Mega Doctor News
Newswise — For nurses, servers, construction workers, and many others, work means a lot of time on the feet. Repeated motions can lead to muscle, nerve, or tendon stress. A split-second equipment slip can outmatch steel-toed boots and result in a fracture or break.
Moyosore Tillery spent more than a decade addressing these types of injuries as a physical therapist focused on occupational health and outpatient orthopedics. In private practice, she also treated runners with foot pain.
While Tillery notes that diagnosing and addressing foot pain is incredibly patient-specific, she says there is one general truth: “It’s almost never just one thing.” A physical therapist can help narrow in on issues and mitigate further damage.
“It’s ultimately about what’s happening above or below a joint,” said Tillery, an assistant professor in the Department of Rehabilitation Sciences at Tufts University School of Medicine. “We use our expertise as movement scientists and movement analysts to try to figure out what’s weak, what may be tight, what may be hyper- or hypomobile, and a lot of our skillset is geared toward identifying and addressing all of those different issues.”
Risk Factors
Most people get sore feet from time to time. But there are a few factors that put some people at higher risk. Occupation, of course, plays a role. People sitting at a desk may be less likely to suffer from foot pain than those who regularly perform physical labor or move often in their jobs. But genetics, sex, lifestyle, weight, and even geographic location and terrain can also influence the likelihood of foot pain. When monitoring for potential sore spots, it helps to make note of how these factors may play into your specific circumstance: Do you often hike on uneven ground? Are you commuting to work by bike? Does work require you to wear specific shoes, such as steel-toed boots, that put you at higher risk for developing corns?
Some pain risk factors will change throughout our lives. Pregnancy, for instance, can put additional strain on the feet because of the added weight, and make injury more likely because hormones in the body relax muscles. As we age, our bone density changes, as does our flexibility. “Things that are stretchy are just less stretchy as we age,” said Tillery. “We have to stay ahead of that, or at least be aware.”
Avoiding Injury
Having that awareness allows for mitigation of any additional risks. Running can help build bone density, according to Tillery, and any physical activity will make sure our body is used to movement. “These things are preventative, but it also goes hand-in-hand with what we do as physical therapists in the rehab process,” she said. “There’s a reason exercise is involved, to build up what we will lose as we age.” A physical therapist can also conduct a “biomechanical analysis” — a study of how a body moves when performing specific tasks — which can identify and help correct any weaknesses in the body that could lead to pain down the line.
Before physical activity, Tillery recommends “dynamic stretching and mobility exercises.” Think of a short, quarter-mile walk before beginning a run — something to get the blood flowing in a way that won’t jolt muscles immediately from rest to high-intensity movement. It’s also helpful to cross-train. Mixing in different types of physical activity can help the body avoid stress injuries from repeated motion, like plantar fasciitis, a condition that occurs when the tissue connecting the heel to the toes becomes inflamed.
And then there’s strengthening. When you hit the gym, you probably don’t think about pumping iron to strengthen your feet. But there are exercises that can make our all-important foot muscles more agile, mobile, and strong, like toe curls, flexing your ankle up and down, and calf raises.
There are some foot problems that are extremely difficult to avoid that are unrelated to injury. Arthritic inflammation can lead to bunions because of associated joint damage or misalignment, for instance, and gout can cause swelling and extreme joint pain. You may be able to reduce complications from these conditions if you’re aware that you’re predisposed to them and take precautions to alleviate symptoms.
Pain: What to Look Out For
Providing all-encompassing advice for the onset of foot pain is difficult, because, as Tillery explains, it’s all dependent on the patient — and the pain. The foot has more than two dozen bones, 30 joints, and more than 100 ligaments, muscles, and tendons, and discomfort can stem from any number of areas. Injuries “can span the joint, the muscles — even nerve flexibility,” says Tillery.
But there are a few symptoms worth paying attention to. Foot pain often begins in the hips and the gluteal muscles — a trio of muscles that help us walk. If you notice any tightness in your hips or discomfort when you sit or stand, think about ways to stretch and relax those muscles, like a 90-90 stretch or a supine hip flexor stretch.
Asymmetry can serve as another indicator of oncoming pain — is one side of your body feeling a bit off? Understanding a patient’s baseline on one limb can help physical therapists like Tillery set up a treatment plan. “We’ll often use the unaffected limb as a baseline to assess where the deficits are for the affected limb,” she said.
Overall, Tillery says any type of sensation change may be your body offering you a sign that something isn’t right. Depending on the severity, that may be when you should reach out to a professional.
How to Respond
Because each injury can depend on the person, Tillery advises talking to a professional before making any decisions about how to treat pain. “Go see your trusted medical provider who can screen and do less-invasive tests, and then let them guide you,” she says.
Depending on the severity of an injury, that may mean a visit to a physical therapist or other primary care providers — if the pain is minimal or not particularly traumatic — or a trip straight to the emergency room. “Obviously if it’s black, it’s blue, and it’s completely numb, go to the emergency room or urgent care,” says Tillery.
Last, it pays to stay patient. Not every person will heal on the same timescale, and patient education plays an important role in helping people understand how long the process may take for them. If injury does happen, people who smoke may take longer to heal. Nicotine contracts blood vessels, restricting blood flow and the movement of nutrients that are important for healing. People with diabetes can also be slower healers because of slower circulation and less oxygen reaching different tissues in the body. These circumstances are important to be aware of, because they may influence the advice a medical professional provides to boost healing after an injury.
