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Overview<br>Arch pain (usually Plantar Fasciitis) is pain that is usually felt first thing in the morning or after rising up from a prolonged resting position and pain increases after more use of feet. The causes of arch pain include: weight, a foot injury, overuse, abnormal biomechanics of the foot (e.g. flat feet or abnormal pronation), footwear, certain activities, inappropriate training, and medical conditions (eg. rheumatoid arthritis). Treatment of arch pain include weight reduction, rest, ice, activity modification, anti-inflammatory products, sports massage, stretching, strengthening, acupuncture, strapping, steroid injection, ultrasound and orthotics.<br><br><br>Causes<br>Plantar fasciitis, another sports injury detailed on this website, is regularly the cause of foot arch pain or strain. This can arise due to faulty biomechanics in your feet, which alone can also provoke foot arch pains. The most prominent biomechanical difficulties are flat feet and high arches. With flat feet (or overpronation) the arches appear to be almost flattened, causing unevenness by forcing the feet roll inwards in order to maintain balance and support the body's weight. This places inordinate pressure on the plantar fascia and arches. If by contrast you have high arches (instep), the ankle can roll outwards, again causing undue strain on the arches. Too much of this strain can lead to stretching of the plantar fascia and pain in the arches. Other causes include overstretching or otherwise pressuring the arches, for example by exercising with fatigued leg muscles which leave the feet with excessive work to do. You are also particularly at risk if in your 40s or 50s and commencing an intense program of training after a long period of inactivity.<br><br>Symptoms<br>Arch pain symptoms could include any of the following, a dull, constant ache if the ligaments have been stretched, swelling or tenderness in the foot, redness or bruising in the event of a more serious injury, difficulty putting weight on the foot, sharp pain when the foot is turned or manipulated, tenderness when pressure is applied. Because the arch of the foot is such a complex structure, arch pain could be an indicator of several different types of injuries. Chronic illnesses such as arthritis could also cause arch pain, and depending on the cause or source of your pain, you may experience discomfort in a variety of different areas. Ask a doctor if you believe you may have injured your foot arch.<br><br>Diagnosis<br>To come to a correct diagnosis, your podiatrist will examine your foot by using his or her fingers to look for a lump or stone bruise in the ball of your foot. He or she will examine your foot to look for deformities such as high or low arches, or to see if you have hammertoes. He or she may use x-rays, MRIs (magnetic resource imaging), and CT scans to rule out fractures and damage to ligaments, tendons, and other surrounding tissues. Your doctor will also inquire about your daily activities, symptoms, medical history, and family history. If you spend a lot of time running or jumping, you may be at a higher risk for pain in the bottom of your foot. These diagnostic tests will help your doctor come to a proper diagnosis and create an appropriate treatment plan.<br><br>Non Surgical Treatment<br>Use corrective prophylactic measures. Purchase new shoes or replace the insoles of your current shoes. Athletic shoes lose the elastic properties of the soles through usage and age. A good rule of thumb is to replace your shoes every six months, more often if there is heavier usage. The use of after-market insoles can increase energy absorption and add support to the foot. Custom fabricated orthotics or off-the-shelf orthotics may also improve the biomechanics of the foot. Focus on muscle strengthening and flexibility. You may be given exercises to increase the strength and stability of the affected area and to correct muscles that may not be balanced. Exercises to increase flexibility will maintain or improve the length of a muscle. Flexibility helps to make a stronger muscle that is less likely to be injured.<br><br><br>Surgical Treatment<br>Surgery for flat feet is separated into three kinds: soft tissue procedures, bone cuts, and bone fusions. Depending on the severity of the flat foot, a person?s age, and whether or not the foot is stiff determines just how the foot can be fixed. In most cases a combination of procedures are performed. With flexible flat feet, surgery is geared at maintaining the motion of the foot and recreating the arch. Commonly this may involve tendon repairs along the inside of the foot to reinforce the main tendon that lifts the arch. When the bone collapse is significant, bone procedures are included to physically rebuild the arch, and realign the heel. The presence of bunions with flat feet is often contributing to the collapse and in most situations requires correction. With rigid flat feet, surgery is focused on restoring the shape of the foot through procedures that eliminate motion. In this case, motion does not exist pre-operatively, so realigning the foot is of utmost importance. The exception, are rigid flat feet due to tarsal coalition (fused segment of bone) in the back of the foot where freeing the blockage can restore function.<br><br><br>Prevention<br>Warm up properly. This means not only stretching prior to a given athletic event, but a gradual rather than sudden increase in volume and intensity over the course of the training season. A frequent cause of plantar fasciitis is a sudden increase of activity without suitable preparation. Avoid activities that cause pain. Running on steep terrain, excessively hard or soft ground, etc can cause unnatural biomechanical strain to the foot, resulting in pain. This is generally a sign of stress leading to injury and should be curtailed or discontinued. Shoes, arch support. Athletic demands placed on the feet, particularly during running events, are extreme. Injury results when supportive structures in the foot have been taxed beyond their recovery capacity. Full support of the feet in well-fitting footwear reduces the likelihood of injury. Rest and rehabilitation. Probably the most important curative therapy for cases of plantar fasciitis is thorough rest. The injured athlete must be prepared to wait out the necessary healing phase, avoiding temptation to return prematurely to athletic activity.<br><br>Stretching Exercises<br>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.
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Overview<br>Each foot contains 26 bones, which form two arches. The longitudinal arch runs the length of the foot, and the transverse arch runs the width. The bones of the arch are primarily held together by the shape with which they fit with each other and by fibrous tissues known as ligaments that serve to hold the bones to each other. The muscles of the foot, along with a tough, sinewy tissue known as the plantar fascia, provide secondary support to the foot. There are also fat pads in the foot to help with weight-bearing and absorbing impact. Arch pain can occur whenever something goes wrong with the function or interaction of any of these structures.<br><br><br>Causes<br>In most cases, plantar fasciitis develops without a specific, identifiable reason. There are, however, many factors that can make you more prone to the condition. Tighter calf muscles that make it difficult to flex your foot and bring your toes up toward your shin. Obesity. Very high arch. Repetitive impact activity (running/sports). New or increased activity.Although many people with plantar fasciitis have [http://stantonneihakapfy.hazblog.com heel spurs], spurs are not the cause of plantar fasciitis pain. One out of 10 people has heel spurs, but only 1 out of 20 people (5%) with heel spurs has foot pain. Because the spur is not the cause of plantar fasciitis, the pain can be treated without removing the spur.<br><br>Symptoms<br>The primary symptom is pain or aching in the arch area. This can be accompanied by inflammation and tenderness. If the pain is caused by the plantar fascia, it is likely to be considerably more severe in the mornings due to the muscles being unused.<br><br>Diagnosis<br>The diagnosis of high arch (cavus) foot deformity or Charcot Marie Tooth disease can be made by an orthopedic surgeon in the office. Evaluation includes a thorough history and physical examination as well as imaging studies such as X-rays. The orthopedic surgeon will look at the overall shape, flexibility, and strength of a patient?s foot and ankle to help determine the best treatment. Nerve tests may occasionally need to be performed to help confirm the diagnosis.<br><br>Non Surgical Treatment<br>Standing and walking barefoot are two easy ways to start treating flat feet naturally. Balancing on one leg and light jumping while barefoot will further progress the normal development of the foot; and finally running while barefoot is the ultimate way to naturally and most effectively strengthen the muscles, tendons, and ligaments of the lower leg and foot. Of course a child running barefoot is much less likely to have FFF than a shod child. Sometimes other interventions and therapies are needed for flat feet. In the case of RFF, which is much less common than FFF, treating the cause of the problem is recommended. If the RFF is causing problems (such as pain) then in some cases, depending on the individual, surgery or a supportive orthotic may be beneficial.<br><br><br>Surgical Treatment<br>Tendon transfers: Too much pull of certain muscles and tendons is often the cause of the deformity related with a cavus foot. Moving one of these muscles or tendons may help the foot work better. In addition, patients with a cavus foot may have weakness in moving the foot up, which is sometimes called a foot drop. In these cases, a tendon from the back of the ankle may be moved to the top of the foot to help improve strength. Correcting the deformity of the foot may not be possible with soft tissue procedures alone. In these instances, one or more bone cuts (osteotomies) may be needed. Instead of a bone cut, a fusion (arthrodesis) procedure may be used. A fusion removes the joint between two bones so they grow together over time. During a fusion the bones may be held in place with plates or screws. Calcaneal osteotomy: This procedure is performed to bring the heel bone back under the leg. This is needed if correction of the deformity in the front of the foot does not also correct the back of the foot or ankle. A calcaneal osteotomy can be performed several ways and is often held in place with one or more screws. Sometimes patients have a deformity that has caused damage to the joints. In these cases, soft tissue procedures or bone cuts may not be enough, and it may be necessary to eliminate the joint. Clawed toes are a common problem with cavus foot deformity. This can be treated with tendon surgery, fusion or removal of part of the toe bones. Following surgery the toes are often temporarily held in place with pins.<br><br><br>Prevention<br>Strap the arches into the anatomically correct positions with athletic tape and leave them like this for some time. If the fallen arches are an issue with the muscular structure, this may give the muscles an opportunity to strengthen. This is definitely not a fallen arches cure all the time but it can help prevent it more times than not. Ask a doctor or physical therapists to show you how to do this taping. Find shoes that fit. This may require that you get your foot measured and molded to ensure that the shoe will fit. Shoes that are too big, too tight or too short, may not directly cause the fallen arches, but they can assist with the damage to the area. These shoes should have thick cushioning inside and have plenty of room for your toes. Walk without shoes as much as possible. Shoes directly assist with weakening and distorting the arches of the feet so going without shoes can actually help strengthen your arches and prevent fallen arches. Walking on hard and bumpy surfaces barefooted makes the muscles in your feet strengthen in order to prevent injury. It is a coping mechanism by your body. Insert heel cups or insoles into the shoes that you wear the most. Many people wear uncomfortable shoes to work and these are the same shoes that cause their arches the most problems. Inserting the heel cups and insoles into these shoes can prevent fallen arches from occurring. Many people place these inserts into all their shoes to ensure support. Ask a medical professional, either your doctor or a physical therapist, about daily foot exercises that may keep the arches stronger than normal. Many times, you can find exercises and stretches on the Internet on various websites. Curling your toes tightly and rotating your feet will help strengthen your longitudinal arches. Relax your feet and shake them for a minute or so before you do any arch exercises. This will loosen the muscles in your feet that stay tight due to normal daily activities. Wear rigid soled sandals whenever possible to provide a strong support for your arches. Wooden soled sandals are the best ones if available. Walk or jog on concrete as much as you can. This will create a sturdy support for your arches. Running or walking in sandy areas or even on a treadmill, does not give rigid support. Instead, these surfaces absorb the step, offering no support for arches.<br><br>Stretching Exercises<br>Stretching your calf and Achilles tendon may also help as a tight Achilles can make your foot overpronate. To stretch your calf and Achilles tendon, step forwards with your left leg and bend it, with your right leg straight and both feet pointing forwards. Push your right heel into the ground while keeping your right leg straight; you should feel the stretch at the back of your right leg, below the knee. Hold the stretch for 15 to 30 seconds and repeat with the opposite leg. Repeat the stretch two to four times on each leg, and repeat the overall exercise three to four times a day.

Revisión de 19:30 11 jun 2017

Overview
Each foot contains 26 bones, which form two arches. The longitudinal arch runs the length of the foot, and the transverse arch runs the width. The bones of the arch are primarily held together by the shape with which they fit with each other and by fibrous tissues known as ligaments that serve to hold the bones to each other. The muscles of the foot, along with a tough, sinewy tissue known as the plantar fascia, provide secondary support to the foot. There are also fat pads in the foot to help with weight-bearing and absorbing impact. Arch pain can occur whenever something goes wrong with the function or interaction of any of these structures.


Causes
In most cases, plantar fasciitis develops without a specific, identifiable reason. There are, however, many factors that can make you more prone to the condition. Tighter calf muscles that make it difficult to flex your foot and bring your toes up toward your shin. Obesity. Very high arch. Repetitive impact activity (running/sports). New or increased activity.Although many people with plantar fasciitis have heel spurs, spurs are not the cause of plantar fasciitis pain. One out of 10 people has heel spurs, but only 1 out of 20 people (5%) with heel spurs has foot pain. Because the spur is not the cause of plantar fasciitis, the pain can be treated without removing the spur.

Symptoms
The primary symptom is pain or aching in the arch area. This can be accompanied by inflammation and tenderness. If the pain is caused by the plantar fascia, it is likely to be considerably more severe in the mornings due to the muscles being unused.

Diagnosis
The diagnosis of high arch (cavus) foot deformity or Charcot Marie Tooth disease can be made by an orthopedic surgeon in the office. Evaluation includes a thorough history and physical examination as well as imaging studies such as X-rays. The orthopedic surgeon will look at the overall shape, flexibility, and strength of a patient?s foot and ankle to help determine the best treatment. Nerve tests may occasionally need to be performed to help confirm the diagnosis.

Non Surgical Treatment
Standing and walking barefoot are two easy ways to start treating flat feet naturally. Balancing on one leg and light jumping while barefoot will further progress the normal development of the foot; and finally running while barefoot is the ultimate way to naturally and most effectively strengthen the muscles, tendons, and ligaments of the lower leg and foot. Of course a child running barefoot is much less likely to have FFF than a shod child. Sometimes other interventions and therapies are needed for flat feet. In the case of RFF, which is much less common than FFF, treating the cause of the problem is recommended. If the RFF is causing problems (such as pain) then in some cases, depending on the individual, surgery or a supportive orthotic may be beneficial.


Surgical Treatment
Tendon transfers: Too much pull of certain muscles and tendons is often the cause of the deformity related with a cavus foot. Moving one of these muscles or tendons may help the foot work better. In addition, patients with a cavus foot may have weakness in moving the foot up, which is sometimes called a foot drop. In these cases, a tendon from the back of the ankle may be moved to the top of the foot to help improve strength. Correcting the deformity of the foot may not be possible with soft tissue procedures alone. In these instances, one or more bone cuts (osteotomies) may be needed. Instead of a bone cut, a fusion (arthrodesis) procedure may be used. A fusion removes the joint between two bones so they grow together over time. During a fusion the bones may be held in place with plates or screws. Calcaneal osteotomy: This procedure is performed to bring the heel bone back under the leg. This is needed if correction of the deformity in the front of the foot does not also correct the back of the foot or ankle. A calcaneal osteotomy can be performed several ways and is often held in place with one or more screws. Sometimes patients have a deformity that has caused damage to the joints. In these cases, soft tissue procedures or bone cuts may not be enough, and it may be necessary to eliminate the joint. Clawed toes are a common problem with cavus foot deformity. This can be treated with tendon surgery, fusion or removal of part of the toe bones. Following surgery the toes are often temporarily held in place with pins.


Prevention
Strap the arches into the anatomically correct positions with athletic tape and leave them like this for some time. If the fallen arches are an issue with the muscular structure, this may give the muscles an opportunity to strengthen. This is definitely not a fallen arches cure all the time but it can help prevent it more times than not. Ask a doctor or physical therapists to show you how to do this taping. Find shoes that fit. This may require that you get your foot measured and molded to ensure that the shoe will fit. Shoes that are too big, too tight or too short, may not directly cause the fallen arches, but they can assist with the damage to the area. These shoes should have thick cushioning inside and have plenty of room for your toes. Walk without shoes as much as possible. Shoes directly assist with weakening and distorting the arches of the feet so going without shoes can actually help strengthen your arches and prevent fallen arches. Walking on hard and bumpy surfaces barefooted makes the muscles in your feet strengthen in order to prevent injury. It is a coping mechanism by your body. Insert heel cups or insoles into the shoes that you wear the most. Many people wear uncomfortable shoes to work and these are the same shoes that cause their arches the most problems. Inserting the heel cups and insoles into these shoes can prevent fallen arches from occurring. Many people place these inserts into all their shoes to ensure support. Ask a medical professional, either your doctor or a physical therapist, about daily foot exercises that may keep the arches stronger than normal. Many times, you can find exercises and stretches on the Internet on various websites. Curling your toes tightly and rotating your feet will help strengthen your longitudinal arches. Relax your feet and shake them for a minute or so before you do any arch exercises. This will loosen the muscles in your feet that stay tight due to normal daily activities. Wear rigid soled sandals whenever possible to provide a strong support for your arches. Wooden soled sandals are the best ones if available. Walk or jog on concrete as much as you can. This will create a sturdy support for your arches. Running or walking in sandy areas or even on a treadmill, does not give rigid support. Instead, these surfaces absorb the step, offering no support for arches.

Stretching Exercises
Stretching your calf and Achilles tendon may also help as a tight Achilles can make your foot overpronate. To stretch your calf and Achilles tendon, step forwards with your left leg and bend it, with your right leg straight and both feet pointing forwards. Push your right heel into the ground while keeping your right leg straight; you should feel the stretch at the back of your right leg, below the knee. Hold the stretch for 15 to 30 seconds and repeat with the opposite leg. Repeat the stretch two to four times on each leg, and repeat the overall exercise three to four times a day.

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