Sunday, December 1, 2013

Foot Arch Pain - Why Does it Hurt and What Can I Do About it?


What Is The Foot Arch?

The foot arch is located between the heel bone and the ball of the foot. It is formed by the bones, ligaments, muscles, fascia, and tendons of the foot. Its purpose is to support the weight of the body and to help propel the body forward while walking. To do this, the foot requires both a high degree of stability and a great deal of flexibility, which is provided by the arch.

There are three arches that help form the overall foot arch.

1. The medial longitudinal foot arch runs along the inside of the foot from the front to the back and is the one most people think of when they think of their arches. Part of its job is to absorb most of the shock that occurs upon impact and support the structure of the foot.

2. The lateral longitudinal foot arch runs in the same way as the medial longitudinal arch, but it is located on the outer edge of the foot. For most of us it is fairly horizontal and contacts the floor along its entire length when standing. It can be seen best in people with high arches.

3. The transverse foot arch, also called the metatarsal arch, unlike the first two, runs from the outside to inside (lateral to medial) across the mid/front part of the foot and also helps provide support and flexibility.

General Foot Arch Classifications

There are three general classes of foot arch, primarily based on observation of the medial longitudinal arch (the main arch at the inside of your foot).

1. Normal arch

2. High arch (associated with supination)

3. Low arch (flat feet, associated with overpronation)

Low arches, or flat feet, known as pes planus, usually occurs when the arch disappears upon standing or taking a step. In a smaller percentage of people it remains low whether they are standing on it or not. People with low arches or flat feet are often overpronators. With too much pronation, the ankle turns inward and the arch collapses upon standing. It can give a knock-kneed appearance.

In individuals with a high arch, known as pes cavus, you can see a big gap between their foot and the ground at the inside (medial longitudional) arch, and sometimes even on the outside (little toe side) as well. This condition often leads to the ankles rolling slightly outward and giving them the appearance of being bow-legged. Both of these conditions change the mechanical approach to walking and can cause painful arch symptom.

How Can I Tell What Type of Foot Arch I Have?

To estimate what type of arch you may have, look at your feet in a standing position. If you have a clear space between the ground and your foot arch, even on the outside (little toe side) you may have a high arch. If you have absolutely no defined medial (inside) foot arch, you are most like flat-footed.

You can test this by stepping on a dry surface with a wet foot. If your footprint shows only a thin strip along the outside of your foot connecting your heel and ball-of-the-foot area, you have a high arch. If the connecting strip is approximately half the width of the foot you most likely have a normal or medium arch. If most or all of the sole of the foot touches the floor between the heel and the ball-of-the-foot area, you have a low foot arch or flat foot.

What Problems are Associated With Foot Arch Position?

The foot is the primary part of our body that absorbs the force when we hit the ground. So the arch has a lot of work to do and can become injured fairly easily. Direct force can cause injury, or when the ligaments or the muscles of the foot are overstretched. Overuse can also result in a significant amount of irritation and pain. Poor biomechanical alignment can cause pain not only to the arch of the foot, but to other parts of the foot, ankles, knees, hips, and lower back. Arthritis of the joints in the area may also occur if your arch is improperly aligned.

Injury leading to inflammation of the plantar fascia is a common source of pain as well. The plantar fascia is a thick band of fibrous tissue that extends from the heel to the toes and acts as a support platform, making up one of the main components of the foot arch. Excessive pronation or supination generally caused by having flat feet or a high arch, can cause micro-tears and tension where the plantar fascia attaches to the heel. When this happens, the point of insertion into the heel becomes inflamed and plantar fasciitis pain occurs.

Foot Arch Pain: How Is It Treated?

If you are having pain, a visit to your doctor may determine the best course of action. Often for foot arch problems, foot orthotics or arch supports will be prescribed. Foot orthotics work to distribute your weight more evenly when you are walking and to adjust poor biomechanical alignment that is contributing to your pain. For a flat foot, your arch supports will have longitudinal arch support, and may have angles built in to tilt your foot in a better position. For a high foot arch, your orthotic insoles will cushion the heel and help absorb some of the shock.

Other treatments include stretching exercises, heel cups or heel cradles, plantar fasciitis night splints, and proper fitting footwear.

If you know you have a high or low foot arch but have no pain, you may never develop a problem...or you may develop problems over time. Make sure you don't ignore even slight foot arch symptoms. Over the counter arch supports (off the shelf arch supports) may bring the symptoms under control before they become a bigger problem, or they may be able to help prevent foot arch problems before they occur in the first place.

If you are getting over the counter arch supports for foot arch pain, make sure they are designed with enough stability to actually support the arch. Many products on the market today add a bit of cushion, but very little support.

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