Why the Heck do My feet Hurt?

Painful feet can ruin your entire day or hold you back from things you enjoy doing. The cause of painful achy feet can greatly vary. Two of the most common causes are due to either very flat feet known as pes planus or high arches referred to as pes cavus. 

Pes Planus

Flat feet come with side effects such as a heel that splays outwards (calcaneal valgus), a forefoot that points outwards (forefoot abduction), a arch that collapses when standing resulting in pronation, an ankle that rolls inwards (ankle valgus), and in severe cases the knees will be in a “Knocked kneed” position (genu valgus). People with Pes planus feet, such as myself, usually feel pain along the inside of the ball of the foot (first metatarsal head), along the arch, along the outside of the ankle joint just under, and even the outside of the knees.  Shin splints are often associated with pes planus.

Pes planus can be either congenital or acquired. Congenital pes planus is generally due to genetics as where acquired pes planus is likely due to injuries affecting the achilles tendon and the posterior tibial tendon causing the arch to collapse. Other possible causes maybe obesity and autoimmune disorders such as a charcot event. Pes planus usually accompanies conditions such as cerebral palsy and muscular dystrophy.

Pes Cavus

Pes cavus is a very high arch and is often rigid as compared to the common flexibility of the pes planus foot. The pes cavus foot often causes the foot to roll outwards, with the forefoot and heel moving inwards towards the body (forefoot adduction and calcaneal varus). The ankle and knee may also follow with the ankle rolling outwards (ankle varus) and the knees appearing to be bow legged (genu varum). Feet of this type may also present with rigid hammer or claw toes. people suffering from pes cavus generally have pain on the tops of their toes, along the outside (lateral) bottom surface of the foot, along the ball of the foot and heel (due to the majority of the weight being placed onto them), and along the inside of the ankle/foot joint, just under the ankle bone. This condition can be caused by genetic, club foot, neuromuscular diseases, polio, cerebral palsy and Charcot Marie Tooth disease (CMT). 

What to do About it?

In general, people experiencing some type of foot pain can be traced back to their gait and specifically what their foot is doing during ambulation. If the foot is excessively rolling inward or outward, one simple solution is to provide the arch with some support in way of a custom foot orthosis. A custom foot orthosis is very helpful when trying to reduce the amount of pressure on one or more parts of the foot and redirecting the excessive motion to a more neutral position. In severe cases a person may require a type of ankle orthosis (AFO) or even surgery. 

If you think you are a good candidate for foot orthotics (inserts), please talk to your doctor and orthotist. After a simple physical examination of your feet, an orthotist can quickly determine what you would most benefit from and then custom make a pair of foot orthosis to meet your needs. There are many ways to fabricate a foot orthosis and by seeing an orthotist you can be assured that you are going to get the best combination of materials and support. Be aware that you will likely need a prescription from your physician in order to have foot orthotics custom made for you.