CAUSES & MANAGEMENT
An Article Written by Yen-Chii Wong
Podiatrist – New Step Podiatry
Painful arches can make it difficult to walk and stand. In the arch of the foot, muscles, ligaments, and joints work together to keep our feet functioning efficiently, but sometimes they need a little help along the way. There are three main arches in the human foot, but we commonly see arch pain in the medial longitudinal arch.
What’s in the arch of the foot?
There are 4 layers of muscles that sit on the underside of the foot – we call these intrinsic foot muscles. They run purely underneath the foot and don’t attach anywhere above the ankle joint. Three of the largest intrinsic muscles are:
– Abductor hallucis
– Flexor digitorum brevis
– Quadratus plantae
These muscles work with the plantar fascia, which stretches from the heel to the ball of the foot. They help to keep the foot stiff and springy when it’s coming off the ground (podiatrists call this the toe-off phase of gait) and loose and floppy when it’s flat on the ground (we call this midstance).
These movements help our feet store and return energy when walking, running, and jumping! The intrinsic foot muscles also:
– Help us maintain balance
– Prevent the arch from collapsing and helps it absorb loads going through the foot
Along with the intrinsic foot muscles, there are many ligaments, extrinsic muscles (these run up into the leg), tendons, and fascia that also support the arch.
What can cause arch pain?
– Starting a new job or sport that requires a sudden increase in the amount of time you spend on your feet
– Having a job where you are standing or walking for long shifts
– Wearing shoes with improper support
– Direct trauma to the area
– Reduced ankle range of motion
– Reduced or hypermobile 1st MPJ (big toe joint) range of motion
– Weak or imbalanced intrinsic foot muscles
– Prolonged pronation when walking, placing more strain on the muscles through the arch
– Rigid, stiff foot type which doesn’t allow for enough shock absorption
– Presence of midfoot osteoarthritis or other inflammatory arthritis conditions – this is particularly relevant for dorsal interosseous compression syndrome, which is an irritation or inflammation of the joints and ligaments on the top of the midfoot.
Does it matter if I have a high or low arch?
The shape of your arch while sitting or standing still doesn’t mean you will develop arch pain. It’s all about how well these intrinsic muscles can adapt to the activities you’re doing. However, if your foot is less efficient at moving in (pronating) and out (supinating) when it needs to when walking, there may be increased forces going through your arch muscles, joints, and ligaments. If they aren’t used to moving regularly with this amount of force, they can start to feel sore and cause pain.
What can podiatrists do for arch pain?
– Manage your training load if your arch pain is related to your sporting activities.
– Provide ways to offload painful structures in the arch. This can mean in-shoe padding, temporary strapping or bracing, changes in shoes, and foot orthoses.
– Recommend exercises to stretch and strengthen the weak or tight arch muscles for relief and to reduce the risk of arch pain recurring in the future.
– Use hands-on therapy if needed – this includes shockwave therapy or foot mobilisation.
– Refer for x-ray, ultrasound, MRI, or CT imaging if needed.
Book an Appointment at Our Canberra Clinic for a biomechanical assessment to help you with your arch pain
Our podiatrists are here to ensure those in Canberra have access to quality services that can help individuals get the treatment they deserve. Easily book an appointment at our clinic online or give us a call on 02 6198 4818.