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  • Northeast Wisconsin
  • October 2018
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Why do my feet hurt?

There are many reasons why our feet may hurt. Often times, we are told (or we assume) we are suffering from a commonly diagnosed condition called “plantar fasciitis.” Although this may be true, there are several other possibilities that are frequently overlooked. Effective treatment with lasting relief is dependent on discovering the true source of the pain.

As a physical therapist, I see lots of feet. When I was fresh out of school (18 years ago, ugh!), I jumped on the plantar fasciitis bandwagon and targeted that tissue for my treatment. Although this often helped, it took a very long time for the pain to resolve. Thankfully, my thought process and skills evolved as I gained experience and took more continuing education on the topic of feet. Today, my most effective care occurs when I look beyond the plantar fascia and truly search for other sources of pain. The following list includes plantar fasciitis as well as some other possibilities for your sore feet.

Plantar fasciitis classic characteristics

  1. Pain in the morning upon initial step onto the floor or after sitting for a while
  2. Pain can be better with activity but then returns as the activity continues
  3. Tender at the origin of the plantar fascia on the underside of the heel and/or in the arch

What causes it?

  1. Endurance sports
  2. Prolonged standing/walking (micro trauma over years)
  3. Change in activity or overuse

How to treat it

There are many, many options for treatment: arch supports, strengthening of foot muscles, stretching lower leg muscles and plantar fascia, night splints, ice, rest, etc.

Pain in your arch could also be from...

  • Tightness and/or muscle knots in your lower leg muscles that refer pain to your feet (including gastrocnemius, flexor digitorum longus, abductor hallucis and/or your tibialis posterior)
  • Lack of motion in the joint directly below your main ankle joint known as the subtalar joint

Pain in your heel could also be from...

  • The fat pad in your heel. The thickness of this natural cushion diminishes with age providing less overall shock absorption. Bones can hurt when pushed on; therefore, if this cushion has shrunk, and you are barefoot or wearing hard shoes, your heel can hurt. This fat pad can also get inflamed from repetitive impact, standing too long and direct trauma.
  • Lack of motion in your primary ankle joint (talocrural) and/or your subtalar joint.

How to prevent foot pain and take better care of your feet

  1. Keep your feet and ankles strong
    • Arch lift: While standing, lift your arch while keeping your heel and the bases of your big toe and little toe on the ground. Try to avoid scrunching your toes. Make sure to keep equal pressure on the front and back of your foot. Start with both feet at the same time and then progress to standing on one foot.
    • Slow heel drop: While standing with your feet hip width apart, lift your heels up and then take 3-5 seconds to slowly lower them back down. Progress to one leg at a time.
    • Toe tricks: While standing with your heel and ball of foot on the ground, lift your big toe slowly up and down while keeping your other toes in contact with the ground. Then lift all of your toes up and practice tapping your big toe on the ground by itself.
  1. Keep your calves flexible and soft
    • Two-way old school calf stretch
    • Massage
    • Foam roll
  2. Keep your hips flexible and strong. Your hips and feet work together to keep us moving. If one or the other is imbalanced (tight and/or weak), it affects how the other one functions.
    • Piriformis stretch
    • Adductor stretch
    • Hip flexor stretch
    • Bridges
    • Clamshell
  3. Wear good shoes that are right for you and your feet
    • Low heel “natural” footwear helps to strengthen our feet. However, a person’s tolerance to this will completely depend on the current condition of your feet and your overall foot type as well as the type of activity you do.
    • Modifying your footwear for a time period to treat sore feet is a viable option. For example, switching over to a more shock absorbing shoe after suffering from a heel injury can be very helpful for your recovery.
    • Supportive shoes and/or arch supports is almost always a good idea for those who are up on their feet for long periods of time and those with low arches.
    • To be perfectly honest, selecting the right footwear can be very tricky. Sometimes, it is simply trial and error. However, finding a knowledgeable salesperson at a quality shoe store combined with education on your existing foot condition and type is really the key.
    • Avoid flip flops! Your big toe has to work pretty darn hard to keep those flip flops on your feet. This is the exact opposite thing it should be doing while you’re walking. There is typically no arch support or heel cup or shock absorption or — the list goes on!
  4. Consider seeing a physical therapist as soon as your feet are hurting. It is much easier to diagnose and treat your foot condition before it compounds and gets more complicated. Physical therapists are trained to expertly evaluate and diagnose your feet and your entire kinetic chain. We are skilled to treat your soft tissue and joints with manual interventions. We are also the experts in prescriptive exercises to eliminate your pain and restore your function. 
Dr. Elizabeth Wergin, DPT, CMTPT

Dr. Elizabeth Wergin, DPT, CMTPT, is a physical therapist and owner of Juniper Physical Therapy, a holistic cash-based clinic, in Manitowoc. She earned her master’s degree in 2000 from Saint Louis University and her doctorate in 2013 from the University of Montana. She is passionate about health and wellness and loves being able to help people stay active and pain free in a natural manner. She offers direct access (no MD referral needed), hour long sessions and specializes in manual therapy and prescriptive exercise.

For more information, please visit www.juniperpt.com . Juniper PT is located at 924 Buffalo Street; Manitowoc. 920.323.9838. [email protected] https://www.facebook.com/juniperpt/ 

Website: www.juniperpt.com
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