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  • Writer's pictureMary Brooking

Foot pain or injury? Step this way ….

Updated: May 23, 2023

The human foot: 26 bones and a multitude of muscles, tendons and ligaments are present in an incredible structure that helps keep us upright, doesn’t fatigue and uses both longitudinal and transverse arches to be the stable foundation of our body and our movement. And yet we are very capable of taking it for granted, ignoring aches and pains and attributing them to time spent standing.

Unfortunately, when foot injuries do occur they often have a profound impact on mobility and overall well-being. My mind has been sharply focussed on my foot recently due to a broken toe and its ongoing consequences, and I’m appreciating the benefits of a strong, mobile foot as never before. In this post, I'm exploring common foot injuries and also prevention strategies to give us the ability to continue enjoying using, but hopefully not taking for granted, our amazing feet.

Morton’s Neuroma A neuroma is an abnormal enlargement of nerve tissue, and a Morton’s neuroma is a thickening or swelling of the tiny nerves passing between toe joints, commonly the third and fourth toes, which can then become irritated by pressure from the toes and the ground. It can feel like a burning pain in the ball of the foot, tingling or numbness in the toes or the sensation of having a pebble in your shoe.

It can occur as a result of wearing tight, pointed or high heeled shoes, repetitive movements such as running, following an injury to the foot and due to other foot conditions such as bunions or flat feet. An ultrasound scan provides an effective diagnosis, or if you feel or hear a click when your toes are squeezed together this is another sign of a Morton’s neuroma.

Treatment initially includes orthotics, toe separators & foot strengthening with further options of injections or surgery being possible if these are not sufficient to make symptoms manageable. Wearing well cushioned shoes with a wide toe box that allows your toes to move freely and avoiding high heels is also important. Bunions This condition arises when the big toe moves towards the other toes making the big toe joint prominent on the inside of the foot. There is a hereditary aspect to bunions but wearing tight, high heeled or pointed shoes can also be a cause.

The change in position of the big toe alters the mechanics of the gait cycle which can become problematic for running, walking and other activities. The foot will no longer plant and then push off a flexed big toe but will roll over its inside edge which can put additional pressure on the calves, knee and hip meaning they are more prone to injury.

Orthotics, toe separators and strengthening both the foot and the whole of the leg to maintain alignment of ankle, knee and hip will form the beginning of any treatment, together with wearing wide fitting shoes with no heel.

Metatarsal stress fracture A stress fracture (which used to be called a hairline fracture) is an overuse injury leading to tiny cracks in bones. Its common in the long bones of the foot, most commonly affecting the second and third metatarsals.

These fractures typically occur due to a repeated movement which stresses the bone, often following sudden increases in activity levels. The result is pain on movement which increases as the movement is repeated, and reduces on rest. Pain is very local with no pain touching the bone until right on the site of the fracture.

Common reasons for these developing include inappropriate footwear, biomechanics which result in high foot stress (often the result of weak hip/glute muscles), low bone density which could be due to VitD deficiency, loss of female menstrual cycle (either from menopause or amenorrhoea) or relative energy deficiency, increasing training volume or intensity too quickly.

Treatment is rest, for at least 6 weeks to allow the bone to heal. This may include using crutches and a boot to fully protect the foot in this period. Returning to activity needs to be gradual, otherwise the risk is injury will recur. The reason the initial injury occurred also need to be understood and addressed.

Plantar fasciitis Plantar fasciitis is inflammation and damage to the fascia or connective tissue that runs from the heel bone to the toes along the sole of the foot. The plantar fascia acts to protect and maintain the arch of the foot and absorb impact forces when the foot lands, whether walking, running or jumping.

Early signs include pain on the inside of the heel, just where the arch of the foot starts, first thing in the morning or after rest but wearing off quickly. It can progress so that it occurs more frequently, takes longer to wear off or becomes continual. Causes vary but a common risk factor is tight calf muscles and reduced upwards ankle flexion.

Treatment includes avoiding any barefoot walking, wearing orthotic insoles, off the shelf is fine, when possible if they don’t cause pain, warming your foot up after a period of rest before moving e.g. by writing alphabet in air with foot, regular stretching, 3 times a day of calf muscles, with both straight and bent leg to target both sets of calf muscles, foot and calf strengthening exercises.

Sports Massage can help recovery by both working on the plantar fascia itself and also on the calf muscles to increase the range of motion in the soft tissue and reduce the stress on the injury. It also encourages healing of the fibres that make up the fascia. Return to running or other aggravating activities gradually if pain doesn’t increase while running or go above a mild discomfort. Benefits of sports massage for foot injuries Sports massage helps to reduce pain associated with foot injuries by releasing muscle tension and promoting blood circulation. Foot injuries often lead to muscle tightness and imbalances which can be addressed through massage, releasing tension restoring flexibility. This, in turn, aids in reducing the risk of further injury and supports a faster recovery.

Regular sports massage sessions can enhance the flexibility and range of motion in the foot. By addressing tension in muscles and fascia/connective tissues, sports massage helps to restore proper biomechanics and allows the foot to move more freely, reducing strain and promoting overall foot health.

Preventing Foot Injuries:

While sports massage is valuable in the healing process, adopting preventive measures is essential to maintain foot health. Consider the following strategies:

  1. Proper Footwear: Choose shoes that provide ample support, a wide toe box, and appropriate cushioning. Avoid tight-fitting shoes or those with high heels. Opt for footwear that accommodates the natural shape and mechanics of your feet.

  2. Gradual Training Progression: Gradually increase intensity and duration of any exercise to allow your feet and entire body to adapt. Sudden spikes in activity can place excessive stress on the feet, increasing the risk of injuries such as stress fractures.

  3. Foot strengthening exercises: These can improve foot stability, enhance flexibility, and reduce the likelihood of injuries. Try to include these in your routine: Towel scrunches - by raising and lowering your forefoot grab a towel on the floor with your toes on each downward movement and scrunch the towel towards you. Toe yoga - Lift the big toe while leaving all the lesser toes on the floor, then reverse. Foot splays - Separate all your toes as much as possible, then relax

  4. Warm-up and Stretch: Include your feet in your warm up & stretch routine with calf raises, ankle circles, and toe stretches

  5. Maintain a Healthy Weight: Excess weight can put undue stress on your feet and increase the likelihood of foot injuries. Maintaining a healthy weight reduces the strain on your feet and promotes overall foot health.

  6. Mindful Self-Care: Pay attention to any discomfort or pain in your feet and address it promptly. Practice self-massage techniques, soak your feet in warm water with Epsom salts, and elevate them to reduce swelling and promote relaxation.

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