Pain in your foot when you exercise? Nagging ache even you are resting? Worried about what might be wrong? In this 2-part article, let Sports Medicine expert, Dr Low Wye Mun, tell you about some conditions that may be bothering you, and what you can do about them. 

They say that you have to have SOUL to play the blues convincingly. Well, there are a few things that the SOLE (and the foot it supports) can tell you about the blues – especially foot and ankle conditions that give you ache or pain, and interfere with your best efforts at exercise and sports. In the interests of all of you who have been plagued by SOLE matters, here are some tips on recognizing common conditions and managing them.

Numbness in your foot & toes

• How it feels: This is usually felt over the top of the foot, and sometimes around the toes and sides of the feet. The numbness may come on only after you start exercising (eg. after 30 minutes of hard cycling) and disappear after the you rest. Or it may persist and even affect you when you are not exercising (eg. after a trekking or hiking trip).
• What it is: Most commonly, the numbness is due to pressure being applied to the nerves just under the skin of your feet. This pressure may be due to shoes or boots which have been tied too tightly, or as a result of your feet swelling as you exercise. The shape of your foot may play a part : people with high arches or flat feet or with very wide feet may place greater pressure on the skin of the foot where it touches the shoe/boot
• Treatment: relieve the pressure on your feet by loosening some laces or lacing our shoes in such a way that the laces don’t cross over the foot or cause tightening of the shoe against the area that is numb. For soccer or rugby players and those who use hiking boots, you might want to try using an additional layer of padding under the tongue of your shoes/boots – some closed cell foam which is found in packing materials – as this may help to reduce the pressure on the skin and nerves. Inside tight cycling shoes, try moving your toes around after a hill climb or long sustained period of hard cranking. If all else fails, see your sports doctor who may also want to check if the numbness is related to other conditions (eg. diabetes).

Pain under the heel 

• How it feels: Pain occurring under the heel may be related to high impact activities (eg basketball, netball, high impact aerobics, martial arts). When you land on your heels, there is a sharp pain. As the condition gets worse, you may even feel this pain from the pressure of walking.
• What it is: This pain may result from over pressure on the heel pad which is the fat pad that protects the underside of the heel. There may also be some small dark spots appearing on the skin at the back or side of the heel. These are small blood vessels called capillaries which have burst as a result of repeated or heavy impacts that you have been taking on your heels.
• Treatment: the best way to heal this condition is to literally give the heel pad a rest. That does not mean stopping your sports (which would cause you heart ache in addition to your heel pain…). It does mean reducing the amount of impact forces you subject your heel to (that means the number of times you land hard on your heels, and how hard you land on them).
• More treatment: Another very important check is to see if your sports footwear has started to lose its shock-absorbing feature. This may because the mid-sole of the shoe has started to break down both as a result of repeated heavy impacts as well as just plain old aging. You should consider using a shock-absorbing heel insert in your sports shoes as well as your normal work shoes. And remember to give those heels a break when you are at home: avoid walking around barefoot on hard tiled floors: a simple and inexpensive pair of soft slippers will bring your heels a very welcome padding as you, well, pad around your, uh, pad…

More Heel Pain … 

• How it feels: This heel pain is not as dramatic as the heavy impacts to your heels. It sneaks up on you, and affects runners as well as those of you who spend a lot of time on hard surfaces (courts) or use hard shoes on hard ground (eg. soccer, rugby, hockey). You feel the heel pain most regularly as soon as you wake up and take those first few steps of the day. The pain under your heel may be so bad that you have to walk rather carefully to avoid stressing the heel. As the day goes on, the pain recedes. But it comes again with a vengeance after physical activity or sometimes even during the exercise. The pain is more frequent in those of you who have pronated or slightly/very flat feet.
• What it is: The pain arises from an overstretching of a ligament under the arch of your foot, called the plantar fascia. This is attached to the heel bone and extends forwards to the toes. The overstretching causes inflammation to occur and this is most common just near the attachment of the fascia to your heel bone. With pronated or flat feet, or if you have very tight calves, the fascia is placed under even greater tension.
• Treatment: You should see your sports doctor to have this checked out properly. This condition is sometimes associated with a heel spur, which is an outgrowth of the heel bone. There may be a need to take some medication to lower the inflammation, and in advanced stages, a steroid injection may be required. Apart from this, you will do well to change the mechanical factors that make this condition worse: stretch those tight calf muscles, use shoes with a slightly higher heel as well as slippers at home (this reduces the tension on the tense fascia), and use insoles that help to support those tired and flattening arches.

Finally, When you see your sports doctor, please remember to bring your sports footwear with you (running shoes, hiking boots, tennis shoes, football boots, etc). If you have just changed to a new pair, bring along your old pair with you too. This is so your shoes can be checked, telling the doctor a lot about your feet and how you run or walk, and possibly revealing problems in the footwear that may have caused the pain or ache.

In the next issue, Dr Low will tell you more about pain around the ankle, behind the heel, and in the front of you foot. Make sure you stay tuned to the SOLE channel !!