What Pain in the Arch of Your Foot Means

“Oh, my aching feet.” Some people say this after a long day of walking or standing. While they’re uncomfortable now, they know that after resting their feet and perhaps a nice warm bath, the discomfort will dissolve.

Not so with arch pain. About half of all cases of foot pain are disabling, and much of this pain takes place in the foot’s arch area.

What Pain in the Arch of Your Foot Means?

Your most visible arch, the Inner Longitudinal Arch, is a vital part of your foot, stretching from your heel to the base of your toes. This arch:

• Acts as a shock absorber

• Helps to balance and stabilize your feet as you walk

• Adapts to changing terrain (think mountain hikes versus flat sidewalks)

• Bears the weight of your entire body

If you injure any part of the complex network of muscles, ligaments, tendons, and bones that comprise this arch – or put excess stress on your feet through overuse, for example – you can experience arch pain.

Arch pain can feel like tightness, pulling, or a burning sensation on the bottom of your foot, typically in the ball and heel of the foot. However, since the proper functioning of your ankles, knees, hips, and back all rely on healthy feet, you might feel pain anywhere up the kinetic chain.

Causes of Foot Arch Pain

Your foot is comprised of more than 100 ligaments, tendons, and muscles, but did you know you have four arches in your foot?:

• Inner Longitudinal Arch: runs from the ball of your foot to the heel, and controls excessive pronation or supination

• Outer Longitudinal Arch: absorbs the “roll” of your foot as you walk, reducing stress on your knees, hips, and ankles

• Transverse Arch: located above your heel, improving balance and increasing stability

• Metatarsal Arch: spread across the ball of the foot, improving balance and relieving pressure on the forefoot.

An injury, overuse, or structural issue can cause foot arch pain, and may be aggravated due to aging, stress, weight gain, or neurological conditions such as Morton’s Neuroma, an inflamed nerve in the ball of the foot.

Plantar Fasciitis

Plantar fasciitis is inflammation of the fascia, a thin sheath of fibrous tissue that runs along the bottom of your foot from the heel to each of your toes. The suffix “-itis” refers to inflammation. 

This common cause of foot arch pain affects one in ten adults, so it may be some small comfort to know you’re not alone. 

Plantar fasciitis risk is higher for women, for people 40 to 60 years old, and for those who:

You’re also at increased risk of plantar fasciitis arch pain if you have:

• Flat feet or high arches

• Tight Achilles tendons, or “heel cords”

• An unusual walk, such as overpronation

Flat Feet

Flat feet are feet that lack a normal arch, causing the entire foot to touch the floor when you’re standing. While the condition is common in children whose bodies are still developing, if flat feet remain into adulthood, they can lead to arch pain.

According to a national foot health assessment conducted for the Institute for Preventive Foot Health, 8 percent of American adults 21 years of age and older have flat feet. An additional four percent have fallen arches, which are normal arches that weaken or “fall” over time due to tendon damage.

You’re at greater risk of flat feet if you are:

Adults can also become flat-footed even if they previously had a normal arch. This condition, known as adult acquired flatfoot, is common in women over 40. Pregnancy also increases the risk of developing adult-acquired flatfeet.

Overpronation

When you’re “on a roll”, it means you’re experiencing a prolonged period of success. The same is true for feet that are functioning in a normal, healthy manner: they pronate, or roll inward, when you take a step. This is part of the complex biomechanics of motion that make our feet such marvels of engineering.

However, when your feet roll excessively – that is, overpronate ­– it can become painful. If your foot bones roll inward too much, you can end up with flat arches, and arch pain when walking.

Overpronators are susceptible to stress injuries such as:

• Shin splints

• Runner’s knee

• Stress fractures

• Plantar fasciitis

• Achilles tendinitis

High Arches

If flat feet are a health challenge, it might seem that high arches would be ideal. But as with overpronation, too much of a good thing is just as much of a challenge as too little.

High arches tend to be a structural issue. And high arches may be quite painful, because of the stress on the metatarsals (the bones just behind the toes). If you have high arches, you also know how difficult it can be to find shoes that fit well.

People with high arches are prime candidates for arch supports, which are designed to relieve pain, provide balance and comfort – and, especially in the case of high arches, prevent possible disability.

Unsupportive Shoes

Fashionable footwear – particularly women’s footwear – can be uncomfortable. It often seems the more stylish the shoe, the less supportive it is for the foot. Women wedge their feet into pointy shoes that pinch their toes, or choose elegant boots with no arch support, and can suffer excruciating pain in the foot arch as a result.

Dr. Alyssa Dufour, PhD, led a study at the Institute for Aging Research of Hebrew SeniorLife, which found that wearing unsupportive shoes such as high heels, slippers, and sandals can cause both heel and ankle pain.  

Of course, it’s natural to want to look your best, particularly at work and on special occasions. You may think wearing flip-flops or going barefoot at home is a good way to counterbalance unsupportive footwear the rest of the time – but these alternatives can make arch pain worse.

This doesn’t mean you need to wear sneakers or unattractive shoes to protect your feet, however. The solution is surprisingly simple: arch supports. Arch supports help place your feet in their ideal position, distributing pressure evenly across your foot and aligning your body up the kinetic chain.

With the right kind of arch supports inside your shoes, you can eliminate arch pain when walking. After all, a fashion-forward woman (or man) typically has a few little secrets tucked away that help them look good. Arch supports can be yours.

Injury or Overuse

Sometimes foot arch pain occurs because you’ve overdone it. Overuse can lead to injuries such as strains, sprains, and even hairline bone fractures if you push your body beyond its limits. 

Maybe you’re training for a marathon and exercised too long, or were wearing worn-out athletic shoes. Overuse can cause muscle and tendon fatigue, which lead to arch pain. Overuse injuries are also more common as we get older, since our bodies can’t adapt and recover as quickly as they did when we were younger.

An injury can also happen suddenly, if you step off a curb in a way that twists the arch of your foot, for example, or slip on a wet surface.

Whatever the reason, to avoid overuse, injuries, and arch pain, aim to:

• Wear supportive shoes that offer good arch support

• Wear arch supports to keep your feet in their ideal position

• Pace yourself: increase your activity level gradually

• Cross-train: vary the types of exercise you do each day, and incorporate low-impact exercise such as walking or swimming to use different muscle groups, which will help prevent overuse injuries

Signs You Should See A Doctor

Home remedies such as the classic R-I-C-E (rest, ice, compress, elevate) may suffice for minor foot pain. If this doesn’t resolve the problem, you may need to see a doctor. 

Schedule an office visit if you:

• Have constant, burning arch pain, numbness, or tingling, involving your foot 

• Have swelling that doesn’t improve after two to five days of home treatment

• Have persistent foot pain that doesn’t improve after several days

Seek immediate medical attention if you:

• Have an open wound

• Have signs of infection, such as redness, warmth and tenderness in the affected area, or if you have a fever over 100º F (37.8º C)

• Are unable to walk or put weight on your foot

• Have diabetes and have a wound that isn’t healing or is deep, red, swollen, or warm to the touch

Ways to Prevent Arch Pain

The best way to prevent arch pain is to love your feet! Recognize them as the foundation of a healthy body, and do something special for them on a regular basis — such as a foot massage, or an Epsom salt soak. Your feet will appreciate the TLC.

On a day-to-day basis, you can avoid arch pain by taking smart steps to maintain healthy feet:

• Wear shoes in good condition that have arch support

• Invest in arch support insoles that are designed to support all four arches of the foot

• Stretch before and after exercise to relieve tightness and help relax your arches

• Don’t exercise with an injury! Allow time to heal.

Try Personally Fit Arch Supports

Once your doctor has given you the “all clear” on any specific foot health issue, try personally fitted arch supports to keep your soles in superb shape going forward. 

Good Feet Arch Supports are distinctly different from insoles you can buy off the rack at a pharmacy. They’re personally fit to your specific needs by a Good Feet Arch Support Specialist. During your Free Fitting and Test Walk, a trained Good Feet Arch Support Specialist will spend up to an hour getting to know you and your feet. They’ll ask about your lifestyle and activities, work environment, and the type of footwear you prefer.

You can walk around the store for as long as you like to get a sense of which arch supports feel the best. This try-before-you-buy approach is one of the hallmarks of our precision fit. If you decide to buy Good Feet Arch Supports, you can wear them home the same day.

Stop into any of our 200 stores nationwide whenever it’s convenient for you, or make an appointment. The choice is yours. We look forward to helping you maintain healthy, strong arches.

Arch Pain | Symptoms, Causes & Treatment by Sydney Heel Pain

ARCH PAIN TREATMENT OPTIONS

• Strapping
• Orthotics where necessary
• Footwear changes
• Shock wave therapy
• Stretching
• Immobilisation boot

CASE STUDY – ARCH PAIN WITH WEIGHT GAIN BY KARL LOCKETT, SPORTS PODIATRIST

HISTORY – ARCH PAIN

A 44-year-old lady presents to the clinic with arch pain in her right foot which came on gradually. She reports an increase in body weight, gaining 14 kilo’s in approximately 6 months. The arch pain started 3months ago, around the time she was starting to feel her body weight was becoming a problem. Mrs X had been through an extremely stressful period at work and this meant she stopped visiting the gym. Her eating habits also became an issue and this compounded the weight gain problem. As her body weight increased she became aware of a mild arch pain and some general fatigue in her foot muscles. She would release the stiffness in her feet with a spiky ball at home and this provided temporary relief. In addition to the onset of arch pain and fatigue, she felt her calf muscles tightening and she would occasionally experience cramps, particularly in the evenings. Mrs X described the pain as a burning sensation under the sole of her foot and a sharp pulling sensation. She would often stop mid stride, and stand still, as the stabbing pain was extreme and she felt like her arch was tearing. One week ago, she went to see her regular physiotherapist who applied some rigid sports tape to her foot, and this provided short term relief.

HER ARCH PAIN WAS WORSE IN FLAT SHOES

Mrs X brought a large selection of shoes to her consultation and wondered if her arch pain and general foot fatigue was due to her choice of footwear. Amongst the collection were 3 pairs of ballet flats, a pair of Merrell street shoes, and some flat and flexible office shoes. Not one pair of her shoes had mid sole support or a small heel. The uppers were soft and flexible and also lacked support.

Mrs X did have a pair of Asics sports shoes too, although she did not bring these along to the consultation, as she had not worn them for some 6 months at the gym. On the odd occasion that she did wear the Asics running shoes she explained that her arch pain would subside and she could spend longer on her feet. This allowed her to carry out some household chores and go for an occasional walk without too much discomfort.

HER ARCH PAIN WAS DUE TO PLANTAR FASCIITIS

Mrs X was referred to the imaging centre for an Ultra sound scan of her painful foot. She was relieved when the report explained the cause of her arch pain, describing inflamed Plantar Fascia – a condition commonly known as Plantar Fasciitis. Plantar Fasciitis can cause pain in the heel and the arch of the foot and is common in people carrying extra body weight. The Sports Podiatrist reassured Mrs X that Plantar Fasciitis was a common condition that was treatable, and that she would make a full recovery within a month or 2, once treatment commenced.

PHYSICAL EXAMINATION OF ARCH PAIN

The medical report from the imaging centre had already described Plantar Fasciitis as the cause of this lady’s arch pain and the physical examination revealed typical findings. There was pain on palpation of the Plantar Fascia, distal to the heel and along the medial slip. Her peroneal tendons were unremarkable and there was no heel pain. Mrs X was able to walk in her bare feet without limping, but was unable to perform a single leg heel raise without pain. This is typical in patients with arch pain as the exercise loads the Plantar Fascia and pulls through the arch.

FACTORS CAUSING THE ARCH PAIN IN MRS X

The increase in body weight was clearly a contributing factor in the onset of Mrs X’s arch pain. The weight gain adds load to the feet and causes stress and strain on muscles and tendons. When the weight gain occurs quickly, the feet don’t always cope with the extra stress and the Plantar Fascia can become overloaded. This leads to the micro tearing and inflammation of the Plantar Fascial fibres.

In addition to this, the extra body weight leads to an increase in calf muscle bulk and tightness. This muscle group works harder during stance and push-off in heavier patient’s. The stiffness in these muscles, which are attached to the back of the heel, causes a stronger pulling action on the back of the foot. This in turn causes a stronger pull through the sole of the foot, which can lead to strain in the Plantar Fascia and result in arch pain.

There’s a fairly good case that would suggest Mrs X would not have developed this acute arch pain had she worn more supportive shoes. Ballet flats, and any shoes that are flat and flexible are likely to cause problems in heavier patient’s, if used for longer periods.

TREATMENT OF MRS X ARCH PAIN

It was explained to Mrs X that she needed to lose weight in order to help her fatigued feet and reduce this chronic and acute arch pain. She was already aware of this and explained she can’t walk for exercise, to burn the calories. She was advised to swim and perform resistance training for her upper body. Mrs X enquired about the use of prescription orthotics. She felt her feet were more unstable since gaining weight. The Sports Podiatrist
explained to Mrs X that the orthotics were a valid treatment option, and that the Carbon Fibre material would be the preferred choice. These are a firm material but are streamlined and less bulky, and so fit into more shoes more easily. They would have slow release poron to provide cushioning and the support from these orthotics would reduce the strain on the whole foot, particularly the arch. This would allow the arch pain to resolve over time, as the micro tears and inflammation subsided.

FOOTWEAR CHANGES

A comprehensive list of appropriate shoes that would offer support and accommodate the orthotics was given to Mrs X. These were tailored to her foot type and body weight. Work shoes, casual shoes and trainers were all recommended.
OTHER

As a temporary measure, rigid sports tape was applied to both feet and this would be used until the orthotics were ready for fitting. Calf massage was also recommended and a comprehensive stretching programme was applied.

2 WEEKS ON

After 2 weeks, Mrs X returned to be fitted with her orthotics. Her pain level had not changed when the arches were palpated. However, she did feel more stable and slightly more comfortable with the strapping in place, and the new shoes on her feet.

6 WEEKS ON

Calf range had improved and pain had reduced by 40%. Mrs X was compliant with stretching but was not applying ice packs to her feet on a daily basis. Her orthotics were very comfortable and were helping. She wore them every day. She had lost 2.5 Ks in weight, partly due to dietary changes and partly due to swimming.

10 WEEKS ON – MINIMAL ARCH PAIN

Mrs X reported that her arch pain had virtually gone. There was some mild discomfort if she was standing still, without walking, for extended periods, as she had recently done at a work conference. However, she was very comfortable and free from pain at all other times. When palpating her arches, she did not flinch and reported mild tenderness but to pain.

Mrs X was asked to continue her change in eating habits but to now introduce walking. 3 k’s to commence and only twice a week. Her stretching must continue and her training programme would be modified in due course, increasing gradually.

PLEASE NOTE: The information in this case study is specific to one individual patient and should not be taken as general advice. If you have arch pain or a condition causing discomfort in your feet, you should seek the help of a Sports Podiatrist.

For more information, click here: Plantar Fasciitis

Written by Karl Lockett

Foot injuries

Various foot injuries often occur in the course of daily activities in different groups.

Athletes are especially prone to foot injuries – for example, foot injuries in gymnasts account for up to 31% of all injuries.

The most common foot injuries are discussed below.

Dislocations of the foot

Such injuries are the result of an unfortunate fall from a height.

At this moment, the foot tucks in and, from a strong blow, flies out of the ankle joint together with the talus.

These injuries are usually associated with leg fractures and ligament injuries.

The final diagnosis of dislocation of the foot is made on the basis of x-ray data.

These dislocations are reduced under anesthesia or anesthesia.

Depending on the type of injury, the trauma specialist will move the foot in one direction or another.

After that, plaster is applied to the damaged part for about 2 months, the limb can be loaded after a month.

In some severe cases, osteosynthesis is required.

Fracture of the talus

As a rule, such a fracture is the result of a severe car accident, a fall from a height.

Fractures of the talus are often associated with other severe injuries, such as comminuted or compression fractures of other bones.

The body, neck (the most common type of fracture), or posterior process of the talus may fracture.

If the bone fragments are not displaced, then plaster is applied for up to 3-4 months. With displacements, it is necessary to reposition the bones.

Fracture of the calcaneus

Occurs after a sharp fall from a significant height and is usually associated with compression fractures of the spine.

In fact, during such an injury, the talus flattens and then breaks the calcaneus.

In the treatment of a calcaneal fracture, the arch of the foot is modeled and a cast is applied. In more complex cases, reposition with the Ilizarov apparatus or osteosynthesis will be required.

Metatarsal fracture

Appears after a strong blow or a heavy fall on the leg from a height. During the treatment, the surgeon models the arches of the foot and then applies a cast.

If displacement has occurred, then under anesthesia the bones are aligned first in length and then in width. In severe situations, surgery may be required.

Fracture of the toes (phalanges)

Occurs after compression or a fall from a height. Most often, the distal phalanges suffer, where comminuted fractures are diagnosed.

If the fracture is not displaced, wearing a splint for a couple of weeks is sufficient.

If you need to fix the fragments, you will need to insert a pin and apply a simulated plaster splint.

Subtalar joint dislocations

Can be internal or external, anterior or posterior, usually occurs after indirect trauma.

During treatment, the traumatologist will first stretch the leg along the axis of the leg, and then sharply take it to the side opposite to the dislocation.

If a dislocated bone can be set in this way, surgical intervention is used.

Chopart joint dislocation

If a person falls on the forefoot or receives a strong blow to the midfoot area.

As a result, the ligaments between four bones are torn: calcaneus, navicular talus and cuboid.

The forefoot itself is displaced to the medial, dorsal, lateral or plantar sides.

If the fracture is uncomplicated, then one-stage reduction is performed, in other cases, arthrodesis and wearing the Ilizarov apparatus are required.

Dislocations of the Lisfranc joint

Caused by a fall from a height or severe compression, such as being squeezed by a wheel.

Usually these are dorsal and lateral dislocations, a little less often – plantar or medial.

Lisfranc dislocations can be complete, when all bones are affected, or isolated. But in this case they are often combined with fractures.

During the treatment, the foot is fixed and a strong pull is made on the anterior section.

The bones are then straightened by hand. Sometimes a needle is inserted for convenience, in difficult cases the Ilizarov apparatus is installed or arthrodesis is performed.

Dislocation of the toes

The causes of this dislocation are the same as those of the other injuries mentioned above. The most dangerous injury is the thumb.

This dislocation can be hydraulically reduced by injecting novocaine until the finger straightens on its own. Then a plaster cast is applied.

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