To better understand physical therapy’s role in treating foot pain, it helps to know a bit about the anatomy of the foot. Below are some foot anatomy facts:

• Each foot has 26 bones including the bones of the toes. Joints are formed where bones connect
• The foot can be divided into the hindfoot, midfoot and forefoot- Each of these areas functions differently to help you stand, walk, run, etc
• Numerous ligaments connect the different bones and help to give the foot its shape and stability to withstand the forces of weight-bearing
• Nearly 30 muscles--some originating from the lower leg and others within the foot itself--work together to create the delicate balance of foot mobility and stability
• The plantar fascia is a thick layer of connective tissue running between the heel and ball of the foot. The plantar fascia: Helps create the arch of your foot, Acts as a shock absorber for the foot, Assists in changing the position of the foot as you walk

Many nerves traverse the foot to supply motor and sensory information to the area

As you can see, the foot is a complex area of the body. While it is made to withstand a lot of force, changes in the anatomical structure of the foot, alterations in muscle strength, ligament stability or overall flexibility in the tissues could lead to pain. Similarly, overuse, injury or introducing new activities at high volume can cause irritation to some of these structures and result in pain or discomfort.

COMMON CAUSES OF FOOT PAIN

There are many potential causes of pain in the foot. Pain caused by arthritis, a fracture or broken foot bone, muscle strain or ligament sprain could occur anywhere in the foot depending on the location of injury. Other causes of foot pain can be identified more easily by location:

Bottom of the foot and heel

• Plantar fasciitis
• Bunions
• Morton’s Neuroma
• Achilles tendonitis
• Sever’s disease
• Tarsal Tunnel Syndrome
• Heel spurs
• Haglund’s deformity

Inside of the foot:

• Mid-portion plantar fasciitis
• Deltoid ligament sprain
• Posterior tibial tendonitis
• Flexor hallucis longus tendonitis
• Bunion

• Big Toe
• Turf toe
• Gout
• Hallux rigidus

• Outside of the foot
• Ligament sprain
• Peroneal tendonitis
• Cuboid syndrome

Determining the cause of foot pain is important. If you opt to schedule a visit with a physical therapist before seeing your doctor, a process called direct access, your physical therapist will use observation, palpation, special tests and other exam elements to try and localize the cause of your pain. Though not always needed, when indicated, your therapist may refer you to a foot and ankle specialist or orthopedic physician to request imaging such as an x-ray, MRI or ultrasound to visualize the structures of the foot to diagnose the cause of your pain. In many cases physical therapy is an excellent treatment option for foot pain, however, in some cases, you may need other medical treatments or surgery to achieve full resolution of symptoms.

If you decide to work with a physical therapist to help correct your foot pain, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

WHAT PHYSICAL THERAPY TREATMENTS ARE BEST FOR FOOT PAIN?

The answer to this question is truly individualized and depends on many factors such as the cause of your foot pain, the severity and chronicity of the symptoms, and other personal factors like your prior level of activity and other medical comorbidities. Your physical therapist will design an individualized treatment plan for you, however, these are some of the more common foot pain treatments offered by physical therapists and which you might experience when working with your PT:

Modalities and manual therapy techniques to reduce pain and inflammation and promote tissue healing and fiber alignment

Weight-bearing modification and support recommendations such as the use of bracing, taping or an assistive device like a cane or walker to offload painful or injured tissues

Muscle strength, endurance and power training to improve stability and strength for return to normal activity once pain symptoms improve

Tissue and joint mobilization, mobility and stretching techniques to restore normal range of motion and flexibility which can be an important aspect of addressing foot pain

Gait training to restore normal walking mechanics with walking and running

Motor control and coordination training to ensure proper muscle activation around the foot which is helpful to prevent the recurrence of the painful symptoms

Sport and work-specific training exercises to prepare the foot to return to your prior activities if the pain has caused you to stop or reduce your activity level.

As you can see, physical therapists have a lot of treatments in their toolbox to address your foot pain but knowing which ones to use requires training and knowledge. If you have an injured foot or are experiencing discomfort in your foot, call us today to learn more about our services and schedule an evaluation