Plantar fasciitis is an irritation of the plantar fascia - the tough tissue on very bottom of the foot that begins at the heel and is attached to the toes. It can result in pain and lead to a heel spur, a bony growth on the underside, forepart of the heel bone. This kind of pain is usually at its worst in the morning, then gradually diminishes during the day. Heel spurs are caused by straining the foot muscles, stretching the long band of tissue connecting the heel and the ball of the foot, and by repeated tearing of the lining of the membrane that covers the hell bone.
Metarsalgia is pain in the forefoot, usualy caused by the over-prominence of one of the metatarsal heads,i.e., the heads of the bones in the ball of the foot. All of these overuse conditions can be aggravated by excessive pronation. Pronation is when the foot rolls toward the outside as the heel hits the ground and rolls toward the forefoot.
Most People associate repetitive motion injuries with the hand and wrist - but did you know that your feet and ankles are also vulnerable? People who are on their feet all day - athletes, salespeople, trial lawyers, teachers, nurses - are at risk for a variety of foot and ankle disorders, including tarsal tunnel syndrome can be just as pa
inful. As with many foot problems, tarsal tunnel syndrome can often be blamed on shoes that do not provide enough arch support and heel stability.
Flat feet, also called " pancake feet," is a condition in which the arch is judged to be lower than normal. There are many degrees of "flat feet," and some physical therapists will point out that curve of a "normal" arch is subjective judgment. Nevertheless, flat feet can cause discomfort and sometimes can lead to plantar fasciitis or other problems.
High arches, as opposed to flat feet, is a condition in which the arches are higher than normal. The main concern here is to make sure that the shoes have enough surface contact and support for the arches; otherwise, the stresses put on the foot and ankle can move "up the chain" through the legs and spinal column. In some cases, high arches may require custom orthopedic shoe inserts to prevent more serious problems.
How Physical Therapy Can Help
While physical therapy is by definition tailored to the individual's problems and needs, certain procedures are common in dealing with foot and ankle disorders. Typically a physical therapist will begin your rehabilitation by taking a detailed history and evaluation of your foot and ankle problem.
The second part of your theraphy is often gait analysis, in which the physical therapist observes you as you walk, or in some cases, run. The physical therapist will take detailed notes, sometimes using video cameras as a diagnostic tool.
At this point, the physical therapist may assess your range of motion - how far and in what directions you can move your foot and ankle, with and without assistance. The physical therapist may also perform tests to assess the strength, sensation and blood circulation in your foot and ankle.
Special tests may be performed as needed, including assessments of individual joints and ligaments. A biomechanical assessment can determine how the foot and ankle align with the lower extremities.
