As shock absorbers, our feet cushion up to one million pounds of pressure during a single hour of strenuous exercise. They also support 1.2 times our body weight during walking and two to three times that during running activities.1 It is not hard to see why our feet are highly susceptible to injury.
If you wake up and suddenly feel pain in your feet, what is going on? Why do your feet hurt, and how can a physical therapist help treat your foot pain?
Foot pain is a frequent reason why people visit their podiatrist or orthopedic physician. With over 26 bones, 33 joints, and five ligaments, there are many structures that can be injured in the foot. When these structures become injured or overstressed, pain may result, and limited functional mobility can occur. So, let's get to the bottom of why your feet hurt
Plantar fasciitis is one of the most common causes of foot pain.2 It results from irritation of a thick band of tissue, called the plantar fascia, that runs across the bottom of your foot. It connects your heel bone to your toes. People with plantar fasciitis experience pain across the bottom of the foot, typically near the inner part of the heel. Discomfort with plantar fasciitis is more common in the morning after waking up and with strenuous exercise like running, although you may feel the heel pain while simply walking.3
Physical therapy for plantar fasciitis involves using treatments to decrease inflammation and assessing the biomechanics of your foot, ankle, and entire lower extremity. Exercises for plantar fasciitis may include stretching, strengthening, and balance exercises.
Metatarsalgia is a condition used to describe a painful foot condition in the area just before the toes, or the ball-of-the-foot. It is called metatarsalgia because the bones in this region of the foot are named the metatarsals. With prolonged jumping or running activities, an increased stress load is placed on this region. Over time, the metatarsal bones become swollen and pain results.
Posterior Tibial Tendon Dysfunction
The posterior tibialis tendon courses down your inner lower leg and attaches to the bottom of your foot near the medial arch. The tendon helps support your foot's natural arch, and irritation here may cause pain, limited walking ability, and flatfoot deformity.
Treatment for this posterior tibial tendon dysfunction may include exercises for flexibility and strength, balance exercises, anti-inflammatory modalities, and orthotics.4 Your PT can examine you and determine the best treatment for your posterior tibial tendonitis.
Turf toe is a sprain at the base of the great toe. It occurs when the big toe bends back beyond its normal range of motion. This often occurs when kicking a soccer ball (and missing the ball and chunking the ground). This can cause a tear in the ligaments that support it.5 Pain with turf toe is experienced during walking and running activities. You may also experience toe cramping with turf toe.
Physical therapy for turf toe involves managing inflammation around your foot and toe and gently restoring normal mobility to the affect toe or toes.
Tarsal Tunnel Syndrome
Tarsal tunnel syndrome occurs when the main nerve that goes to the foot is compressed by bone or tissue. You may be more familiar with a similar condition in the wrist called "carpal tunnel syndrome." The symptoms of tarsal tunnel syndrome are typically felt on the inside of the foot region and are burning, tingling, and shooting in nature.6
Physical therapy is often one of the main ways to treat the symptoms of foot pain.7 Gentle stretching of the foot often helps to alleviate the discomfort felt due to the above disorders. Occasionally with plantar fasciitis, a brace is worn at night to keep the foot in a stretched position.
If you have foot pain, your physical therapist can also offer strategies to help treat your pain and improve your foot function. The ice bottle massage may be done to help control pain and inflammation. Your PT may also have you perform the plantar fascia stretch against a wall. This gently elongates your plantar fascia on the bottom of your foot.
A Word From Verywell
Foot pain can be a difficult thing to manage. It can prevent you from walking normally and may limit your ability to enjoy normal work and recreational activities. If you have foot pain, check in with your doctor and then visit your physical therapist to learn ways you can overcome your foot pain and return to your normal active lifestyle.