Introduction

Overall, nearly everyone takes 3,000-5,000 steps per day. Add to that activities such as running and aerobic exercise, and we add not only more steps, but stress, to our already overly-worked feet. It is no wonder that a large number of people have aches and pains in this part of the body. Determinants such as flat feet or over-pronated feet, individual walking and running style, and the type of shoe a person wears can determine if an individual will experience foot and ankle pain. These determinants not only affect feet and ankles, but also the health of the back, knees and legs. Detailed below are several of the most common conditions that affect the feet and ankle.

Hallux Valgus and Bunions

Hallux Valgus is a problem that happens when the big toe or hallux deviates towards the outside of the foot, frequently nearly overlapping or bumping into the adjacent toe. It is a slow-developing affliction that generally develops a bump on the inside of the big toe, called a bunion. Hallux Valgus pain is usually experienced during weight-bearing activities such as walking or prolonged standing, but if a bunion is visible, a “numbing” or “burning” pain in the big toes can be felt at rest.

The joint between the big toe and the first metatarsal (the first metatarsal-phalangeal) is the genuine difficulty, and not the bone, itself. The pain and deformity associated with Hallux Valgus is due to injury to this joint. Over-pronation that causes aberrant pressure on the big toe and first metatarsal during walking creates the prolonged wear and tear that many times results in Hallux Valgus. Inflammatory arthritis that injures the joint and creates degenerative changes is an additional cause. However, one of the more common causes of the problem is the high-heeled and pointed shoes that women commonly wear. These shoes not only put extra stress on the joint, but also aid in pushing the big toe to the outside.

If you have symptoms of Hallux Valgus, your chiropractor can examine your foot to determine which factors are contributing to your condition, and then use a variety of chiropractic techniques and modalities to relieve pain and improve the function of your foot.

Plantar Fascitis ( Heel Pain )

One of the most prevalent foot ailments is heel pain, and the cause is usually aggravation of the plantar fascia or Plantar Fascitis. The plantar fascia is a band of connective tissue that encircles the muscles on the bottom of the foot . It attaches the heel bone to the ball of the foot, supporting the arch, protecting the foot, and absorbing shock.

People with Plantar Fascitis many times complain of pain in the morning after first standing when they get out of bed and also when they stand up after having sat for a while. The pain begins just in front of the heel bone, but can advance over the entire bottom of the foot.

Over time, inflammation associated with the problem can lead to the development of scar tissue, calcium deposits and eventually heel spurs. Heel spurs, a bony growth on the front part of the calcaneus of the heel bone where the plantar fascia is connected, can cause a acute stabbing pain with walking.

There are many factors that contribute to the development of Plantar Fascitis though people who have other foot conditions, especially Pes Planus (flat feet) and over-pronation are most susceptible. Muscle imbalances between the calf muscles and the muscles on the bottom of the foot are a powerful contributing factor. Frequently the calf muscles get short and tight exerting a strong pull upon the back of the calcaneus. This produces unnecessary stress on the smaller and weaker plantar muscles and its fascia that attach to the other side of the calcaneus. In addition to running and jumping activities, wearing high heels can also create a shortening and tightening of the calf muscles. Other factors that stress the plantar fascia include: sudden strenuous activity after a period of long-term inactivity, abnormal walking patterns, inappropriate footwear, walking on hard or uneven surfaces especially barefooted, and obesity.

Nurses, teachers, and waiters who are required to be constantly on their feet, and those whose activities include aerobic, volleyball, running, basketball, and tennis are more susceptible to Plantar Fascitis.

Once a person develops plantar fascitis, it is often hard to manage and can become very painful and persistent. A chiropractor will be able to determine the cause of your problem and what care is best suited. Treatment might include ultrasound therapy, laser, joint manipulation, muscle stretching and strengthening exercises, special taping and, in some cases, orthotics.

Achilles Tendonitis

The Achilles tendon (the heel cord), is a large tendon that is a continuance of the two largest calf muscles. It goes down the back of the lower leg and attaches to the heel bone. Achilles Tendonitis is an extremely painful, and often debilitating inflammation of the tendon. Injury to this important tendon can make it hard or even impossible to walk. The challenge may be caused by a sudden single incident, such as jumping, but more commonly it results from an accumulation of smaller stresses that create small tears in the tendon over time. Generally, the appearance of symptoms is gradual. The pain may be relatively minor at first, but continuously worsens if the sufferer tries to “work through” the pain. Many Achilles tendonitis sufferers ascribe their initial discomfort to the aches and pains that go along with age or fatigue. In severe cases, a total rupture of the tendon can occur, resulting in traumatic injury and intense pain that makes walking virtually impossible and may even require corrective surgery.

Achilles tendonitis is many times associated with athletes and performers, such as dancers, who participate in running and jumping activities, particularly those that involve sudden starts and stops. Also at risk are women who regularly wear high-heeled shoes then switch to sport shoes for exercise because the tendon and muscles have gradually habituated to the shortened position caused by wearing high-heels. When this happens, the change to exercise or flat shoes forces the Achilles tendon to stretch further than it is accustomed to, hence creating stress and aggravation. If possible, high-heels should not be worn everyday. But, if it is unavoidable, then stretching every morning and night can help to keep the Achilles tendon lengthened.

As mentioned above, Achilles tendonitis is often age-related, especially in men who are athletes. As a person ages, the arch tends to flatten causing over-pronation and increased stress on the Achilles tendon, as well as the calf and foot muscles. Similarly, problems are also common in the “weekend warrior” who exercises infrequently, as well as those who are just commensing to exercise. In such people, the muscles and tendons have little flexibility due to inactivity, and overdoing exercise in the beginning can cause tendonitis. Therefore, people who are just commencing to exercise after a long layoff should stretch properly, start slowly, and increase gradually.

Regardless of how it happened, if you are experiencing Achilles tendonitis symptoms, it is important for you to see a qualified professional. Your chiropractor is a highly-skilled professional who can help you to manage the condition before it becomes severe.

Pes Planus ( Flat Feet )

Flat Feet, or Pes Planus as it is called by the medical community, is quite prevalent. It is likely that at least one quarter of humans have flat feet. Human beings are not born with an arch, but develop them somewhere between ages 3-10. However in certain people this development never happens. Along with 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 lifestyle, job, and level of activity. Age and weight also play a role in the development of the affliction. Middle-aged persons 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.

Some people have flat feet and never feel any distress, while others experience pain in the feet and knees, and occasionally in the hips and lower back as well. If you feel you have flat feet and are experiencing pain, you might want to see your Camarillo chiropractor to determine a plan of treatment that can lessen your pain and prevent more symptoms from developing. Chiropractic therapy includes joint adjustments to promote good foot function and alleviate painful symptoms. Your chiropractor may also prescribe arch-supporting insoles, called orthotics, for additional support and stability.

Metatarsalgia ( Pain in the ball of the foot )

Metatarsalgia, sometimes called “ball-of-foot pain,” is a pain in the bottom of the foot just behind the toes where the foot bends during walking. The metatarsal bones extend from halfway up the foot to the toes. A dysfunction in one or more of these five bones is the cause of pain.

The feeling of pain can be limited to where the metatarsal bones attach the toe bones or it can extend along the entire length of the metatarsals, and likely between them. Discomfort in this area can vary from a stiff feeling upon movement of these bones to a burning or stinging sensation. The degree of discomfort depends upon whether the condition is due to a dysfunction in the joints or an irritation to the nerves as they travel along the metatarsals.

The cause of the problem is due to either structural or functional reasons. An example of a structural cause is when the metacarpal bones are either too long or too short producing abnormal mechanics in the feet and too much stress upon this area. Flat feet or extreme 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 sufferer. These include excess body weight, tight or high-heeled shoes, and excessive or poor running or athletic training. Excess weight and the wearing high-heeled shoes both add to stress upon the metatarsal, which leads to joint pain and nerve aggravation. Repetitive foot activities, like running, directly stress the metatarsals by exposing them to constant trauma.

A chiropractor is able to effectively treat metatarsalgia, no matter what the cause may be. After determining the underlying factors, you will receive a number of non-invasive therapies, inluding orthotics when necessary, and you will be advised on how you can avoid future pain.

See your Camarillo chiropractor as soon as possible if you are experiencing any of the foot problems mentioned above.

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