Pain in your foot when you exercise? Nagging ache even you are resting? Worried about what might be wrong? In the second of a 2-part article, Sports Medicine expert, Dr Low Wye Mun, tells you more about conditions that may be bothering you, and what you can do to help your feet.

In last month’s article on foot ache and pain, I tried to help you understand some of the conditions that aggrieve the soul. This month, we continue your qualification as a SOLE man (or woman) with some other conditions that are commonly seen and felt in the feet.

Bulging, painful big toe joint

• How it feels: Painful !! Especially after using certain fashionably-shaped shoes or standing for a long time or taking part in sports that have sideways movements. The pain is felt over the inner part of the joint at the base of your big toe, and there may also be swelling and redness when this joint is irritated. What it is: This is called a bunion, and is something that you have probably noticed for some time. It may affect the big toe on one foot more than the other, and you notice that your Mom or Dad has this condition as well. The pain, redness and swelling are signs of inflammation of the joint after too much pressure has been applied against the joint or you have moved the joint too much.
• Treatment: The treatment of an angrily inflamed joint means a trip to your doctor. Medication to quell the stormy toe joint is a good start, but the key to a more SOLE-ful life is to take steps to prevent it from happening again. This means careful choice of shoes, ones with enough space in the front part of the foot to allow for the bunion and not place undue pressure on it. Oh-oh. This may mean less fashionable shoes… You should also be aware this condition may be partnering a flattening of your foot arch, and that this gets worse as you put on weight, grow older, and in certain special states such as pregnancy. There may be a place for surgery on the joint, but your doctor is the best person to advise you on this. Incidentally, you do want to check with your doctor to make sure that this is not another condition such as gout.

Pain behind the heel 

• How it feels: If you feel the back of your heel and ankle, you will be able to put you fingers around a tough tendon that runs from your calf muscle downwards to your heel bone. This is the Achilles tendon (named after the Greek mythological god, Achilles) and it may sometimes get irritated and inflamed. This gives rise to pain in the tendon itself (squeezing the tendon is not an enjoyable sensation at those times) or its attachment to the heel bone. The pain is worse when you wear flat shoes, or when your exercise causes you to have to push off from the front of your foot (jogging, step aerobics, tennis, etc). The pain seems to be better when you wear shoes or sandals with slightly higher heels.
• What it is: The inflammation of the Achilles tendon is caused by it being overstretched too often, too much, or very suddenly. This is often the case when you play sports that use a flatter shoe on hard surfaces (eg. hard court soccer, badminton, volleyball) or when your favorite running shoes are starting to show their age. The aging of the shoes results in a breakdown or hardening of the inner cushioning of the shoe (called the mid-SOLE), and this allows your heel to sag more when you run, slowly over-stretching the tendon.
• Treatment: Apart from doing your best rest and apply ice to the sore area, this is definitely Sports Doctor-time again !! Some medication can bring prompt relief, but do bring your running shoes along for him to check the condition of the shoes. He will also check if your calf muscles are overly tight as well as this contributes to chance of you getting this condition again. Stretching of your calf muscles, strengthening exercises, and advice on shoes will help you keep this condition at bay.

Pain under the middle of your foot 

• How it feels: The soul of the SOLE is its arch. That is the name given to that curved space on the inner side of each foot. The arch varies in height and when it is very low, it is called a “flat foot.” Pain can occur in the area of arch and this may range from being an ache from standing too long or exercising to a burning, fiery feeling of something over-stretching. The ache may be worse when you are bare-footed on hard surfaces such as tiled flooring.
• What it is: The pain you feel is due to over-stretching and (once again) inflammation of the ligaments and joints that support the arches. In people with lower arches or flat feet, these supporting structures are already stressed and it does not take much to over-use them.
• Treatment: Have your sports doctor or foot specialist check your feet carefully. You can then be advised on a number of things that can help you to manage the ache and to prevent it from recurring. What can you expect? Well, the arches may need more support and this can come from a range of things such as insoles for your shoes as well as choosing shoes with more arch support to begin with. For runners, such shoes are commonly known as motion control or stability shoes. The sorts of insoles that may be used range from rigid orthotics (the most expensive option) to semi-rigid sports insoles, and finally, to softer arch supports. There are also some exercises and stretches that you can do too. So go have this checked out for enduring relief from ache (and endearing relationship with your SOLE..).

The final reminder is to bring your most commonly used work and sports shoes with you when you see your sports doctor. It is not that he has a shoe-fetish. Rather, they allow him to put together the whole situation regarding your foot pain and then treat you in the very best way he can.