At Back II Life, we prescribe orthotics to our patients for various signs and symptoms of foot pain. Many medical conditions often stem from a biomechanical gait abnormality that can be treated with custom orthotics. Here are some common ailments related to poor foot biomechanics.
Achilles tendinitis is an overuse injury of the Achilles (uh-KILL-eez) tendon, the band of tissue that attaches your calf muscles at the back of the lower leg to your heel bone, or calcaneus.
Achilles tendinitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs. It’s also common in middle-aged people who play sports, such as tennis or basketball, only on the weekends.
This occurs when the tough band of tissue that extends from the outside of your hip to the outside of your knee (iliotibial band) becomes so tight that it rubs against the outer portion of your femur.
If the foot over-pronates, this is accompanied by internal rotation of the entire lower limb, producing a constant friction between the band and the bony prominence of the femur. It is therefore very common among runners especially if they run on a banked track or downhill. Symptoms include pain and swelling, typically a mechanical problem that causes knee pain, but it can also be felt sometimes in the thigh.
Metatarsalgia is not an injury; it’s actually a symptom or a group of symptoms. These may include pain in the ball of the foot, with or without bruising, and inflammation. The ball of your foot is the area between your toes and your arch. Metatarsalgia is named for the five metatarsal bones in the midsection of your feet that connect to your toes.
One of the hallmarks of this disorder is pain in the ball of the foot during weight-bearing activities. Sharp or shooting pains in the toes also may be present, and pain in the toes and/or ball of the foot may increase when the toes are flexed. Accompanying symptoms may include tingling or numbness in the toes. It is common to experience acute, recurrent or chronic pain as a result of this problem.
Metatarsalgia develops when something changes or threatens the normal mechanics of the foot. Ultimately, this creates excessive pressure in the ball of the foot, and that leads to metatarsalgia. Some of the causes of metatarsalgia include:
• Being overweight: the more weight is brought to bear on the foot, the greater the pressure is on the forefoot when taking a step.
• As men and women age, the fat pad in the foot tends to thin out, creating less cushioning and making them more susceptible to pain in the ball of the foot.
• Wearing shoes that do not fit properly: Shoes with a narrow, tight toe box, or shoes that cause a great deal of pressure to be put on the ball of the foot (high heels, for example) are often the cause of metatarsalgia. Because such footwear inhibits the walking process and forces the wearer to alter his or her step to adjust to the shoe, the mechanics of the foot are compromised.
• Certain foot shapes contribute to metatarsalgia. A high-arched foot, or a foot with an extra-long metatarsal bone can cause pressure on the forefoot region and contribute to pain and inflammation there.
• Claw toes or hammertoes can press the metatarsals toward the ground and cause stress on the ball of the foot.
• Arthritis, gout or other inflammatory joint disorders can produce pain in the ball of the foot.
It happens when the tissue around a nerve that leads to a toe thickens from irritation or compression. It most often occurs between the third and fourth toes, but can also occur between the second and third toes. It most commonly occurs in middle-aged people, especially middle-aged women.
A neuroma can occur in response to the irritation of a nerve by one or more factors:
• Abnormal foot function or foot mechanics: primarily excessive pronation that causes strain on the nerve.
• Improper footwear: constricting, narrow, poor-fitting shoes with a tight or pointed toe box tend to compress the end of the foot, leading to excessive pressure in the area of the nerve. High-heeled shoes are a particular culprit here. Many people experience relief by switching to lower heeled shoes with wider toe boxes.
• Previous trauma to the foot: Those who engage in high-impact, repetitive sports activities that bring trauma to the foot, such as running, aerobics, racquet sports, skiing or ballet etc. have a greater chance of developing a neuroma.
Morton’s neuroma is often associated with:
- flat feet
- high arches
- hammer toes
Sometimes, a neuroma results from injury to the foot.
The plantar fascia is a thick, weblike ligament that connects your heel to the front of your foot. It supports the arch of your foot and helps you walk. Plantar fasciitis is one of the most common causes of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes (plantar fascia).
Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning. As you get up and move more, the pain normally decreases, but it might return after long periods of standing or after rising from sitting.
Plantar fasciitis is more common in runners. In addition, people who are overweight and those who wear shoes with inadequate support have an increased risk of plantar fasciitis. The pain is usually worse after exercise, not during it.
Runner’s Knee is the common term used to describe any one of several conditions that cause pain around the kneecap or patella. As the name suggests, running is a common cause of runner’s knee, but any activity that repeatedly stresses the knee joint can cause the disorder, including walking, skiing, biking, jumping, cycling, and playing soccer.
The knee pain often increases when you run, walk up or down stairs, sit for long periods, or squat. Simple treatments — such as rest and ice — often help, but sometimes physical therapy is needed to ease the pain.
The hallmark of runner’s knee is a dull, aching pain around or behind the kneecap, or patella, especially where it meets the lower part of the thighbone or femur.
Other symptoms include swelling and popping or grinding in the knee.
In the case of iliotibial band syndrome, the pain is most acute on the outside of the knee. This is where the iliotibial band, which runs from the hip to the lower leg, connects to the tibia, or the thicker, inner bone of the lower leg.
Sacroilliac syndrome is a painful inflammatory condition of the sacroiliac joints. The patient generally experiences pain in the buttock and thigh regions. It is typically aggravated by sitting for long periods.
Quite frequently it is caused by an injury such as would be sustained by a fall on the buttocks or during a lifting activity. However, there is some evidence to suggest that a chronic irritation from abnormal foot mechanics is also a possible cause.
When a foot over-pronates, it creates a tendancy towards internal rotation of the lower limb. Due to the anatomy of the hip joint, this internal rotation translates into an extension of the pelvis (PSIS’s rotate upward while ASIS’s rotate downward). If the mechanics of the feet are not symmetrical, then conflicting rotations may occur at the two sacroiliac joints. This appears to set up a chronic irritation of these joints leading to the inflammation.
Each person experiences symptoms of SI joint disorders somewhat differently. Common symptoms include:
- pain in the lower back
- pain in the buttocks, hips, and pelvis
- pain in the groin
- pain limited to just one of the SI joints
- increased pain when standing up from a sitting position
- stiffness or a burning sensation in the pelvis
- pain radiating down into the thighs and upper legs
- feeling like your legs may buckle and not support your body
The term “shin splints” describes pain felt along the front of your lower leg/shin bone. Shin splint pain concentrates in the lower leg between the knee and ankle.
Shin splints frequently affect people who engage in moderate to heavy physical activity, common in runners, dancers and military recruits. You may be more likely to develop shin splints if you participate in strenuous physical activities or stop-start sports such as tennis, racquetball, soccer, or basketball. Sometimes the pain of shin splints can be so intense that you must stop the activity.
Shin splints is a cumulative stress disorder. Repeated pounding and stress on the bones, muscles, and joints of the lower legs prevents your body from being able to naturally repair and restore itself. Medically known as medial tibial stress syndrome, shin splints often occur in athletes who have recently intensified or changed their training routines. The increased activity overworks the muscles, tendons and bone tissue.
Most cases of shin splints can be treated with rest, ice and other self-care measures. Wearing proper footwear and modifying your exercise routine can help prevent shin splints from recurring.
If you have shin splints, you might notice tenderness, soreness or pain along the inner side of your shinbone and mild swelling in your lower leg. At first, the pain might stop when you stop exercising. Eventually, however, the pain can be continuous and might progress to a stress reaction or stress fracture.