Introduction

The average person takes between 8,000 and 10,000 steps per day. In addition many of us are engage in activities such as running and aerobic exercise that add many more steps and stress to our poor over worked feet. It is no wonder that many people have aches and pain in this part of the body. Factors such as flat feet or over-pronated feet, our walking and running style, the type of shoe wear can determine if we will get foot and ankle pain. However these factors can also affect the health of your back, knees and legs. Below are a few of the common conditions that affect the feet and ankle.

Pes Planus ( Flat Feet )

Flat feet or Pes planus as it is called by the medical community is very common and it is estimated that at least one quarter of the population has flat feet. We are all born with flat feet and somewhere between the ages 3-10 we develop and arch. However in certain people this development never occurs. Besides genetic causes, there are a number of factors that can cause flat feet or predispose people to the condition. Sometimes people develop arches only to have them collapse later in their life. This often depends upon their lifestyle, job and level of activity. Age and weight also play a role in the condition's development. Middle-aged people who have been working on their feet for years often experience flat feet, as do overweight people who are placing added stress on their feet and legs.

normal adult foot

pes planus

Having flat feet does not necessarily mean you will have pain as it's possible for people to have the condition and never feel any discomfort. For people who do develop pain, it usually occurs in the feet and knees, and possibly in the hips and lower back. If you suspect you have flat feet and do experience pain you should see your chiropractor especially to determine a plan of management that can ease pain or prevent symptoms from developing. A number of options, including prescribing arch-supporting insoles called orthotics and performing joint adjustments can improve foot function and alleviate any symptoms.

Plantar Fasciitis ( Heel Pain )

One of the most common of the foot ailments is heel pain and the cause is usually inflammation of the plantar fascia or plantar fasciitis. The plantar fascia, is a band of connective tissue that surrounds the muscles on the bottom of the foot . It connects the heel bone to the ball of the foot, supporting the arch, protecting the foot and absorbing shock.

Patients with plantar fasciitis often complain of pain in the morning after first standing when they get out of bed and when the stand after they sat for a while. The pain originates just in front of the heel bone, but can spread over the entire bottom of the foot. Over time, inflammation associated with the condition can lead to the development of scar tissue, calcium deposits and eventually heel spurs. These spurs are a bony growth on the front part of the calcaneus of heel bone where the plantar fascia attaches and can sharp stabbing pain with walking.

There are many factors that contribute to the development of plantar fasciitis though people who have other foot conditions, especially pes planus (flat feet) and over-pronation are most susceptible. One of the most important factor is muscle imbalances between the calf muscles and the muscles on the bottom of the foot which both attach to the calcaneus or heel bone. Often the calf muscles get short and tight exerting a strong pull upon the back of the calcaneus. This causes undo stress upon the smaller and weaker plantar muscles and its fascia that attach to the other side of the calcaneus. Wearing high heels will cause a shorting and tightening of the calf muscles as well as running and jumping activities. Other factors that stress the plantar fascia include: sudden strenuous activity after a period of long-term inactivity, abnormal walking patterns, improper footwear, walking on hard or uneven surfaces especially barefooted, and obesity.

People who are constantly on their feet, such as nurses, teachers and waiters, are more susceptible, as are athletes who participate in foot-stressing activities such as aerobics, volleyball, running, basketball and tennis.

Once one develops plantar fasciitis, it is often difficult to manage and can become very painful and persistent. A chiropractor will be able to determine the cause of your problem and what treatments are best suited. These might include ultrasound therapy, joint manipulation, muscles stretching and strengthening exercises, special strapping and in some cases orthotics.

Hallux Valgus - Bunions

Hallux valgus is a condition when the big toe or hallux deviates towards the outside of the foot often almost overlapping or bumping in to the adjacent toe. It is a slow developing condition that usually develops a bump on the inside of the big toe often called a bunion.

The pain associated with Hallux Valgus is usually felt during weight bearing activities such as walking or prolonged standing. However if someone has developed a bunion the pain can be present at rest and if often described as a "numbing" or "burning" sensation in the big toes.

To be exact, the actual problem is not in the bone itself but in the joint between the big toe and the 1st metatarsal bone, the 1st metatarsal-phalangeal. It is the damage to this joint that causes the pain and deformity associated with Hallux Valgus. The condition is usually the result of wear and tear over a long period of time from factors such as over-pronation which causes abnormal pressure on the big toe and first metatarsal during walking. Other causes of hallux valgus include inflammatory arthritis that can damage the joint and cause degenerative changes. A broken toe that does not heal properly can also predispose a person to hallux. However one of the more common causes of the problem is the high heeled and pointed shoes that women often wear. These shoes not only put extra stress upon the joint but also help to push the big toe to the outside. It is know wonder that women have the condition much more often than man.

If you have hallux valgus, your chiropractor can examine your foot to determine which factors contributed to your condition. He or she can then use a number of techniques and modalities to decrease pain and improve your foot's function.

Metatarsalgia ( Pain in the ball of the foot )

Metatarsalgia is sometimes called ball-of-foot pain, a pain in the area on the sole of the foot just behind the toes where the foot bends during walking. The pain is actually caused by a problem in one or more of the five metatarsal bones that extend from about half way up the foot to the toes.

While many patients with metatarsalgia feel pain where their metatarsal bones join their toe bones, some also feel pain along the entire length of the metatarsals and possibly between them. Problems in this area can vary from a stiff and stiff feeling when you move these bones to a burning or stinging sensation. This depends upon whether the problem is due to a dysfunction in the joints or an irritation to the nerves as they travel along the metatarsals.

The cause of the condition can vary but the cause is due to either structural or functional reasons. An example of a structural causes is when the metacarpal bones are either too long or too short causing abnormal mechanics in the feet and too much stress upon this area. Flat feet or excessive arch can also alter the stresses on the metatarsals causing similar symptoms.

There are other factors that can affect these bones that are often in the control of the individual. These include excess body weight, tight or high-heeled shoes, and excessive or poor running or athletic training. Excess weight and wearing high-heeled shoes increases stress upon the metatarsal which leads to joint pain and nerve irritation. Repetitive foot activities, like running, directly stress the metatarsals by exposing them to constant trauma.

Regardless of the cause, your chiropractor can effectively care for metatarsalgia. After determining what factors are underlying your condition, he or she can offer a variety of non-invasive therapies including orthotics as well as advice on how you can avoid future pain.

Achilles Tendonitis

Achilles tendonitis is a painful and often debilitating inflammation of the Achilles tendon, also called the heel cord. This large tendon is an extension of the two biggest calf muscles and runs down the back of the lower leg attaching to the heel bone or calcaneus. Injury to this important tendon can make it difficult or even impossible to walk. The problem may be caused by a sudden single incident such as jumping, but more commonly it results from an accumulation of smaller stresses that produce small tears in the tendon over time. In most cases, the appearance of symptoms is gradual. The discomfort may be relatively minor at first, but gradually worsens if the patient tries to "work through" the pain. Many Achilles tendonitis sufferers attribute their initial discomfort to the aches and pains that accompany age or fatigue. In severe cases, a total rupture of the tendon can occur, resulting in traumatic damage and severe pain. Such injuries can make walking virtually impossible and may even require corrective surgery.

Achilles tendonitis is often associated with athletes and performers such as dancers who are involved in running and jumping activities especially involving sudden starts and stops. However, women who typically wear high-heeled shoes are also at risk especially if they switch to sport shoes for exercise. In these cases, the Achilles tendon and muscles gradually adapt to a shortened position created by wearing high-heels, as the heel does not have to stretch all the way to the ground. When this occurs, the switch to exercise or flat shoes forces the Achilles tendon to stretch further than it is accustomed to causing stress and inflammation. For these reasons, high heels should not be worn everyday. If they are deemed necessary, stretching should be done every morning and night to keep Achilles tendon lengthened.
Achilles tendonitis often appears in middle-aged people, especially men who are athletes, due to the changes that occur in the foot as we age. Our arch tends to flatten as we grow older causing over-pronation and increased stress upon the Achilles tendon and the calf and foot muscles. Similarly, problems are also is common in the "weekend warrior" who exercises infrequently, and those who are just starting to exercise. In such people, the muscle and tendon have little flexibility due to inactivity and overdoing exercise in the beginning can cause tendonitis. Therefore, people who are just starting to exercise after a long layoff should stretch properly, start slowly, and increase gradually.

Regardless of the cause of the problem if one is experiencing the symptoms of Achilles tendonitis they should consult a qualified professional such as a chiropractor to manage the problem before it becomes severe.

Chiropractic care provides state of the art diagnosis and treatment for problems associated with any of the above mentioned conditions of the feet & related structures. Please see our treatment pages for a discussion on how we can help your problem.