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Pain in the foot

Why does my foot hurt when I put it on the ground when I get out of bed?

Foot pain can come for several reasons, but a common cause of pain that occurs especially in the heel is plantar fasciitis. This pain is often described as a stabbing pain in the heel area. It is usually worse when first walking after getting up in the morning, but can also be noticed after long periods of standing or rising from sitting. It is usually worse after exercise, but not during.

The plantar fascia is thick tissue that covers the bottom of your foot to provide padding. It attaches by the heel to the achilles tendon. This fascia can become irritated and stretched and then inflamed. Risk factors include having a high arch in your foot - or no arch at all, spending long hours standing without good support in your shoes, doing activities that result in repeated pressure on your foot such as running and being overweight which puts extra pressure on the foot.

The stabbing type heel pain which is a common symptom of plantar fasciitis comes from the fact that we often sleep with our toes and feet pointing down. This allows the tissue to shorten up along the heel and back of your ankle. When you stand up, a sudden stretch is applied to this tissue which hurts! One basic approach that often helps is to find a way to sleep or rest with your foot/ankle bent up. Many supports are available to use to keep the foot and ankle in this position while you sleep.

Because the plantar fascia is on the bottom of the foot, it is vulnerable to stress and stretching when shoes do not properly support the contours of the foot. Many over the counter inserts are available to try and some people are able to find ones that do a reasonable job of supporting the foot. Custom orthotic inserts where a mold of the foot is taken so that orthotics can be made to specifically provide support to the structures are ideal.

A Physical Therapist is an expert in the evaluation and treatment of the leg, ankle and foot. They can assess walking patterns, muscles and joints to determine what is causing the stress on the system. They can develop an individualized program to improve the mechanics of walking and strengthen systems to decrease stress and pain.

My knee hurts! What can I do about it?

Our knees take a lot of stress through our life. They have to be stable enough to hold us up, strong enough to lift us and move us and flexible enough to do everything from climb stairs to curl up under us as we lounge on a couch. Our knee joint is between the long bone of the thigh (femur) and the two bones of the calf (tibia and fibula). It has ligaments which are tough flexible tissues to hold the bones together. The muscles that come down from your hip and up from your ankles crossover or attach near the knee joint.

Knee pain can come from a breakdown of any of the structures in the joint. A careful assessment needs to be done, including a history of the pain and when it occurs as well as tests which try to reproduce or duplicate the pain when stress is placed on specific structures. This helps to pinpoint the cause so an individualized treatment plan can be developed.

One factor that is often ignored but is critical to knee health is the strength and flexibility of the hip muscles. When the hip muscles (in front of hip, on side and in back) are not strong enough, the knee often has to take on extra work to provide the stability and mobility we need.

Another overlooked factor in knee health is the stresses that may be put on the knee due to improper support from footwear. If the foot is rolling in or out or the ankle is not moving properly, the knee has to move differently than it is made to compensate and keep you standing and walking

A Physical Therapist is an expert in doing a hands on evaluation to assess the whole lower extremity system and how the parts do or don’t work together. They can develop an individualized program to correct weakness, improve flexibility and improve body mechanics to decrease stress on your knee and make you have less pain.


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