
All of the above point towards serious foot conditions that may need immediate treatment. It is suggested that you see a professional like a podiatrist or a physiotherapist sooner than later, as that will decide your prognosis and the speed of recovery.
You need only visit the ER in the event of severe emergencies, such as broken bones, extreme lacerations and bleeding, or other acts of violent trauma to your body. Otherwise, regular painkillers should be able to keep you functioning until you can visit a podiatrist, physiotherapist, or general practitioner.