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Why do my Feet Hurt When I’m Standing?

You wake up, drink your coffee, and get ready to go to work. You hop into the car, get to work and start your day. Sure enough just like that the pain sets in, much like it has every day before. Whether it’s standing in one spot or walking around the pain is persistent. Sometimes it can get worse towards the end of the day, others at the beginning and sometimes no pain at all.

Your feet are the base of support to your body and when you have a busy day with pain, standing can be a nightmare.

So What’s Happening and What Can I Do About It?

There are many factors that contribute to foot pain when standing. We will go over just a couple in this article and what you can do to help alleviate the discomfort.

Swelling is something many of us will experience over the course of a long work day especially when standing still. The body is less efficient at pumping blood back to the heart when standing and as a result swelling within the calves and feet can occur. This in most cases can cause that achy sensation that worsens over the course of the day prominently in the feet and calves. To combat the swelling, a great tool can be graduated compression stockings. These work by providing higher grade compression at the foot/ankle and weaker at the top of the calf to efficiently push the blood that pools in the feet and calves back to the heart a little quicker. They come in all types of colours and styles to fit any occasion and will keep you on your feet longer.

Pain in the toes is another issue that can occur with prolonged standing. One major factor in toe pain specifically when standing is the fit of your shoes. A lot of times when we are wearing shoes that fit too tight, we create areas of abnormal pressure on the foot. This occurs most often in the forefoot where we can see numbness, callusing or even bunions form! The trick to dealing with this type of pain is to get a proper fitting shoe. Wearing a shoe that has a deep toe box while also providing adequate width and length is key to tackling pain in the toes. When we wear shoes that fit narrow or are raised in the heel these issues present themselves because we are shifting more pressure towards the toe box and there is no space to accommodate the foot.

Plantar fascia pain is something that most of us will experience in our lifetimes. When we are always on the go, putting a lot of miles on our feet and don’t stretch adequately, we pay the price with arch pain. Plantar fasciitis occurs when the thick band of fascia that runs from the bottom of your heel to your toes becomes inflamed and as a result can cause pain for the first few steps of the day and throughout the day. Typically, this pain can be brought on by a number of things including unsupportive footwear, foot structure, work day length etc. Orthotics are a tool that can help to alleviate this pain by offloading the plantar fascia and help to make the foot (and lower limb in general) work more efficiently. They can be made to work with any type of shoes and are the key to great foot health!

Quick Tips for Standing Foot Pain:

  • Wear proper fitting footwear that allows adequate extra space for your feet
  • Wear compression socks to combat swelling that occurs with prolonged standing
  • Get orthotics to help with arch and general foot pain

There are many different treatments and modalities to address pain when standing. If you are experiencing anything as described above or any foot pain in general reach out to your nearest Canadian Certified Pedorthist by clicking here. We definitely can help!

By Tyler Ashurst, Canadian Certified Pedorthist


Why are my Feet Numb?

Numbness is a lack of sensation in a body part. It can be a partial or a complete loss. Although loss of sensation is the main symptom of numbness in your foot, you may experience some additional, abnormal sensations. These include prickling or pins-and-needles sensation, tingling and weak-feeling feet

So what causes numbness in your feet? That is not quite as easy a question to answer because there are several causes. Some of them are simple and obvious. Others are not so simple:

  • It can be as simple as the foot going to sleep because you sat cross-legged. This is more likely to be temporary but others can be longer lasting ore even permanent!
  • It can also be caused by tight clothing, scars or swelling.
  • Obesity is also a cause. For obesity issues, work with doctor or dietitian to seek weight loss alternatives. If obesity is due to inactivity, a pedorthist can help you get more active with less pain.
  • High blood pressure can also accompany obesity and the two work to increase numbness in body parts.
  • Issues with blood vessels like peripheral vascular disease or vasculitis – an inflammation of the blood vessels can cause numbness as well.
  • Deficiencies of vitamins that are essential to nerve health and functioning are also a cause. The most common ones that can cause this are certain B vitamins and vitamin E.
  • Toxin accumulation can cause numbness as well. Alcoholism or chronic alcohol abuse with kidney disorders that cause high amount of toxins build up in the body and damage nerve tissue.
  • Nerve issues like disk herniation can be involved as well.
  • A low functioning thyroid can lead to fluid retention and increase pressure surrounding nerve tissues. Diseases that cause chronic inflammation and can spread to the nerves or damage connective tissue surrounding nerves.

One of the more common causes of numbness with pins and needles is Tarsal tunnel syndrome. It is a lot like Carpal tunnel syndrome. It is a compression of the posterior tibial nerve located along the inner part of the heel. It can produce symptoms that extend all the way from the ankle to the foot, including tingling and numbness anywhere in the foot.

Numbness can be brought on by other causes in the foot and leg:

  • Frostbite one of the causes in winter.
  • Tissue damage in such a condition can cause damage to the nerves locally. The same reason can involve Morton’s neuroma – scar tissue on the nerves between the toes.

Systemic diseases can cause numbness as well:

  • Charcot-Marie-Tooth disease is a less common condition affecting muscled and nerve activity in the foot and leg.
  • Guillain-Barré syndrome is a less common disorder affecting muscle strength and sensation.
  • Systemic diseases like multiple sclerosis, Lyme disease, sciatica, shingles some cancers and some chemotherapy can cause it as well.

Numbness can also be the result of a chronic condition, like diabetes. The symptoms can also be progressive. You may begin to lose some sensation in your foot then slowly lose more and more feeling as time goes on.

Diabetes is serious, and if numbness in the toes and other foot problems related to the disease go unrecognized or untreated, it could lead to major complications, which could include an amputation. Have your doctor check your blood sugar level to see if diabetes might be the cause of the numbness in your toes.

Numbness can be also a sign of an emergency situation that you need to get to a hospital. If you see numbness show up suddenly with no warning, you need to be evaluated for spinal cord injury, seizures, strokes or transient ischemic attacks also known as TIA or “mini-stroke”. These are the symptoms of a stroke that appear intermittently and can resolve. Just because the symptoms resolve does not mean that nothing is going to happen. Often these are prodromal or harbingers of a real stroke going to take place shortly!

Seeking medical advice for numbness in your foot may help slow or delay its progress. Talk to your physician or Canadian Certified Pedorthist at the first signs of numbness. To find a pedorthist near you visit pedorthic.ca.

By Canadian Certified Pedorthist Jim Pattison

 

 

 


Help! My Feet go Numb?

Numbness in the feet tends to be something that many people push off, and often overlook as a problem.  Numbness in your feet is not normal. Sometimes this can be simple and easy to fix, and other times it can be much more complex. It is not something that usually fixes itself. If there is numbness, it’s a sign that something needs to be changed.  Your Canadian Certified Pedorthist can help you find solutions to this problem!

What Causes Numbness?

While there can be many causes of numbness in the foot, the most common cause tends to be high pressure areas. This can create pressure points and even impinge nerves or reduce blood flow. In some cases, these can be isolated areas of your foot, including toes, forefoot, heels or even just small regions of skin. Other times, it could be your entire foot experiencing numbness. Your Pedorthist will evaluate your foot structure, range of motion, and well as your gait pattern. This can help identify any structural or movement patterns that could be causing an issue. They will also consider your activity levels and type, as well as evaluate if your footwear is appropriate for you and what you’re doing.

Numbness can also be caused by damage to nerves, potentially even causing neuropathic pain. This can be because of certain health conditions or medical treatments. Other times, it can be as a result of a previously preformed surgery. Because of the complexity of the network of nerves that run through the body, even back injuries can cause numbness.

How Can it be Treated?

  • Over-the-counter (OTC) Insoles: Re-distributing pressure, or controlling excessive movement patterns can help to relieve pressure points on the feet and impinged nerves. OTC insoles are generic ‘one-size fits most’ options that can be a simple solution.
  • Custom-Made Orthotics: This custom device is made from a 3-dimensional volumetric cast of your feet, to specifically address the cause of YOUR discomforts. They will often create an even distribution of pressure, off-load necessary areas and add cushion/shock absorption as needed. This can help any structural of movement-based patterns contributing to impinged nerves or pressure points. This custom product can be adjusted to ensure you feel the best you can.
  • Footwear: A proper fitting shoe can go a long way. If the shoe itself is too small or ill fitting, it can be the cause of numbness. Changing into a proper fitting shoe or a different style with the right features can make all the difference. The proper shoe is like having a good foundation for a house; an orthotic or insole won’t have the same success if the shoe is working against it. Sometimes, this can mean switching from barefoot to a shoe you already have. Barefoot standing and walking can put a lot of stress on the feet.
  • External Referral: In some cases, your Pedorthist will notices imbalances or note other injuries that are out of their scope of practice. In this case, your Pedorthist may refer you back to your primary health care provider for further investigation, or to another health care provider for different treatment option. Sometimes, the addition of physiotherapy, massage therapy or chiropractic treatment can help. 

Booking an appointment with your Canadian Certified Pedorthist

Be prepared to answer some questions about what you’re experiencing. There are a few key things they’ll want to know to help identify probable causes and treatments. Thinking about these in advance really helps the process.

  • How would you describe the numbness? i.e.  A lack of feeling or pins/needles?
  • What part of your foot is experiencing the numbness? i.e. Toes, heel, bottom of foot.
  • How long have you been experiencing the numbness? And were there any major lifestyle changes around that time?
  • When do you notice the numbness flare up? i.e. Is it constant, only certain activities or times of day?
  • What type of footwear are you wearing most often and when you experience the numbness?
  • Do you have (or a history of) any significant medical conditions?
  • Do you have a history of injuries or surgeries in the lower limbs or back?

Standing, walking, running and moving should feel good! Don’t underestimate the significance of the discomfort you’re feeling, or the potential to relieve it with proper treatment!

To find a Canadian Certified Pedorthist near you, visit https://www.pedorthic.ca/.

By Canadian Certified Pedorthist Katherine Hall


Pedorthic Pointers for Occupational Safety & Health Week

To mark North American Occupational Safety and Health Week, here are a few ways to protect your feet while you work! If you stand or walk at work on concrete, tile or hardwood floors all day, the hard surfaces may lead to pain and discomfort. Protecting your feet from these hard surfaces can be a great way to deal with any current or future issues.

Shoes at Work

Because we are typically wearing the same shoes for the entire workday, wearing the appropriate shoes can go a long way in comfort!

Find a shoe that fits properly. If the shoe is too short, narrow or shallow, the sides of the shoe will irritate the toes. This can especially be a problem in a safety shoe because of the steel toe. If you have a wide foot, search for shoes that have wide widths available, or tend to fit on the wider side. On the other end of the spectrum, if the shoe is too big or wide, the foot could move around and irritate the toes. If you have a narrow foot, search for shoes with narrow widths available, or fill any extra space with thicker inserts.

If you work standing or walking on hard surfaces, look for a boot with a softer midsole (thick part of the sole). In regards to safety shoes, there may not be many options out there, but it is a great feature if it’s available! A softer midsole will provide additional shock absorption to protect your feet and legs.

A shoe with an adjustable closure, such as laces or Velcro, is another important feature to improve comfort. The option of adjustability will allow a more appropriate fit for your specific feet, which can change throughout the day based on swelling.

Support is another important consideration. If the foot is moving around too much, this can overwork the structures in the feet and legs and potentially lead to pain. Shoe support can be tested in a couple different ways. For support through the middle of the foot, the shoe should not bend in half easily. A safety shoe should already have this feature because of safety considerations that are require. For support at the heel, the back of the shoe/heel should not collapse with pressure. If additional support is needed, a custom-made orthotic or an over-the-counter insert may be necessary.

If a custom-made orthotic or an over-the-counter insert is to be used, a shoe with a removable insert can improve comfort and possibly the support.

Proper Support

Support through a custom-made orthotic or over-the-counter insert is another way to improve comfort throughout the day.

Especially if there is already pain in the feet or legs, additional support may benefit. The support can help in multiple ways depending on what features are necessary, such as preventing muscles from overworking, aligning joints into a more optimal position and/or providing additional cushioning and shock absorption.

If pain is not a concern at the moment, an over-the-counter insert may be beneficial to prevent any future pain. Sometimes, pain can develop slowly over time, especially if there are internal and external factors preventing optimal support and comfort.

If you are unsure if support would benefit you, an assessment with a Canadian Certified Pedorthist will give you more information!

Outside of Work

Even if work is where you spend most of the time on your feet, what you wear outside of work is also important to consider! This will allow your feet to recover and prepare more effectively for your working hours.

A go-to shoe with the appropriate fit and support will make it easier to choose the most comfortable shoe every time you leave the house.

What you’re wearing inside your home is also an important consideration, because you may stand and walk more than expected! Depending on preference and the level of support needed, there are different options to choose from. A walking or running shoe would give the most amount of support, but may be too warm for some. A supportive slipper or sandal can be great options because they give support, as well as the option of breathability if preferred. If balance is an issue, a shoe with a backing is be a great feature to consider.

Canadian Certified Pedorthists can give you more information about your specific workplace footwear needs after an assessment of your feet. To find a pedorthist near you, visit https://www.pedorthic.ca/.

By Canadian Certified Pedorthist Julia Hayman


How can Pedorthists Help my Pronation Issues?

Pronation is a natural movement of the foot that occurs during gait. Pronation allows the foot to absorb shock as our foot hits the ground. When arches are low or flat, they have the tendency to excessively pronate and roll in too much. Very often, the opposite is true for high arches and we find that the foot underpronates, or doesn’t pronate enough which leads to poor shock absorption at the level of the foot. There are many injuries associated with overpronation; plantar fasciitis, arthritic toes, bunions, knee and/or low back pain. Under pronation, while less common, can cause stress fractures, shin splints and knee pain.

Overpronation

Overpronation can be complicated to eliminate. Pronation involves the recruitment of the plantar fascia, and this repetitive recruitment could weaken the foot and cause injury.  Custom made orthotics and footwear can really improve this condition.

Custom-made Orthotics:

  • Deep heel cup made with firm material will offer maximum control.
  • Semi rigid orthotic will absorb excessive movement while offering cushioning and support.
  • Progressive increase to the arch of the orthotic will support the plantar fascia and encourage efficient gait.

Orthopaedic Footwear:

  • Motion control footwear has pronounced stability in the medial portion of the shoe in efforts to decrease pronation.
  • Select footwear that can easily accommodate custom made orthotics with removable liners and offer wider width options.
  • Rocker bottom sole that will allow efficient toe off while reducing pronation.

Underpronation

Underpronation is difficult to eliminate during gait, but custom orthotics and proper footwear can help greatly. Reduced pronation during gait can be attributed to high or rigid foot types.   An arch that is considered pes cavus may under-utilize the plantar fascia during gait and in turn increases the stress on the structural landmarks of the foot; the heel and ball of the foot. This foot type tends to experience  symptoms of aggravating body pain,  in particular the knees and back. Minimal pronation results in minimal shock absorption and puts the foot at risk for common high pressure injuries common with underpronation; stress fractures, arthritis, shin pain, lateral knee pain, hip and/or back pain.

Custom-made Orthotics:

  • Semi soft materials will allow for maximum shock absorption
  • Deep heel cup and Prominent lateral edges will control supination (roll out).
  • Accommodations to prominent structures in the foot to further offload problem areas.

Orthopaedic footwear:

  • Select a shoe with a wide-base sole. This will decrease the ability of the foot to supinate.
  • Select a neutral shoe with a sturdy heel counter. A neutral shoe will provide excellent cushioning.
  • Select a shoe with a deep fit with adjustability to ensure proper fit of high arches and custom orthotics.

You can take a look at the soles of your shoes to see where the wear is occurring. If it happening on the middle or inside of the shoe this is generally a sign that your foot is not hitting the ground in the correct position and may be causing you pain. If the wear is on the outside of the heel, and it isn’t excessive then this is normal wear. If you are experiencing pain in your feet, legs, knees or back reach out to your local Canadian Certified Pedorthist to have your feet and gait assessed. Click here to find a Pedorthist near you.

By Julia Hayman, C. Ped (C)


Tips to Reduce Pain in Knees, Shins and Ankles

Lower limb pain and discomfort is a common concern Pedorthists hear from our patients. Leg pain can come from trauma to soft tissues or bone but also very commonly from overuse. Many jobs have people standing or walking for long periods of time, day after day and week after week. This can lead to pain in your legs and knees.

Below are a few of the common conditions that Canadian Certified Pedorthists treat.

Ankle pain

Ankle pain can be felt on the inside or outside of the ankle depending on the cause or contributing factors. In high arched feet there is often a tendency for the weight to be shifted to the outside of the foot, which stretches the structures on the outside of the ankle and compresses the joint on the inside. High arches can also be prone to lateral ankle sprains.

Flat feet paired with excessive pronation can lead to overstretching of tendons and ligaments on the inside of the ankle, which makes it more difficult for certain muscles to work efficiently and in turn can lead to ankle pain. Creating stability and providing cushioning through orthotics and/or footwear can help you continue on with your day to day activities without ankle pain.

If you have chronically weak ankles due to multiple sprains or you are working or playing on uneven ground, an ankle brace may be a great solution to help keep you feeling comfortable throughout your day.

Shin splints

The shin (or the front part of the leg) contains a few different groupings of muscles. Shin splints typically cause pain on the inside of the lower leg, but pain may also be felt in the muscle groupings on the very front of the shin, or even on the outside. The muscles around the shin attach to different parts of the foot, assisting your foot while you walk. If your feet roll excessively in or out when you walk, the muscles have to work harder to control the motion at your feet. Over time the muscles can be overworked and this leads to pain.

Improper shock absorption in the feet is a frequent cause of shin splints so choosing the correct shoes and providing support to your feet can reduce the strain that is causing the pain. For high arched feet, a neutral cushioning shoe will provide shock absorption and the rocker sole aids in a proper toe off. For flat feet, a stability shoe or motion control shoe gives you a solid base of support and helps to reduce the extra motion occurring at the foot.

Off the shelf and custom-made orthotics are very useful in helping to treat shin splints as they provide the feet with support and help to evenly distribute pressures.

Runners knee

Patellofemoral pain syndrome, often called runners knee, is typically felt as a dull, aching pain in the front of your knee. While active, people often experience the pain during running or jumping sports and you may also experience this pain when walking up or down stairs or after sitting with a bent knee for long periods of time.

To treat runners knee, a multiple treatment approach is usually the best approach. Canadian Certified Pedorthists can help to reduce excess motion in the feet and to increase cushioning through the use of custom-made orthotics and proper footwear. Knee bracing to help stabilize the knee cap and maintain proper knee tracking may also be suggested. Stretching and strengthening of the muscles in your legs is also be a piece of the puzzle.

Osteoarthritis

Osteoarthritis of the knee is a “wear-and-tear” form of arthritis and is the most common form of arthritis seen at the knees. It occurs most frequently in people over the age of 50 but can affect people at an earlier age. Osteoarthritis occurs when the cartilage, the body’s natural cushioning, breaks down and over time the space between the upper leg bone and the lower leg bone is decreased. Common symptoms include stiffness and tenderness around the knee. You may also experience swelling at the knee. Osteoarthritis worsens over time and being aware of it early and taking simple steps can help you function with less pain day to day.

Off the shelf insoles and supportive footwear can make a big difference for those experiencing mild OA of the knee. Bracing that provides stability and even mild compression are also helpful in the early stages. As the condition progresses an offloading brace is recommended in order to transfer the pressure from the side (or compartment) affected by the arthritis. Keeping your body active is important in a person suffering with arthritis so finding ways to make walking or cycling or any movement less painful is imperative.

Canadian Certified Pedorthists are specialized in the assessment for and manufacturing of custom-made orthotics. By completing a thorough assessment of your lower limb range of motion as well as a comprehensive gait analysis, you will learn about your feet and how they work and what is leading to your pain. While custom-made orthotics are an integral part of the treatment plan there are many treatment options that a pedorthist can provide to help with your pain. Footwear, when fit properly and chosen for your foot type and activity, can be a huge part of relieving your pain. Many off the shelf products such as foot compression sleeves, ankle braces or knee braces can help you get through your days with less pain. Canadian Certified Pedorthists will also give suggestions for allied health practitioners that can help to treat your pain.

If you are experiencing pain in your day to day life or pain is limiting you from enjoying certain activities take the right step and contact your local Canadian Certified Pedorthist. You can find one near you be clicking here.

By Jasmine Basner, C. Ped (C)


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