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Pain In The Arch Causes Symptoms And Treatments

Overview
One of the most common foot maladies people suffer from is plantar fasciitis. This condition arises when undue stress is placed on the ligament in your foot that supports your arch, the “plantar fascia”. When that ligament is overworked it leads to the classic symptoms of heel and arch pain which worsens when you get up to walk after periods of rest. This isn’t the kind of pain you experience after being on your feet all day at work or walking around Disneyland with your kids. The pain from plantar fasciitis is often intense and debilitating. It is also surprisingly common. Two million Americans suffer from plantar fasciitis every year and 10 percent of the population will experience it in their lifetime. It has become recognized as one of the most chronic and, often times, most difficult foot problems to treat.


Causes
There are many causes for a high arch (cavus) foot. In the United States, the most common cause for a high arch foot is a form of muscular dystrophy called hereditary sensorimotor neuropathy. Most people recognize this by the more commonly used name of Charcot Marie Tooth disease (CMT). This is a disease of the muscles and the nerves of the legs, and occasionally of the hands, in which certain muscles weaken while others retain their strength. The condition is transmitted as an autosomal dominant condition. This means that 50% of the offspring will statistically inherit the disorder. This is, however, just a statistic. In some families, all the children develop the condition while in others, none inherit it.


Symptoms
Pain in arch of foot is really the only symptom of this condition. It is unlikely to see any swelling or bruising and instead there will be a deep tender spot near the heel. Occasionally the pain may radiate further down the foot. With this condition, pain will usually be felt first thing in the morning or after periods of sitting. This is because the plantar fascia tightens and shortens slightly when there is no weight on it and by standing on it it suddenly stretches and becomes painful. After a few steps it starts to loosen off and the pain may subside. If this is the same pattern of pain you experience it is quite likely you have plantar fasciits. Pain may also be felt when walking up stairs or standing on tip-toes (anything that stretches the fascia).


Diagnosis
The medical practitioner will examine how the muscles of your foot function. These tests may involve holding or moving your foot and ankle against resistance; you may also asked to stand, walk, or even run. Pain caused by movements may indicate the cause of the pain. The nerves in the foot will be tested to make sure no injury has occurred there. An x-ray, MRI, or bone scan of the foot and arch may be taken to determine if there are changes in the makeup of the bone.


Non Surgical Treatment
Once the severity and cause of arch and foot pain is determined, a course of corrective and rehabilitative actions can be started. Therapists may use machines and manual therapies to reduce pain and increase circulation to the area to promote healing. Maintenance of fitness levels via modification of activity may be prescribed. Substitute activities that may aggravate the pain and soreness with other activities; for instance, running causes the body to have multiple impacts with the ground, but the use of bicycling, elliptical trainers, step machines, swimming, or ski machines eliminates impact and allows you to continue to maintain and improve your fitness levels. Take medications to help reduce pain and inflammation. Follow up with your doctor until you are better.


Surgical Treatment
With flat feet, there is a tendon on the inside of the foot than can often become weakened, injured, split and/or ruptured. This tendon, is called the posterior tibial tendon, and is the main arch supporting tendon. Obviously damage to this tendon can cause collapse of the arch. Some people have genetically inefficient tendon, and tends to be the case in younger people. In mild cases, such as tendon splits, the posterior tibial tendon can be repaired to restore its strength. Acute incontinuity of the tendon can be primarily repaired. Often the posterior tibial tendon is augmented with a tendon transfer of an adjacent tendon to provide both strength and continuity. In any tendon repair, advanced or retensioning of the tendon is performed. In most flat foot surgery a tendon augmentation is often combined with other boney procedures to restore structure and balance to the foot.


Prevention
Arch pain occurs when the plantar fascia becomes worn down due to constant strain or excessive exercising. This may be caused by increasing your running or hiking mileage too fast, wearing inadequate footwear, lack of stretching, running on steep hills, standing on your feet for too long and abnormal anatomy such as flat foot. Stretching is an important exercise that should not be overlooked because the tightness or lack of tightness of the joints in the foot can also cause pain in the arch.


Stretching Exercises
You may start exercising the muscles of your foot right away by gently stretching and strengthening them. Frozen can roll. Roll your bare injured foot back and forth from your heel to your mid-arch over a frozen juice can. Repeat for 3 to 5 minutes. This exercise is particularly helpful if it is done first thing in the morning. Towel stretch. Sit on a hard surface with your injured leg stretched out in front of you. Loop a towel around your toes and the ball of your foot and pull the towel toward your body keeping your leg straight. Hold this position for 15 to 30 seconds and then relax. Repeat 3 times. Standing calf stretch. Stand facing a wall with your hands on the wall at about eye level. Keep your injured leg back with your heel on the floor. Keep the other leg forward with the knee bent. Turn your back foot slightly inward (as if you were pigeon-toed). Slowly lean into the wall until you feel a stretch in the back of your calf. Hold the stretch for 15 to 30 seconds. Return to the starting position. Repeat 3 times. Do this exercise several times each day. Seated plantar fascia stretch. Sit in a chair and cross the injured foot over the knee of your other leg. Place your fingers over the base of your toes and pull them back toward your shin until you feel a comfortable stretch in the arch of your foot. Hold 15 seconds and repeat 3 times. Plantar fascia massage. Sit in a chair and cross the injured foot over the knee of your other leg. Place your fingers over the base of the toes of your injured foot and pull your toes toward your shin until you feel a stretch in the arch of your foot. With your other hand, massage the bottom of your foot, moving from the heel toward your toes. Do this for 3 to 5 minutes. Start gently. Press harder on the bottom of your foot as you become able to tolerate more pressure.

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