Arch pain is a term given to a collective group of conditions causing pain in the inside of or under the arch of the foot. Plantar fascial strain is by far the most common type of ‘arch pain’ we see day-to-day in our podiatry clinics. The plantar fascia is a long tendon like cord running from the toes, under the arch, and attaching to the underside of the heel bone.
If you pull your big toe back, you can often see and feel the prominent cord- like fascia protruding out.
Who gets arch pain?
People of all ages who have hypermobile (flexible) and pronated (rolled in) flat feet make up the majority of people presenting to our clinic with plantar fascial strain. The arch height needs to be high and rigid at the propulsion phase of the walking cycle in order to move the body weight forward efficiently. When the arch is flexible or when the foot pronates (rolls in), the arch unlocks and flattens with each step we take. This in turn causes the plantar fascial cord to overwork leading to pain and damage.
People who spend long hours standing and walking at work or exercising are also affected. These people may have normal/stable foot types but long hours standing on hard, consistently flat concrete floors takes its toll on this important support structure of the foot.
What are the symptoms of arch pain?
Most people describe plantar fascial strain as a burning/tearing type feeling in the middle of the cord- middle of the arch area. It’s usually worse first step in the morning or after sitting and generally gets a little better after walking and when the foot is warmed up.
How do we treat arch pain?
Arch pain (plantar fascial strain) is an easy condition for our podiatrists to manage. Biomechanical condition such as pronation (rolling in) are treated with custom orthotics. The customisation of the orthotic device is important as wedging and design is centred around getting more dorsi-flexion (pull back) of the big toe so the foot can lock in nice and high for the propulsion phase of the walking cycle. We often design a deep groove on the top of the orthotic arch area so we can support the arch without pushing/stretching the injured and sore fascia. Customised orthotic therapy is very effective for this condition.