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What is Plantar Fasciitis?

What is causing your foot pain? Repetitive trauma and overuse of the plantar aponeurosis are believed to be causal factors of plantar fasciitis. Therefore, it is important to know how to decrease this trauma to properly heal the damage and prevent recurring pain and discomfort.

The tissues damage is caused by a biomechanical insufficiency tearing the plantar fascia tissue, at a microscopic level. Your body attempts to heal the damaged tissue during rest, which is why the pain is greatest when a person first wakes up in the morning and steps out of bed or after sitting for an extended period of time and stands to walk again. The first few steps hurt the most because the scar tissue that your body laid down in an attempt to heal the tissue is being retorn. Because the pain decreases after some time does not mean all is well and in fact, more damage is being done.

There are many causes and each person is different so should be treated on a case by case basis. However; a person may notice increased pain following increased or intense activity, during sandal season, when wearing minimalist shoes (especially combines with intense activity) or by the end of the work week from repetitive movements in work shoes, even if appropriate shoes.

If you notice the pain is asymmetrical (only one foot) take a mental note and see if you are also suffering from pain further up the kinetic chain in the knee, hip or lower back of the same side. If you discover there is discomfort or pain higher than the foot on the same side consider seeing a gait specialist. An incorrect gait, amongst other reason, could be the root cause and proper correction will be essential.  

Orthotics, custom or over the counter depending on the severity of the damage and level of insufficient mechanics, have a high success rate of correcting the foot position and relieving the pain and discomfort of plantar fasciitis. Correcting the foot position decreases the repetitive damage giving the tissue time to heal and aiding to improve biomechanics.

Pro tips to keep in mind if you are or ever have suffered from plantar fasciitis:

Roll of a golf ball or lacrosse ball under your foot (semi-weight bearing) as often as possible.
Ice the area your feeling most pain for 10-12 minutes before going to bed at night.
Write the alphabet in the air when you first wake up, prior to getting out of bed.
Wear supportive sandals or shoes indoors, if not already.
Stretch lower leg muscles to increase flexibility.

If you don’t see improvement consider seeing someone with specialized training in the area of gait analysis and lower leg expertise. A certified pedorthist, physiotherapist, chiropractor, and massage therapist can all assist with treatment to improve this condition, sometimes a combination of clinicians can be required.

We are accepting new patients and you can book your appointment online today!

Jeff Lewis C.Ped.(C)

METATARSALGIA

The term Metatarsalgia is derived from pain present around the metatarsal heads. More specifically, a sharp or shooting pain at the ball of the foot, and an aching or burning sensation. The toes may feel some numbness or tingling as well. The metatarsal heads are located just behind the toes where several nerves run between them. If the metatarsal bones get pinched together, the nerves become trapped in the middle, leading to pain and inflammation. Generally, Metatarsalgia has a slow onset of symptoms but it can also develop without warning.




Pain can often worsen from overuse, as the metatarsal heads withstand daily force when standing, walking, running or flexing the toes, especially on a hard surface. Patients often describe the feeling of Metatarsalgia as “walking on a pebble”.

There are several factors that can lead to Metatarsalgia. These include:

  • Poorly fitting footwear: Shoes that fit too tight may squeeze the ball of the foot together, aggravating the nerves that lay between. For example, high heels force the forefoot into a tight space and expose the metatarsal heads.
  • Increase in activity or high impact exercise: With a sudden increase in activity the foot is not used to the increased amounts of pressure, leading to Metatarsalgia. Regular high impact activities and repetitive force can be damaging to the foot.
  • Excess weight: As we move, body weight gets shifted to the forefoot, and with extra weight there is further pressure put on the metatarsals.
  • Foot shape: High arches can put added pressure on the metatarsals. If the second toe is longer than the big toe, more weight transfers to the second metatarsal head making it more susceptible to foot problems.
  • Advanced age: As we age the protective fat pad at the ball of the foot gets thinner, increasing risk of Metatarsalgia.
  • Stress fractures: Small breaks in the bones of the forefoot can change the way you walk due to pain.
  • Medical conditions: Rheumatoid arthritis and diabetes can increase risk of developing Metatarsalgia.
  • Morton’s Neuroma: Compression of a nerve between the third and fourth metatarsal heads causing symptoms similar to Metatarsalgia.
  • Sesamoiditis: Tendons around the sesamoids become irritated or inflamed. Pain is usually felt under the first metatarsal and is most common in ballet dancers.
  • Metatarsophalangeal (MTP) joint capsulitis: Inflammation of the plantar joint capsule, most commonly under second metatarsal head. Described as a “bruised feeling” or having the sensation of a “lump”.

Metatarsalgia is a treatable condition with a high rate of success. One way to relieve pain at the metatarsal heads include wearing properly fitted footwear with a wide enough toe box and a rocker sole. The wide toe box allows sufficient room for the foot to expand and the rocker sole decreases pressure on the ball of the foot. Another method to alleviate forefoot pain during exercise is to stretch before and after activity with a warm up and cool down period. Additionally, listen to your body and rest when necessary. Finally, custom orthotics can be designed to offload pressure at the metatarsal heads. Often a metatarsal pad is built into the orthotic to redistribute weight and help make putting weight on the forefoot more tolerable. If left untreated, the pain may worsen and other problems may occur such as hammer toes or low back pain from altered gait.

Daniel Gemmell C.Ped(C)

DIABETES & FOOT CARE

November is Diabetes awareness month and the Footwork Orthotics team would like to begin our first blog by suggesting tips on Diabetic foot care. There are many challenges that individuals living with diabetes face, and foot care is no exception. It is important to pay special attention to your foot health to prevent future complications. Diabetes can cause a loss of sensation in the feet and lower limbs, often referred to as peripheral neuropathy. The risk of developing neuropathy increases with age and overall duration of diabetes diagnosis. Common signs include numbness, tingling in the feet, and pain. The severity of one’s pain could fluctuate from a burning sensation, to having a hypersensitivity to touch. However, this will depend on the individual and the amount of feeling they retain in their foot. Unfortunately, there is no way to reverse foot sensation once lost. Therefore, proper education and regular visits to your local doctor will help prevent problems like Diabetic ulcers. Ulcers often are caused by shearing forces in a person’s footwear. These can occur because of ill fitted footwear or undetected seems inside the footwear,  because of the loss of sensation these may not be felt by the diabetic patient. Unfortunately; if left untreated the ulcers can cause permanent damage, even amputation of a toe, part of the foot or the entire lower leg, 50% of lower leg amputations are diabetic related. Continue reading “DIABETES & FOOT CARE”