Foot pain and injuries are common amongst those who are athletes, run a lot, or are on their feet for work often. Foot pain typically occurs due to repetitive overuse of the muscles and joints. Proper footwear is imperative to maintain the health and function of the foot.
- Plantar Fasciitis
- Turf Toe
- Sand Toe
- Morton's Neuroma
- Cuboid Dysfunction
Although there can be multiple factors regarding your foot pain, most cases respond very favorably to conservative chiropractic management and physical rehabilitation.
Treatment commonly includes extremity mobilization/manipulation of restricted joints, soft tissue therapy, activity and physical load management, stress reduction, and exercises to restore range of motion and help stabilize the cervical spine.
For those that do not respond well to a trial of conservative management, referrals for imaging (X-ray or MRI), orthopedic, and/or podiatrist consultation may be necessary.
The plantar fascia is a dense, fibrous band on the bottom of your feet that act to stabilize your feet during gait and stabilize the foot. Originally thought to be more inflammatory in nature, evidence has shown it to be more degenerative in nature and that the healing process fails to regenerate "normal" tissue.
Most people affected by plantar fasciitis are over 40, however, this is also present in young runners or those with a rapid increase in activity levels. The most common symptom is sharp pain with the first couple of steps in the morning or following a period of rest.
Patients can develop plantar fasciitis regardless of their foot shap as people with pes planus (fallen arch) increases tension on the plantar fascia, creating microtrauma at the band's medial attachment of the heel bone. Patients with pes cavus (high arch) are predisposed since the foot is immobile and cannot dissipate forces that would normally be absorbed by the plantar fascia.
Factors that can contribute to Plantar Fasciitis:
- Biomechanical causes like pes planus, pes cavus
- Calf and hamstring tightness
- Rapid weight gain and obesity
- Occupations that involve prolonged standing (nurses, teachers, cooks, etc)
Metatarsalgia is a medical term describing pain in the area of the metatarsophalangeal joints of your foot. This is often described as pain along the ball of your foot, typically felt along the 2nd-4th metatarsal heads. People often describe it as feeling like they are stepping on a pebble.
Factors that contribute to Metatarsalgia include:
- Lax ligaments from a collapsed arch
- 1st ray not being used, causing excessive weight shift to the 2nd, 3rd metatarsal
- Shifting weight from rearfoot to forefoot (heels, improper toe box, word down shoes)
- Improper gait/pronation mechanics
- Overuse, including on hard surfaces
In acute cases, Winback Tecar therapy and utilizing Kinesiotape for pain and functional reinforcement has been a gamechanger to alleviate pressure on the metatarsal joints. This in combination with strengthening the intrinsic foot musculature has shown the best results clinically.
Turf toe is a hyperextension injury of the first toe causing a sprain to the first MCP joint. One of the most common symptoms is forced dorsiflexion of the first toe. The injury can be from an acute strain or repetitive injury.
The injury was coined "turf toe" because of the increased amount of injuries when artificial turf was implemented on athletic playing fields, most notably football fields. Turf toe can cause significant playing time loss and sometimes can take up to 6 weeks to heal depending on severity of the injury. The athlete can return to play when they can run and change direction without pain and loss of mobility.