The human foot is a complex structure that bears both the static weight of the body and the immense generated during walking and running. Each foot comprises horizontal and lateral arches, twenty six bones plus numerous muscles, tendons and ligaments which all play important roles in weight-bearing and impact absorption. Problems can occur when something goes wrong in any of these structure.
Arch Pain Causes
Arch pain has numerous potential causes including; direct force trauma, ligament sprains, muscle strains, poor biomechanical alignment, stress fractures, overuse, arthritis and tight/loose foot joints.
Injury to the plantar fascia (a thick, connective tissue which which runs from the heel to the toes), is a common cause of arch pain. When the plantar fascia is damaged, it can lead to a painful condition known as plantar fasciitis.
Plantar fasciitis, stress fractures and arthritis often result from repetitive ‘micro-trauma’ injuries. These can be the result of impact on hard surfaces, wearing unsupportive footwear, or excessive exercise.
Arch Pain Symptoms
Pain and tenderness associated with plantar fascia strains are usually felt on the bottom of the foot, or in the heel area. With mild plantar fasciitis, pain may ease as the soft tissues of the foot warm up. In more severe cases, pain may increase when pressure is applied, or if the arch is stressed.
Tenderness and joint looseness are often signs of ligament sprain/fracture. Pain experienced when the foot is fully extended, flexed, turned in/out may indicate muscle injury.
The tissue forming the arch does not give much protection. Thus impact on hard surfaces can lead to pain, discolouration and swelling. These symptoms may be signs of a more serious injury.
Expert evaluation of arch pain is necessary to plan effective treatment. Arch pain can be categorised into four levels:
- Pain during activity only
- Pain before and after activity, but not during
- Pain before, during, and after activity which also affects performance
- Pain so severe that performance is impossible.
When to Seek Medical Help
Medical help should be sought when pain (a) interferes with daily life or (b) prevents performance of sporting or leisure activities. Other indicators of the need for medical intervention are if the affected area; looks deformed, becomes excessively tender, or is preventing normal movement.
Arch Pain Treatment
In early stages of discomfort or pain, self-treatment with rest, ice, compression, and elevation (RICE) can be effective. Over-the-counter medications. as advised by a doctor or pharmacist, can also be used.
When the level and cause of arch pain has been accurately assessed, a treatment plan can be started and may include:
- Use of machines and/or manual therapies to minimise pain, increase circulation to and promote healing
- Modification of activity – e.g. replacing high impact activities like running, with cycling and swimming
- Replacing ‘worn out’ footwear – sports shoes should be replaced at least every six months or more often if there is very heavy use.
- Wearing custom orthotics/arch supports
- Improving muscle strengthening and flexibility to increase stability and to correct muscles that may not be balanced.
- Once pain is reduced, medical professionals can advise on a plan for a return to normal activities