Arch Pain in the Foot
The arch in your foot is important for you to walk properly. Human beings are the only primates that have an arch on the foot. The foot has 26 bones and is a very unique structure. It must do two basic things well, to make your body work normally.
When you first come down on the ground the foot needs to be a shock absorber * and an adapter to the terrain. This is often referred to as a pronated position of the foot. This is when the foot is flatter and more adaptable. The bones are loosely organized, so the foot can adapt to the terrain, and absorb shock.
When you move forward and the toes move upward, the foot becomes a stable structure and is able to propel you forward, for you to take the next step efficiently. This is often referred to as a supinated position of the foot. The arch of the foot increases in height ** as the foot goes into this stable structure. This needs to occur for the foot to become stable. The stability of an arch can be demonstrated by taking an index card and trying to push it in the middle. You see how easy it is to deform the card. Now create an arch with the card and try to deform the card. You can see that it is much more difficult to deform the paper in the middle when doing this.
The body has a pulley system to help the arch form as you move forward. The pulley is your metatarsal bone behind the toes. The rope on the pulley is the plantar fascia. This is the ligament that goes from the heel bone to the toes. This is shown in the depicted model. As your toes move upward, the plantar fascia is placed under tension, and this causes your arch to form under normal circumstances. If you want to have a stable foot moving forward, you will need to move your toes upward when walking. An insole should ideally support movement of the toes and allow the foot to form a stable arch.
What causes arch pain?
- When the foot arches are too low, the ligaments between the bones are stressed. The ligaments (in yellow in the skeletal foot model) provide stability between two bones. They are a relatively stiff tissue and need to be so, for them to do their job well. When the foot flattens. the ligaments are stretched. This can be one cause of your pain.
- When the foot flattens, it also causes tension on the smaller muscles in the foot called the intrinsic muscles. When these are stretched TOO much, they become weaker. When they weaken, they simply cannot do what they are supposed to do as well. As this occurs, it contributes to the pain and affects the function of the foot. This can result in deformities of the foot with repetitive injury.
- The leg muscles will attempt to stabilize the foot when you have a flat foot, causing pain in the legs.
- Flattening of the foot causes structural changes in the whole body affecting the ankle, knee, hip and back. If these structural changes are severe enough, pain can result in all these areas. This pain is from postural instability. What happens in the foot can affect many other structures. Therefore, foot pain should be considered as a potential source of pain in any other areas.
As we discussed initially, the foot will flatten and become a shock absorber when it first hits the ground. This is normal and necessary and not a problem in most people. However, in some people it flattens too much. This is called excessive pronation. If this is the problem, you may have had flat feet all your life and this pain is something you have lived with for a while. It is difficult for the arch to stabilize properly when the foot is flat. Pregnancy, weight gain and other changes in your life can also lead to flat feet.
What can be done about the pain?
By allowing the toes and foot to move properly, you allow the foot to be both be a shock absorber and a stable structure to move the body forward efficiently. Restoring the proper movement to the foot is essential for this to take place. The need for an insole to do this, led to the development of the Cluffy Lux Step insole.
I had an interesting experience with custom orthotics. I was volunteering in 2013 at the Iron Man Triathlon event in Hawaii. This is the world champion event for triathletes. You must be an elite athlete to enter this event, by qualification. I was helping the athletes transition from the bike to the run, so I was helping them get their shoes on for the run. While there, I saw a lot of terrible feet, I never once saw a custom orthotic being used by a single athlete! This was quite a revelation to me at the time. For many years I used quite a few custom orthotics in my private practice. This motivated me to research and ultimately design an insole that really worked with the foot, to improve overall mechanics and was comfortable for athletes.
Shoes can also provide support to the foot and can help with arch pain as well, but they are usually not the only answer. Shoes are really a secondary solution, not the primary solution. It is important to select a shoe and the best insole.
Also, remember the foot needs to re-stabilize as it moves forward. As you now know, this relies on movement of the toes upward, as the foot rolls forward. I believe a lack of this motion is the greatest problem with foot function and is responsible for most foot pain. This problem is known as functional hallux limitus. What this means, in essence, is that there is a “jamming and locking” of motion in the big toe that occurs with walking. This occurs only in the big toe, and the big toe is the most important toe for normal foot function.
Arch pain occurs for several reasons:
- Some shoes restrict the motion of the big toe as they are too tight around the big toe.
- Some shoes do not allow any movement through the ball of the foot, because they are too stiff.
- We walk improperly, not rolling through the foot correctly, and this changes the bone position and will restrict normal motion.
- We stand for prolonged time periods, and this can cause a change in bone position.
- As we age our bone structure is more likely to change position as we do repetitive activity over many years.
- The foot is excessively flat, and this will also cause restriction of motion of the big toe.
What should you do next?
There is a simple solution to this problem, and that is to raise the big toe slightly off the ground or floor. This is a key feature in our Lux Step insole. If you have foot pain, you probably have limited motion of the toes.
Once motion is restored to the toes, the foot can restabilize as you roll through the foot normally, bending the toes and allowing the plantar fascia to put the foot in stable alignment. When this occurs, the bone structure will change alignment, and the foot will change over time to improve structurally.
When this restriction of motion of the big toe continues over a longer time frame, the big toe joint can get arthritic, and this can be a problem that is difficult to overcome. 2 to 4 % of adults between the ages of 30-60 years old have this problem. Some people with this problem need surgical correction and not all surgeries will restore the mobility of the big toe normally. Some surgeries will only allow minimal motion, or they interrupt the normal mechanics of the joint. If you have arthritis, you may not be able to lift the toe comfortably, so you are stuck with a situation that certainly is not perfect. It is better to deal with this problem when arthritis is not present and take a more proactive approach to your foot pain.
We have engineered the Lux Step insole to comprehensively address all the issues causing arch pain. It is the only product on the market that addresses the limited motion of the big toe, (functional hallux limitus), as well as excessive pronation. Now that you are an educated consumer, you will be able to shop for shoes knowing what to look for, and what a good insole can do for you long-term.