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Plantar Fasciitis Tips

Don’t let plantar fasciitis slow you down

Do you have pain in your heels and through the arches of your feet first thing in the morning and after you have been sitting for a while? If you do, it could be plantar fasciitis, a swelling of the plantar fascia – the main tendon that holds up your foot arch. Plantar fasciitis is one of the most common causes of foot pain.

Unlike muscle, the plantar fascia has very little flexibility so it can easily become irritated, inflamed, over-used or torn. Plantar fasciitis is painful but fortunately it is quite easily treated. Here are some tips for easing plantar fasciitis:

  • Before getting out of bed, warm up your foot muscles by doing some ankle stretches and pulling your toes back towards your shin to open up the arch of your foot.
  • Once out of bed, continue loosening up your muscles with a few calf and hamstring stretches.
  • Keep a small water bottle, or pop bottle filled with water, in your freezer. Place it under the arch of your foot, apply some pressure, and gently roll your foot across the bottle. The ice will soothe your pain and the rolling will help stretch your foot muscles.
  • Wear supportive, properly-fitted footwear to control the motion of your foot. Excessive rolling places extra stress on your plantar fascia.
  • Book a consultation with a Canadian Certified Pedorthist to see if you require custom foot orthotics to support and correct your foot. Depending on your individual biomechanics, custom foot orthotics may make a world of difference if you have plantar fasciitis.

Plantar fasciitis is painful but it is treatable. If you think you have plantar fasciitis book an appointment with your local Canadian Certified Pedorthist so you can get started with a treatment program right away.

By Jim Pattison, C. Ped (C), Prince Albert, SK

 


Why do my feet hurt more when I stand?

Tired, achy feet are normal after a lengthy period of standing but if your feet hurt in one particular area after a long day on your feet, you should book a consultation with a Canadian Certified Pedorthist.

When you stand, the same muscles in your feet fire repeatedly as the pressure on them remains constant. However, when you walk about, the pressure shifts to and from different areas of your foot as the same muscles aren’t working all the time. If you have a sore area on your foot, walking will be less painful than standing as the pressure is on the area for less time.

Pain in one area of the foot that becomes worse when standing indicates a problem that requires pedorthic treatment. Although a Pedorthist needs to assess you to identify the exact cause of your pain, common conditions that cause localized pain are: arthritis, stress fractures, broken bones, ulcers or even using insoles that are badly worn.

Although your Pedorthist will recommend specific treatment to ease your individual condition, often people who have localized foot pain require softer insoles as they ease pressure on their foot. If you have a stress fracture in the metatarsals (forefoot bones) you may need extra support and cushioning to balance the pressure in your injured foot. If you have arthritis in the foot, custom foot orthotics, along with orthopaedic footwear, will ease pressure from the painful arthritic areas.

In addition to custom foot orthotics and different footwear your Pedorthist may also recommend you modify your activities to decrease the amount of time you spend standing in one spot. If your job requires you to stand for lengthy periods, your Pedorthist will discuss ways you can move around a bit to reduce the pressure on your painful area.

As with all foot pain, don’t try to self diagnose or self treat. Consulting a foot and lower limb expert is the quickest way to ease your pain and return to your normal activities.

 By Jim Pattison, C. Ped (C), Prince Albert, SK

 

 

 


What is the biggest cause of foot problems?

As a Canadian Certified Pedorthist who sees many different foot conditions each day, I don’t believe any condition is greater than another. Foot pain is foot pain and nobody should have to live with it. I am trained to figure out the cause and solution to foot pain and seeing my patients feel and move better following treatment is one of my favourite parts of my job.

Each day, the average person stands for up to five hours and walks about 10,000 steps with their feet serving as a shock absorber.  As each foot has 26 bones, 33 joints, 20 ligaments and more than 100 muscles there are many different parts absorbing the shock from the daily pounding. If any of these parts are damaged through overuse, medical conditions, injuries or poor fitting footwear, pain and mobility issues will result.

The most common problems I see in my clinic are:

  • Plantar Fasciitis – heel pain
  • Heel Spurs – bony growths on the back or bottom of the heel
  • Achilles Tendonitis – dull pain near the heel or along the back of the leg
  • Metatarsalgia – forefoot pain
  • Neuromas – a painful bundle of nerve tissue that grows between the toes
  • Stress Fractures – a tiny crack in the bone
  • Sesamoiditis – inflammation under the big toe joint
  • Bunions – a hard red bump at the base of the big toe
  • Hammertoes– toes that have an irregular, permanent bend in the joint
  • Tarsal Tunnel Syndrome – pain along the inner leg behind the ankle bone
  • Haglands Deformity – a bony enlargement on the back of the heel
  • Corns and callusing – painful patches of thickened skin

In addition to these conditions, I also regularly see patients living with diabetes, arthritis, fibromyalgia and gout as these diseases affect the feet and lower limbs.

As you can see, there are many causes of foot pain so it’s important to seek professional advice to determine the cause of, and an appropriate treatment program for, your foot pain. Treatment options to reduce foot pain and increase mobility, include foot orthotics, footwear recommendations and modifications, stretching, icing and more.

If you think you have any of the above conditions, don’t self-treat. Book an appointment with a Canadian Certified Pedorthist in your community. Your Pedorthist will conduct a comprehensive assessment of your feet and lower limbs to determine the cause of your pain and will design a treatment program for you. Click here to find a Canadian Certified Pedorthist near you http://www.pedorthic.ca/find-a-pedorthist/

 By Mike Neugebauer C. Ped (C) Vancouver, BC

 

 


My Feet Are Two Different Sizes

My feet are two different sizes, how do I buy shoes that fit?

For your foot health and comfort, it is important to buy properly fitted shoes but if your feet measure two different sizes (and most people’s do) how do you decide which size to purchase? I recommend three different solutions, depending on your situation:

Solution 1

If your feet measure within a half size of each other and you don’t have any other problems with your feet, purchase shoes to fit your largest foot. Although, you should buy footwear that fits your larger foot, it’s also important to make sure it fits your smaller foot. For example, my right foot is a 9.5 EEE and my left foot is a size 9 EEEEE.  I can usually wear a 9.5 EEE shoe as long as it is a generous EEE width and the shoe is square at the toes. To make sure the shoes fit both of your feet, try them on and walk around in the store before purchasing them.

Solution 2

My Feet are two different sizesSome people have about one size difference between their feet. For these individuals it will be more difficult to get both shoes to fit comfortably without modifications.  If you fall into this category, you should visit a Canadian Certified Pedorthist to find a shoe that fits your larger foot and then have the second shoe modified to fit your smaller foot. Your Pedorthist may need to put a pad in the front of the shoe to draw your smaller foot towards the heel. A tongue pad (shown at the left) is a pad that is glued on the tongue of the shoe to help ensure a proper fit. A tongue pad makes the shoe fit tighter to keep the shoe from sliding around.

Mass shoe stores may suggest you put a heel cushion into your shoe to accommodate your shorter foot. However, the objective is to pull the back of your foot into the heel of the shoe and putting a heel pad in will achieve the opposite as it forces your foot to the front. Forcing your foot forward will make the shoe harder to wear because your heel will slide up and down. It also increases the risk of toe injury as your toes will bang the front of the shoe.

Solution 3

A smaller group of people have more than a two size difference between their feet. These people usually had trauma or surgery on their feet when they were growing up. They may also have a leg length discrepancy. It is unlikely footwear can be modified to fit such varying size feet. However, there are a couple of solutions for this situation, depending of the type of shoes the person requires.

  • If you require the shoes immediately, I recommend you purchase two pairs (one to fit the larger foot and a second to fit the smaller foot).
  • If you have time to do some research, some specialty shoe manufacturers make mismatched pairs. They may charge a surcharge, but it is generally less expensive than buying two pairs of shoes.
  • A few places such as the National Odd Shoe Exchange (http://www.oddshoe.org/index.php) provide people with different size feet a place to trade shoes that do not fit. You simply look on the exchange to find if there is someone with the opposite shoe needs. You then purchase two pairs of shoes, and send the pair that does not fit to the exchange. The exchange then sends you back a second new pair to meet your needs.
  • Custom made shoes – shoes that are made specifically for you – are also an option. Although this is the most expensive option, custom made shoes are the most likely to fit perfectly.

If you are having difficulty finding shoes to fit your needs, contact your Canadian Certified Pedorthist. Your Pedorthist is a footwear expert and will recommend the best solution for you.

By Jim Pattison, C. Ped (C), Prince Albert, SK

 


What are heel spurs?

Heel spurs are a frequent culprit of foot pain seen in pedorthic clinics. The pain can range from a dull nagging ache that feels like there is a rock in your shoe, to an excruciating pain that prevents you from walking, standing or doing your regular activities.

Also known as calcaneal spurs, heel spurs typically develop from repetitive damage to the heel which causes calcium deposits to form. Ongoing damage can lead to a buildup of calcium, which causes frequent pain. X-rays are often used to confirm heel spurs but they can also be detected through a medical exam and palpation.

There are two common types of heel spurs:

  • An Inferior Calcaneal Spur results from repetitive stress to the bottom of the heel, causing the area to become painful. As this type of heel spur causes discomfort similar to plantar fasciitis pain, it is important to take an X-ray to ensure it is not mistakenly treated as plantar fasciitis.
  • A Posterior Calcaneal Spur results from repeated trauma to the back of the heel where the Achilles tendon attaches. This specific spur is often present to the naked eye and easy to feel.

There are a number of successful treatment strategies for heel spurs. Custom made foot orthotics are commonly used to reduce pressure areas. Typically, the orthotic is designed with a heel well, a hole cut out of the bottom of the heel cup, which is then filled with soft material, to cradle or cushion the inflamed area and reduce pressure and impact forces when walking, standing or being active.  Physiotherapy is also often used to strengthen and stretch the area.  Icing the bottom of the foot is recommended to reduce inflammation.  Some individuals may also find relief with heel spur cushions, which are soft pads put under a patients heel inside their shoes, while other individuals may be advised to purchase new footwear if their existing footwear has lost its cushioning capabilities or its structural integrity.

If you think you have a heel spur, check with your doctor or consult a Certified Canadian Pedorthist to determine which treatment course is right for you.

By Steve Stredulinsky C. Ped (C) Calgary, Alberta

 

 

 


What are hammertoes?

A hammertoe is a toe that has an irregular, permanent bend in the joint, in some instances causing the toe to resemble a hammer. Often painful or difficult to move, hammertoes may affect a single toe or all of the four lesser toes (toes that have two hinge joints).

The most common cause of hammertoes is poorly fitting footwear. Footwear that is too tight at the toes or has an excessive heel height that forces the toes to be crushed into the toe box of the shoe will cause hammertoes to form over time.  Hammertoes are frequently seen in conjunction with bunions, as ill-fitting footwear also causes bunions to develop on the big toe.

There are a number of treatment options for hammertoes.

Braces – over the counter soft hammertoe cushions or braces can help to reduce pain and decrease pressure on the tops of the toes inside the shoes.  A hammertoe cushion has soft padding under the foot and an elastic piece that the toe fits into so the wearer can adjust the resistance against the toe.

Footwear – investing in properly fitted footwear is paramount to reducing pressure on the affected toe and ensuring it doesn’t get worse.  A deeper, wider toe box will reduce stress on the joints and top of the toes. To ensure you are getting a proper fitting pair of shoes, make sure you visit a footwear professional who measures both of your feet with a Brannock device.

Physiotherapy – in mild cases, a strengthening and stretching program can help reduce areas of discomfort and minimize the deformity from worsening.

Orthotics – custom made foot orthotics can help reduce pressure points and areas of discomfort and also help the foot fit more efficiently into footwear.

Surgery – in more severe cases, surgical intervention may be required to reduce pain and discomfort in the affected area.

If you have hammertoes, check with your family physician or book in an assessment appointment with a Certified Canadian Pedorthist to explore all of your treatment options.

By Steve Stredulinsky C. Ped (C) Calgary, Alberta

 


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