Dr. Gurinder Bedi

Foot arch pain is used in broader context for describing pain in bones, ligaments, muscles and nerve on the foot bottom. Slight damage to any of the components in the foot bottom can cause great pain. For starters, the pain lasts for a brief period, but increases over time if the condition is left untreated. Foot arch pain is more commonly witnessed in people over the age of 60 and among athletes engaged in sports of high impact.
The treatment plan of the pain totally depends on the cause. An early and right diagnosis goes a long way in treating the condition faster. For occasional mild to moderate pain, simple solutions such as footwear change can do the trick. Doctors often suggest four simple methods. This starts with rest followed by applying ice and then trying compression and elevation.

Anti-inflammatory medications are used to treat foot arch pain. Cases that are severe in nature can be treated with steroid and anti-inflammatory injections. For extreme cases, cortisol injections are prescribed too. This is done to relieve pain and release plantar fascia. Even stretching exercises are known to give relief from the pain. Some of the recommended exercises during this period are:

1. Stretch-related to plantar fascia: This exercise should be performed by crossing the legs at the junction of the knee. The body weight should be rested on the unaffected leg and it should gradually come down to touch the toe. The idea is to stretch the plantar fascia. A set of 20 such movements should be practised on a daily basis. Each movement should last for about 10 seconds.
2. Foot flexing: This exercise can be practised before getting out of bed. This is the tie when the pain from the plantar fascia is felt the most. This exercise should be repeated 20 times each lasting for about 10 seconds.
3. Rolling stretch: This exercise should be started by sitting in a chair. A tennis ball should be placed under the foot arch and the same should be rolled back and forth for ten times at a time. The same should be repeated with the second foot. Once this posture gets comfortable, the same should be practised by standing on the ball. It is known to be extremely useful for people suffering from foot arch pain.

How to prevent foot arch pain?
1. Wear shoes that are half an inch lose as they will make feel comfortable while walking
2. Losing weight; obese tends to cause pain in the foot arch
3. Performing free hand exercise and simple stretching on a daily basis
4. Not to overuse the foot. People who stand for more than 5-6 hours at stretch on a daily basis are observed to have foot arch pain. If you wish to discuss about any specific problem, you can consult an orthopedist.

Heel bone spur is a form of calcium deposit that causes a bony protrusion under the heel bone. An X-ray can reveal up to a half inch elongation under the hill. Without image report, this condition is commonly known as heel spur syndrome. Heel spurs are mostly painless but reports of pain in not uncommon. They are often related to plantar fasciitis. The latter is an inflammation of the connective tissue that stretches through the foot bottom connecting the heel bone and the football.

What causes heel spurs?
Heel spurs are a result of prolonged calcium deposit. This condition can result from the heavy strain on the muscle of the foot and ligament, stretching of fascia and wear and tear of the heel bone membrane. These injuries are frequently observed among athletes who are involved with activities such as jumping and running. 

What are the risk factors?
1. Walking abnormalities that involve putting more than normal stress on the bone, nerve and ligament in and around the heel.
2. Running on surfaces that are hard in nature
3. Shoes lacking arch support
4. More than normal body weight 
5. Spending too much time on the feet
6. Too flat or too high arches
7. A person suffering from diabetes
8. In case the protective pad of the heel is fading away due to old age or other bone disorder

Non-Surgical treatment
Unlike common belief, only rest may not be the best way to treat heel bone spurs. On the contrary, a patient might feel sharp pain immediately after sleep. This happens when he tries to walk and the plantar fascia elongates all of a sudden. The pain decreases with more walking. Some treatment methods that work for 90 percent of the sufferers includes wearing the right shoe, stretching exercises, wearing orthotic devices inside the shoes and physical therapy. Over the counter medicine such as Aleve, Tylenol and Advil can be consumed to reduce the pain and for improving the overall condition. Corticosteroid injection also tends to give relief from the inflammation.

Surgical treatment
If heel spurs persist for more than 8-9 months, surgical options should be explored by the patient. There are two angles on which a doctor works, either removing the spur or release the plantar fascia. Pre-surgical exams are necessary to ensure that a person is eligible for surgery and all non-surgical avenues are explored. Post-surgical activities are equally important for the process of healing. Usage of bandages, crutches, splints and surgical shoes is a mandate to avoid complications such as infection, numbness, and scarring. Possible side effects should be discussed with the surgeon well before the surgery. The estimated healing time from this procedure is close to 8-12 weeks. If you wish to discuss about any specific problem, you can consult an orthopedist.

Tennis toe is also known as runner’s toe since athletes are mostly runners; skiers and tennis players also get this injury often. Due to its ugly appearance, tennis toe is also known as a black toenail. This injury causes bleeding under the toe along with moderate to heavy pain. Although it is not considered to be type 1 serious injury, it can still force an athlete to abstain from participating in any events. The blood from the toenail might take its own sweet time to get out of the way. As a result, the recovery time for this injury can last for weeks together. This, unfortunately, is also an ideal condition for infection to set in.

How does it happen?
This condition may arise because of the friction between the toenail and the running shoes or constant downward pressure on the toe. In case if the shoe is tighter than normal, it can damage the toenail. If on the other hand, the shoe is very loose, it can result in similar condition due to heavy pressure on the nail. Tennis toe can also arise in a situation, if the toe constantly bangs the shoe from inside. Extreme hot weather may also result in toe swelling. Finally, one may encounter tennis toe if a blow is faced on the toe. Irrespective of the cause, the blood clots inside the nail resulting in swelling and pain. Too much damage might result in falling off of the toenail altogether.

Treatment plan:
1. If the tennis toe is minor, the injury resolves all by itself
2. The toenail should be clipped together to ensure that it does not result in any friction with the shoe.
3. During the injury, it is advised that a person wears bigger size shoes with wider toe space so that it does not result in any further irritation.
4. If the toenail is torn, make sure to tap it up so that adequate protection is there from outside forces.
5. In case the injury is serious a doctor might have to intervene and drain the blood with a surgical instrument.
6. Another medical solution is to remove the toenail surgically, drain the blood and tape it up for a good one week until new nail formation takes place.

Precautionary measure:
1. Running shoes should be at least half a size bigger than the normal size.
2. Toenails should be regularly trimmed in order to avoid any injury.
3. If a person has a tendency of sweating too much, it makes sense to wear a pair of socks at all times.
4. While running, shoe laces should be tightened to avoid sudden friction between the toe and the shoe resulting into tennis toe.