Foot Arches Pain Behind Knee

Overview
Plantar fasciitis is a common and often persistent kind of repetitive strain injury afflicting runners, walkers and hikers, and nearly anyone who stands for a living, cashiers, for instance. It causes mainly foot arch pain and/or heel pain. Morning foot pain is a signature symptom. Plantar fasciitis is not the same thing as heel spurs and flat feet, but they are related and often confused. Most people recover from plantar fasciitis with a little rest, arch support (regular shoe inserts or just comfy shoes), and stretching, but not everyone. Severe cases can stop you in your tracks, undermine your fitness and general health, and drag on for years.


Causes
Spending a lot of time on your feet. Especially when you are not used to doing so. For example you may have started a new job such as waiting tables where you are on your feet all day and wake up the next day with sore feet. This is a sign of damage and over time could lead to plantar fasciitis. Being Over-Weight. Never an easy topic to discuss but in simple terms, the heavier you are, the greater the burden on your feet. There are times when you're walking when your entire body weight is borne on one leg and therefore one foot, placing great strain on the plantar fascia. Wearing shoes with poor arch support or cushioning. A tight Achilles tendon. This is the big tendon at the bottom of your calf muscles above your heel. If this is excessively tight this can affect your ability to flex your ankle and make you more likely to damage your plantar fascia. Suddenly changing your exercise routine. Using running as an example if you suddenly run many more miles than your are used to or change to a new running surface e.g. grass to tarmac - these factors can put excessive strain on the plantar fascia and lead to plantar fasciitis. All of these risk factors ultimately lead to a specific change in foot structure. The term given is over-pronation and this basically describes rolling in of the foot and lowering of the arches. It is this change that excessively elongates the plantar fascia which can lead to plantar fasciitis.

Symptoms
Flat feet can exhibit a variety of symptoms, from mild to severe. The extent of the flat foto does not always correlate with the extent of symptoms. Patients may complain of arch pain and heel pain. Commonly there is pain on the outside of the foot, where the foot meets the ankle as the collapse foot abuts against the ankle. Muscle cramps within the foot, and onto the leg (shin splints) may occur. In general, patients have pain with activity, such as walking or running. The pain may be deep and focal to a generalized widespread achy feeling. Irritation from shoe gear can cause redness and swelling. Common reasons patients seek treatment are pain, interference with walking or activities, difficulty fitting shoes, swelling, and notice a change in appearance of the foot and/or unsightly appearance.

Diagnosis
The doctor will examine your feet for foot flexibility and range of motion and feel for any tenderness or bony abnormalities. Depending on the results of this physical examination, foot X-rays may be recommended. X-rays are always performed in a young child with rigid flatfeet and in an adult with acquired flatfeet due to trauma.

Non Surgical Treatment
Rest from any aggravating activities and apply cold therapy whilst in the acute phase when the foot or ankle is painful and inflamed. Your Doctor may prescribe anti-inflammatory medication to help reduce pain and inflammation. Once the initial pain and inflammation has gone then a full rehabilitation program which includes stretching and strengthening exercises for the foot can begin. Consult a foot specialist, podiatrist or physiotherapist who can assess this and biomechanical problems of the foot. Nerve conduction studies may be done to confirm the diagnosis and indicate the location of the entrapment. An X-ray or MRI may also be useful to determine the presence of any other structures such as cysts, arthritis or a tarsal coalition.


Surgical Treatment
If you have pain that has not been responsive to other treatments, there is a new non-surgical treatment that was recently approved by the FDA. ESWT (extracorporeal shockwave therapy) uses strong electrohydraulic acoustic (sound) energy that triggers the body?s natural repair mechanism. This treatment method is safe, effective and requires a very short recovery period compared to older surgical techniques.


Stretching Exercises
Easy Beginner Version. Start with your bare foot on a flat surface, toes spread out. Place a penny under the ball of your foot and the end of a pen under the middle of your arch (sticking out from the inside of your foot). Activate your arch by flexing your arch muscle. You should feel the muscles on the ball of your foot pushing down on the penny, but your arch shouldn't be pushing down on the pen. These tools help you (1) avoid rolling your foot and (2) avoid pressing down with your toes (as an extra tip, you can slide a business card under your toes before doing the exercise-when you activate your arch, you should be able to slide the business card out easily with your fingers). Do your best to keep your toes relaxed. Advanced Version. Once you're ready to move on, you can try this advanced version. It builds on the above exercise to incorporate full body twisting and balance, helping you to maintain proper arches while you move. Using the same ideas from above, stand on a flat surface in your bare feet with a penny under the ball of your foot and the end of a pen under your arch. This time, stand with your back a few inches away form a wall or a door. Lift your other leg (the one without the penny or pen) and stand on one foot. Use the wall for balance, if necessary. Lift one arm and stretch it across your body until you touch the wall or door on the opposite side, maintaining a straight back. Keep your foot straight and your arch on the penny but above the pen. Your arch will want to follow the movement and roll off, but you will need to activate it to stay stable during the movement. Lift your other arm and stretch it across the opposite side of your body, still keeping your arch in place.