One of those often-painful soft tissue that attaches to heel spurs at the bottom of the foot is called "plantar fascia". Fascia, located throughout the body, is a fibrous connective tissue similar to a ligament. You can see fascia when you handle meat. It is the white, connective tissue separating layers of meat or attaching to bones. The "plantar" fascia in our bodies is that fascia which is seen on the bottom (or plantar portion) of the foot, extending from the heel bone to the ball of the foot. Compared to other fascia around the body, plantar fascia is very thick and very strong. It has to be strong because of the tremendous amount of force it must endure when you walk, run or jump. But while the plantar fascia is a strong structure, it can still get injured, most commonly when it is stretched beyond its normal length over long periods of time. When plantar fascia is injured, the condition is called "plantar fasciitis", which is usualy pronounced either "plan-tar fash-I-tis" or "plan-tar-fash-ee-I-tis." (Adding "-itis" to the end of a word means that structure is inflamed.) It is sometimes known more simply as 'fasciitis'. Plantar fasciitis is the most common type of arch pain.
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.
The muscle imbalance around the foot and ankle gives rise to a typical pattern of deformity in addition to the high arch (known as cavus). The bone under the big toe (called the first metatarsal) can become very prominent and the toes can curl or clench like a fist (called claw toes). Excessive amount of weight may be placed on the ball and heel of the foot, which can lead to the ankle weakening and giving way (this is referred to as ankle instability) and soreness. Calluses and sometimes stress fractures may occur where the foot is exposed to extra friction or pressure, such as on the outer (or lateral) border of the foot.
Flat feet are easy to identify while standing or walking. When someone with flat feet stands, their inner foot or arch flattens and their foot may roll over to the inner side. This is known as overpronation. To see whether your foot overpronates, stand on tiptoes or push your big toe back as far as possible. If the arch of your foot doesn't appear, your foot is likely to overpronate when you walk or run. It can be difficult to tell whether a child has flat feet because their arches may not fully develop until they're 10 years of age.
Non Surgical Treatment
There are many different causes of and treatments for flat foot. The most important part of treatment is determining the exact flat foot type on an individual basis, and doing so early on. The main objective is to become educated on the potential problems, so that you can stop them before they start. Conservative treatment is often successful if initiated early. The old adage "a stitch in time saves nine" definitely applies to the human body, hopefully more figuratively than literally. Do not ignore what your common sense and your body are telling you. Yes, you can live without an arch, but never neglect a symptomatic foot. If you neglect your feet, they will make you pay with every literal step you take.
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.
Achilles stretch. Stand with the ball of one foot on a stair. Reach for the step below with your heel until you feel a stretch in the arch of your foot. Hold this position for 15 to 30 seconds and then relax. Repeat 3 times. Balance and reach exercises. Stand next to a chair with your injured leg farther from the chair. The chair will provide support if you need it. Stand on the foot of your injured leg and bend your knee slightly. Try to raise the arch of this foot while keeping your big toe on the floor. Keep your foot in this position. With the hand that is farther away from the chair, reach forward in front of you by bending at the waist. Avoid bending your knee any more as you do this. Repeat this 15 times. To make the exercise more challenging, reach farther in front of you. Do 2 sets of 15. While keeping your arch raised, reach the hand that is farther away from the chair across your body toward the chair. The farther you reach, the more challenging the exercise. Do 2 sets of 15. Towel pickup. With your heel on the ground, pick up a towel with your toes. Release. Repeat 10 to 20 times. When this gets easy, add more resistance by placing a book or small weight on the towel. Resisted ankle plantar flexion. Sit with your injured leg stretched out in front of you. Loop the tubing around the ball of your foot. Hold the ends of the tubing with both hands. Gently press the ball of your foot down and point your toes, stretching the tubing. Return to the starting position. Do 2 sets of 15. Resisted ankle dorsiflexion. Tie a knot in one end of the elastic tubing and shut the knot in a door. Tie a loop in the other end of the tubing and put the foot on your injured side through the loop so that the tubing goes around the top of the foot. Sit facing the door with your injured leg straight out in front of you. Move away from the door until there is tension in the tubing. Keeping your leg straight, pull the top of your foot toward your body, stretching the tubing. Slowly return to the starting position. Do 2 sets of 15. Heel raise. Stand behind a chair or counter with both feet flat on the floor. Using the chair or counter as a support, rise up onto your toes and hold for 5 seconds. Then slowly lower yourself down without holding onto the support. (It's OK to keep holding onto the support if you need to.) When this exercise becomes less painful, try doing this exercise while you are standing on the injured leg only. Repeat 15 times. Do 2 sets of 15. Rest 30 seconds between sets.