Foot and ankle pain is caused by one or a combination of these three main causes…
The plantar fascia is a thick tissue that runs along the bottom of your foot and spans from your heel to the ball of your foot. This tissue helps to absorb shock as you walk and move around as well as store energy and propel you forward. Frequently called plantar fasciitis, in the last decade or so this term has been found to be inaccurate as the suffix, -itis, indicates inflammation which is rarely present in this condition. As you are walking and moving around, the plantar fascia has to stretch which helps give support and stability to the foot. However, when the plantar fascia becomes irritated from too much pressure, it often results in small tears or microtrauma. This can become very painful when having to bear weight during standing, walking, and running
Plantar Fasciopathy typically occurs in these 3 groups of people:
Those with altered foot mechanics:
People who have flat feet, high arches, or an abnormal walking pattern are at a higher risk of developing plantar fasciopathy because changes in how weight is distributed through the foot can cause abnormal stress on the plantar fascia leading to inflammation and tissue degeneration. This can include people who frequently wear high heeled shoes and/or have tight muscles through their calves.
Those who are obese:
The heavier you are, the more pressure your feet have to endure as you stand and move around. The extra weight puts more stress on the plantar fascia and can lead to inflammation and tissue degeneration.
Those who spend a lot of time on their feet:
Some job requires you to spend a lot of time on your feet and stand on hard surfaces which can put extra stress on the plantar fascia if the muscles in your feet aren’t strong enough to take extra stress off of the plantar fascia.
Symptoms of plantar fasciopathy to look out for include:
- Pain at the bottom of the foot, typically close to the heel, without traumatic injury
- Pain upon standing and first few steps in the morning or after a long rest period
- After standing or walking for a long period of time
Achilles tendinopathy is an injury caused by overuse. The Achilles tendon connects your calf muscles to your heel. Tendinopathy can develop with repetitive and/or intense activities, especially with activities that you aren’t used to doing on a regular basis. This has frequently been called achilles tendinitis but as our understanding of the injury process has progressed inflammation is rarely present and therefore the term tendinopathy is more accurate
People who are at risk for Achilles tendinopathy include:
- “Weekend warriors” or individuals who only participate in sports or high levels of activity on the weekends
- Runners who suddenly increase their running distance, train in worn out shoes, or run on hilly terrain
- People who have flat feet
You may have Achilles tendinopathy if you have these symptoms:
- Pain in the back of the lower leg or heel
- Pain that increases with increased activity levels
- Stiffness in the ankle after long rest periods
Ankle sprains are an injury involving stretching or tearing of the ligaments that stabilize the ankle joint further than their capacity. Ligaments connect bone to bone and provide passive stability to the ankle joint. Most commonly ankle sprains occur when the foot twists, turns, or is rolled inward and stretches the ligaments on the outside of the ankle. These are typically graded 1-3 depending on how much damage was done, from just being mildly overstretched to complete tears which will typically cause instability.
People who are at risk for ankle sprains include:
- Women, children, and teenagers tend to have more sprains
- The greatest risk for ankle sprains is present in those with a previous ankle injury
- People participating in sporting events are at risk due to all the quick cutting and turning motions as well as possible contact with other players
- Having poor balance and/or weak or stiff ankles can also predispose you to ankle sprains especially when walking on uneven terrain