Pain in the arch and bottom of foot

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---Topic: Pain in the arch and bottom of foot started by Jason Brown

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Jason Brown
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Sep. 10 2004,07:39

I would be grateful for some advice.   I have been suffering from arch pain in my right foot which is radiating to both my legs and causing me intermittent calf pain and pain in the knees right up to the tops of my legs.    My podiatrist has given me insoles, but the pain is still there.    One of my friends, who is a yoga teacher, has said that he thinks I have damaged the tender just under the ball of my foot and that it is not my arches at all.    I also think that I do not have fallen arches.   I have been back to see my podiatrist and she has told me to keep using the insoles, although she did take out the heel part of the insole.   However, I am still experiencing leg pain in the calves, knees and the tops of my legs.
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Jason Brown
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Sep. 10 2004,14:40

There is a mistake on my original posting.  It should read "one of my friends, who is a yoga teacher, has said that he thinks I have damaged the tendon and not the tender.
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Dr Foot




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Sep. 10 2004,16:29

The type of pain you are describing sounds like a strain to the posterior tibial tendon which runs along the arch. This tendon starts in the calf, stretches down behind the inside of the ankle and attaches to bones in the middle of the foot. Hence, a strain to the foot can cause calf pain and as you over compensate in your movement you will and are noticing knee pain.

Remember that posterior tibial tendonitis is an overuse injury which begins because your tibialis posterior and its tendon are not strong enough to stand up to the training you are doing. Thus, it is important to strengthen the specific, previously harmful training movement greatly (without inducing further damage), so that your muscles and connective tissues will not be harmed significantly when you begin working out strenuously again.

Rest is recommended for six weeks with the use of highly quality flexible orthotics. Icing the area every 4 hours for 10 mins and anti-inflammatory medications are standard remedial agents. After six weeks carry out the below exercises with caution:

Walk on your heels, with your ankles facing upwards. Take coordinated, medium-length steps, and continue until you begin to feel significant fatigue in your ankle area(s); if you have average strength, you should be able to walk in this manner for at least two minutes. Rest for a moment while walking around normally, and repeat. If you feel any pain in your tibialis-posterior area or arch as you do this drill, discontinue the exercise immediately, and move on to the next one.

The tibialis-posterior muscle and tendon also provide support for the arch, so exercises which strengthen the arch will take some of the heavy load off the tibialis posterior and its tendon. To this end, complete two sets of 60 toe grasps with each foot. Stand barefoot with your feet hip-width apart. In an alternating pattern, curl the toes of your right foot and then your left foot down and under, as though you were grasping something with the toes of each foot. Repeat this action (right foot, left foot, right foot, etc.) for a total of 60 repetitions on each foot. Rest for a moment, and then repeat one more set. Try pulling yourself across the floor (smooth surfaces work best) for a distance of four to six feet as you become more skilled at this exercise.

Remember these exercises should be done after six weeks of rest and should be done gradually.


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