Doc Ed 1 - Foot Notes

I am a 45-year-old office worker who jogs two kilometers five times a week. Lately, upon waking up in the morning or after my afternoon nap, I feel pain on my soles when I start to walk. The pain disappears after I walk for a few minutes, but lately, my soles, especially the heel area are slightly sore the whole day. Is this pain caused my jogging? What can I do to eliminate this pain?—

Foot ache is a very common complaint of middleaged people like you who engage in sports that involve a lot of walking or running such as tennis, golf, and of course, jogging. Often, the foot pain is precipitated by a sudden gain in body weight or the wearing of shoes with poor cushioning or inadequate arch support.

There are many causes of foot pain. They include tendonitis, contusions, and stress fractures, but I suspect what you have is a condition called plantar fasciitis, the most common cause of heel pain, which is associated with high impact activities like jogging.

Plantar fasciitis is inflammation of the plantar fascia, a broad band of fibrous connective tissue that spans the area between the heel and the proximal ends of the toes. This fascia supports the arch of the foot and keeps it from collapsing under pressure. In young people, the plantar fascia is very elastic and can withstand stretching. With age, however, this fascia, like the other foot ligaments loses its elasticity. In addition,the fat pad that cushions the heel thins out. Consequently, in middle-aged people like you, excessive or frequent pronation of the foot, which characterizes sports that involve running, can lead to micro-tears in the fascia, which subsequently become inflamed and painful (plantar fasciitis).

Typically, as in your case, the pain of plantar fasciitis is felt when one starts to walk upon waking up in the morning and is relieved after walking for some time. Why is this so?

When a person is resting or asleep, the plantar fascia is in a slightly contracted position. At this position, in a person with plantar fasciitis, the micro-tears in the fascia that occurred during the day start to heal. When the person wakes up and starts to walk, the fascia is stretched and this causes the foot pain. After walking for sometime, the fibers of the fascia that are already healing are re-torn and the pain eases or disappears.

What can you do about your foot ache? Try the following measures:

  • Flex your toes up and down and stretch your ankles for 30 seconds before getting out of bed in the morning.
  • Perform regular daily stretching and strengthening exercises for your foot. Consult a physiatrist (doctor specializing in rehabilitation medicine) or a good physical therapist so you can be taught the right exercises.
  • Ice your feet or apply cold compress for 10 to 20 minutes after jogging.
  • Wear soft-soled shoes with good arch support. You can also use heel pads and arch supports (available in sports shops).
  • If your foot ache is not relieved by the above measures, I advise you to see a physician, preferably a sports medicine specialist or an orthopedic surgeon, so you can be examined and prescribed the appropriate treatment.
  • If left uncorrected, your foot injury could lead to further problems that could involve your ankle, leg, and knee such as bursitis, heel spur (new bone) formation, and nerve injury.

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