Dr. David Hoewisch knows that your foot is complex, and that many conditions can cause foot pain. That is why is so common. Generally speaking, we, humans, take 3,000-5,000 steps everyday. In addition, many of us are involved in activities, such as running and aerobic exercise, that add many more steps, as well as stress to our poor, overworked feet. It is no wonder that many people have aches and pains in this part of the body. Determinants such as flat feet or over-pronated feet, individual walking and running style, and the type of shoe a person wears can determine if someone will get foot and ankle pain. These components not only affect feet and ankles, but also the health of the back, knees and legs. Detailed below are some of the most prevalent conditions that affect the feet and ankle.

Hallux Valgus and Bunions

Hallux Valgus is a condition that happens when the big toe or hallux deviates towards the outside of the foot, often almost overlapping or bumping into the adjacent toe. It is a slow-developing problem that generally develops a bump on the inside of the big toe, called a bunion. The pain associated with Hallux Valgus is generally apparent during weight-bearing activities such as walking or prolonged standing.Although, if someone has developed a bunion, the pain can be present at rest and is generally described as a “numbing” or “burning” sensation in the big toes.

To be exact, the actual dysfunction is not in the bone, itself, but in the joint between the big toe and the first metatarsal bone, i.e., the first metatarsal-phalangeal. The pain and deformity associated with Hallux Valgus is due to damage to this joint. The condition is usually the aftereffect of wear and tear over a long period of time from factors such as over-pronation that causes undue pressure on the big toe and first metatarsal during walking. A further cause of Hallux Valgus is inflammatory arthritis that can harm the joint and produce degenerative changes. A broken toe that does not heal properly can also predispose a person to Hallux Valgus. However, one of the more common causes of the affliction is the high-heeled and pointed shoes that women commonly wear. These shoes not only put additional stress on the joint, but also aid in pushing the big toe to the outside.

If you think you may have Hallux Valgus, your chiropractor can examine your foot to determine which factors are contributing to your condition, and then use a range of chiropractic techniques and modalities to lessen pain and improve the function of your foot.

Plantar Fascitis ( Heel Pain )

Heel pain, known as Plantar Fascitis, is a prevalent foot problem caused by inflammation of the plantar fascia. The plantar fascia is a band of connective tissue that encases the muscles on the bottom of the foot . It attaches the heel bone to the ball of the foot, supporting the arch, protecting the foot, and absorbing shock.

People with Plantar Fascitis many times complain of pain in the morning after first standing when they get out of bed and also when they stand up after having sat for a while. The pain starts just in front of the heel bone, but can advance over the entire bottom of the foot.

Eventually, irritation associated with the condition can lead to the development of scar tissue, calcium deposits and finally heel spurs. These spurs are a bony growth on the front part of the calcaneus of the heel bone where the plantar fascia is connected and can create a acute stabbing pain with walking

People with other foot conditions, especially Pes Planus (flat feet) and/or over-pronation, are most susceptible to Plantar Fascitis, but other factors often contribute as well. Muscle imbalances between the calf muscles and the muscles on the bottom of the foot are a crucial contributing factor. Often the calf muscles get short and tight exerting a strong pull upon the back of the calcaneus. Such a condition causes unnecessary stress on the smaller, weaker plantar muscles and its fascia that are attached to the other side of the calcaneus. In addition to running and jumping activities, wearing high heels can also cause a shortening and tightening of the calf muscles. Other factors that stress the plantar fascia include: sudden strenuous activity after a period of long-term inactivity, abnormal walking patterns, improper footwear, walking on hard or uneven surfaces especially barefooted, and obesity.

People who are continuously on their feet, such as nurses, teachers and waiters, are more inclined towards getting Plantar Fascitis, as are athletes who participate in foot-stressing activities such as aerobics, volleyball, running, basketball, and tennis.

Once an individual develops plantar fascitis, it is often not easy to manage and can become painfully persistent. A chiropractor will be able to determine the cause of your problem and what care is best suited. Care might include ultrasound therapy, laser, joint manipulation, muscle stretching and strengthening exercises, special taping and, in some cases, orthotics.

Achilles Tendonitis

Achilles Tendonitis is a painful, and often, debilitating irritation of the Achilles tendon, also called the “heel cord.” This large tendon is an extension of the two biggest calf muscles and runs down the back of the lower leg connecting to the heel bone or calcaneus. Damage to this valuable tendon can make it hard or even impossible to walk. The challenge may be caused by a sudden single incident, such as jumping, but more commonly it results from an accumulation of smaller stresses that cause small tears in the tendon over time. Usually, the appearance of symptoms is gradual. The pain may be relatively minor at first, but gradually worsens if the individual tries to “work through” the pain. Many Achilles tendonitis sufferers ascribe their initial discomfort to the aches and pains that have to do with age or fatigue. In severe cases, a total rupture of the tendon can arise, resulting in traumatic harm and intense pain that makes walking virtually impossible and may even require corrective surgery.

Athletes and performers, such as dancers, whose activities involve not only running and jumping, but sudden starts and stops, are particularly vulnerable to Achilles tendonitis. Also, women who routinely wear high-heeled shoes are also at risk, especially if they switch to sport shoes for exercise. In these cases, the Achilles tendon and muscles gradually adapt to the shortened position caused by wearing high-heels, as the heel doesn’t need to stretch all the way to the ground. When this happens, the change to exercise or flat shoes forces the Achilles tendon to stretch further than it is used to, thereby creating stress and inflammation. For these reasons, high-heels should not be worn everyday. If they are unavoidable, stretching should be done every morning and night to keep the Achilles tendon lengthened.

Achilles tendonitis often appears in middle-aged people, expressly in men who are athletes, as a result of the changes that happen in the foot as a person ages. The arch tends to flatten as we grow older causing over-pronation and increased stress on the Achilles tendon as well as the calf and foot muscles. Achilles tendon problems are also common in those who exercise infrequently, such as the “weekend warrior” and in those who are just beginning to exercise. In both cases, muscles and tendons have little flexility due to inactivity. Therefore, people who are just beginning to exercise after a long layoff should stretch properly, start slowly, and increase gradually.

Regardless of the cause of the problem, if a person is experiencing the symptoms of Achilles tendonitis, he or she should contact a qualified professional, such as a chiropractor, to treat the problem before it becomes severe. Your chiropractor has many years of experience in treating Achilles tendonitis.

Pes Planus ( Flat Feet )

It is approximated that nearly one quarter of the population has Pes Planus, more commonly known as flat feet. Newborns have flat feet, but somewhere between the ages 3-10 we develop an arch. However, some adults never develop an arch. There are a number of factors, besides genetic disposion that can cause flat feet, or predispose a person to the condition. A person’s job, level of activity, and lifestyle can produce a previously-developed arch to collapse later in life. Age and weight also are implicated in the development of the affliction. Middle-aged persons who have been working on their feet for years often experience flat feet, as do overweight individuals who are placing added stress on their feet and legs.

Some people have flat feet and never feel any distress, while others experience pain in the feet and knees, and infrequently in the hips and lower back as well. If you have flat feet and are experiencing distress, your San Jose chiropractor can give you a treatment plan to not only help with pain reflief, but assist in preventing more problems from developing. Chiropractic treatment includes joint adjustments to correct foot function and resolve painful symptoms. Your chiropractor may also prescribe arch-supporting insoles, called orthotics, for additional support and stability.

Metatarsalgia ( Pain in the ball of the foot )

Metatarsalgia is sometimes called “ball-of-foot pain,” as it is a pain on the sole of the foot just behind the toes where the foot bends during walking. The metatarsal bones extend from halfway up the foot to the toes. A problem in one or more of these five bones is the cause of pain.

The feeling of pain can be limited to where the metatarsal bones join the toe bones or it can extend along the entire length of the metatarsals, and possibly between them. Problems vary from stiffness upon movement to a burning or stinging sensation. The degree of discomfort depends upon whether the problem is due to a dysfunction in the joints or an inflammation to the nerves as they travel along the metatarsals.

The cause of the distress is due to either structural or functional reasons. When a structural problem occurs, such as when the metacarpal bones are either too long or too short, it creates aberrant mechanics in the feet and undue stress on the entire area. Flat feet or extreme arch can also alter the stresses on the metatarsals causing similar symptoms.

There are other factors that can affect these bones that are often in the control of the individual. These include excess body weight, tight or high-heeled shoes, and excessive or poor running or athletic training. Excess weight and the wearing high-heeled shoes both increase stress upon the metatarsal, which leads to joint pain and nerve irritation. Repetitive foot activities, like running, directly stress the metatarsals by exposing them to constant trauma.

A chiropractor is able to beneficially treat metatarsalgia, no matter what the cause may be. After determining the underlying factors, you will be offered a number of non-invasive therapies, inluding orthotics when necessary, and you will be advised on how you can avoid future pain.

See your San Jose chiropractor as soon as possible if you are experiencing any of the foot problems mentioned above.

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