Form follows function, right? A bowling ball is round so it can roll, but a carpenter’s pencil is flat so it can’t. A trampoline has a flexible surface for bouncing, but a dance hall floor is purposefully non-bouncy.
When it comes to our feet, they are natural marvels of design. Each one is built to provide support for our entire body weight, yet remain flexible enough to propel us in our movement.
There are more moving parts in a foot than we might realize, including 26 bones, 33 joints, and more than 100 different muscles and connecting tissues. When they are all working together properly, it’s a true marvel!
When they’re not… well, that often leads to foot pain.
An Imbalance in the Force
Think of your feet as an all-natural machine—like a car made out of meat.
(OK, maybe don’t think of it quite like that, but you hopefully get the idea.)
Our feet, like a car, operate best when everything is balanced. All the parts within the foot are bearing the amounts of weight and force they were intended to. Everything is doing exactly the job it can handle, and movement is highly efficient.
But what happens when a car falls out of alignment? You might notice that the tires start to wear unevenly as the support of the car becomes unevenly distributed. You might also notice the car begin to veer toward one side, taking you extra effort to keep moving in a straight line.
Similar things can happen when you have an abnormal foot structure. The distribution of weight and force across your feet can become imbalanced, leading to certain areas having to endure more than they are used to. This can result in an increased risk of injury and pain over time.
Additionally, the way your foot moves (what you might hear referred to as “biomechanics”) can become affected. One common alteration is having the foot roll too far inward during a step, known as “overpronation”. Other types of altered movement are also possible, however.
You may not find yourself veering off to one side when you move, but such an imbalance can still mean that your body is expending extra energy to keep itself stable. Muscles up your legs and even in your lower back can be firing in different ways to compensate, and can sometimes explain pain that is occurring in these areas, too!
What Could Be Causing Your Foot Pain?
A wide range of anatomical abnormalities can be responsible for pain in the feet and ankles. It often takes a professional evaluation to determine what exactly is causing a problem and the best way to address it. But here are a few examples of what could be happening beneath the surface.
Pain in the Back of the Heel – Achilles Tendinitis
Achilles tendinitis—the inflammation of the large tendon that runs along the back of the leg—is a common source of pain felt in the back of the heel. While overuse can cause this inflammation to develop, anatomy can also be a contributing factor.
The Achilles tendon runs from the calf muscles and connects to the back of the heel bone (calcaneus). If one’s calf muscles are tighter than normal, it causes excessive pulling on the tendon, which can cause its fibers to weaken and break down.
Inflammation of the Achilles tendon can happen toward the middle of the tendon, or toward a lower point where the tendon inserts into the heel bone (insertional Achilles tendinitis). You do not necessarily have to be overly active to experience pain from insertional Achilles tendinitis.
Pain in the Bottom of the Heel – Plantar Fasciitis
Pain that is more focused toward the bottom of the heel may be caused by plantar fasciitis. This is the inflammation of a very important band of tissue that runs along the bottom of the foot.
The plantar fascia runs from the base of the toes to the heel bone. It is an important element in supporting the foot and helping to shape your arches. While strong, it is also flexible, storing and releasing energy when we walk. You can think of the plantar fascia a bit like a bowstring.
If the arch is an abnormal shape, however, it is going to place abnormal stress on the plantar fascia. Think of how bending a bow or trying to straighten it can affect its string. That kind of stress can be damaging to the plantar fascia over time and result in that terrible pain you are likely experiencing every morning if you have plantar fasciitis.
Pain in the Arch of the Foot
While plantar fasciitis can also cause pain in the arch area, so can inflammation of the posterior tibial tendon (PTT).
The PTT connects the calf muscles to the bones on the inside of the foot, running down along the arch in the process. Like the plantar fascia, it also helps support the arch and contribute to smooth walking.
When the PTT begins to weaken and grow inflamed, the condition may be referred to as posterior tibial tendon dysfunction (PTTD) or, in some cases, adult-acquired flatfoot. The latter may be used when the PTT is unable to support the arch as well as it used to, causing it to lower. As noted with plantar fasciitis, a change in arch shape can often be accompanied by further pain.
Pain from PTTD can be felt along the arch, but also extend along the inner side of the ankle and toward the calf muscles.
Another potential cause of heel pain is cavus foot, otherwise known as having a very high arch. This condition is often inherited, as many foot structure abnormalities are, or can also develop because of a neurological condition.
Pinpoint the Problem and Provide the Treatment You Need
We are just scratching the surface of how your foot anatomy can lead to painful problems. A natural machine as complex as our feet and ankles can have many different factors interfering with it. The key is in properly identifying those problems and providing the right ways to address them.
Such treatments may include the use of corrective custom orthotics, lifestyle changes such as wearing different shoes or losing weight, or physical therapy in the form of stretches that can strengthen tissues and loosen tight muscles. Surgery is only considered if no other options will be effective.
If you have been living with pain in your foot or ankle that isn’t going away, the worst thing you can do is keep hoping it will! Call Richardson Podiatry at (972) 690-5374 to schedule an appointment with us and get a start on finding the solutions you need.