Arch pain is commonly experienced by middle aged women who's feet have a tendency to overpronate or roll in. It is also commonly associated with bunions and hammer toe. The plantar plate is a thick ligament type structure with attachments which inserts into the base of our phalanges (toe bones) in the area of the ball of the foot. The plantar plate is designed to protect the head of the metatarsal from pressure and prevent over extension of our toes preventing our toes from spreading or splaying.
The causes of high arched feet can vary greatly. They range from neurological disorders, club foot, injury, and often times there may be no known reason. The idea behind surgery to correct this often painful condition is to bring the arch down and thereby, allow the ground pressure of walking to be more evenly distributed across the entire bottom of the foot. Over time high arch feet can cause severe plantar calluses, ulcerations broken metatarsals and even chronically sprained ankles.
Most flat feet do not cause pain or other problems. Children may have foot pain, ankle pain, or lower leg pain. They should be evaluated by a health care provider if this occurs. Symptoms in adults may include tired or achy feet after long periods of standing or playing sports.
Your doctor may order imaging tests to help make sure your heel pain is caused by plantar fasciitis and not another problem. X-rays provide clear images of bones. They are useful in ruling out other causes of heel pain, such as fractures or arthritis. Heel spurs can be seen on an x-ray. Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound, are not routinely used to diagnose plantar fasciitis. They are rarely ordered. An MRI scan may be used if the heel pain is not relieved by initial treatment methods.
Non Surgical Treatment
Rest is the most important thing you can do. Stay off your feet, or use a cane. Gently apply ice to the arch for at least 30 minutes, and repeat every 3 or 4 hours. Apply mild compression to the foot. Use a Fabriform PSC Foot and Ankle Strap to help support the arch, reduce swelling, and relieve pain and fatigue. This strap is easy to apply and adjust for a custom fit. Low profile allows it to fit in any shoe. Allows you to apply just the right amount of arch support/compression for your foot. Before stepping down after sleeping or resting, stretch the arch of your foot by pulling up on the ball of the foot and toes, as far as you comfortably can; hold the foot in this position for ten seconds. Repeat at least ten times. Consideration should also be given to the use of night splints. These are very effective for stretching the plantar fascia to relieve first weight bearing pain.
Surgery is considered only after 12 months of aggressive nonsurgical treatment. Gastrocnemius recession. This is a surgical lengthening of the calf (gastrocnemius) muscles. Because tight calf muscles place increased stress on the plantar fascia, this procedure is useful for patients who still have difficulty flexing their feet, despite a year of calf stretches. In gastrocnemius recession, one of the two muscles that make up the calf is lengthened to increase the motion of the ankle. The procedure can be performed with a traditional, open incision or with a smaller incision and an endoscope, an instrument that contains a small camera. Your doctor will discuss the procedure that best meets your needs. Complication rates for gastrocnemius recession are low, but can include nerve damage. Plantar fascia release. If you have a normal range of ankle motion and continued heel pain, your doctor may recommend a partial release procedure. During surgery, the plantar fascia ligament is partially cut to relieve tension in the tissue. If you have a large bone spur, it will be removed, as well. Although the surgery can be performed endoscopically, it is more difficult than with an open incision. In addition, endoscopy has a higher risk of nerve damage. The most common complications of release surgery include incomplete relief of pain and nerve damage. Most patients have good results from surgery. However, because surgery can result in chronic pain and dissatisfaction, it is recommended only after all nonsurgical measures have been exhausted.
Stretching your calf and Achilles tendon may also help as a tight Achilles can make your foot overpronate. To stretch your calf and Achilles tendon, step forwards with your left leg and bend it, with your right leg straight and both feet pointing forwards. Push your right heel into the ground while keeping your right leg straight; you should feel the stretch at the back of your right leg, below the knee. Hold the stretch for 15 to 30 seconds and repeat with the opposite leg. Repeat the stretch two to four times on each leg, and repeat the overall exercise three to four times a day.