Why your foot and leg pain has come back!

You rested your feet. You stopped running, or playing that sport, or any other activities that would aggravate the pain while it was getting better. You iced your feet, kept them elevated on the couch and took anti-inflammatories and pain-killers. You stopped wearing those not-so-good shoes during your recovery. Perhaps you even had a cortisone injection. Yet despite all this effort, your pain has now returned. So why has this happened when you’ve done everything as instructed to begin with? 

Here’s the truth: Everything listed above is just a band-aid and does nothing to address the cause of your pain or injury.

Yep, that’s the cold, hard and very unfortunate truth. When you rest, ice your feet, take anti-inflammatories and even have cortisone injections, you’re just masking the symptoms. You want the pain and discomfort to stop, and these methods do that and help you to feel better. While you’re resting your feet and not using them, the damaged structures will even begin to heal and repair. Unfortunately, what this doesn’t do is ask why you got the pain or injury in the first place, what caused it, or do anything to fix or correct the problem to stop it from continuing to cause you pain and frustration for the years to come.

Let us give you a very common example that we see almost daily in our clinics:

A person comes in with pain beneath the ball of their feet. The cause of the pain is a combination of their gait (the way they walk) which puts more pressure through the middle of the forefoot, combined with recently increasing the amount of exercise they’re doing (to get fit for summer, of course). If we’re going to get technical, what’s really happening is that increased pressure and loading through the forefoot has irritated a bursa at the ball of the foot, which is a small fluid-filled cushion that helps tendons glide and move around bone without injury. However, the high repetitive pressure on the bursa has damaged it, so the bursa has swollen and is now putting more pressure on the surrounding bones and is causing considerable pain. 

If this person comes in with this forefoot pain and is told to rest, ice the foot, take anti-inflammatories and pain-killers, wear supportive footwear until it gets a bit better and perhaps have a cortisone injection, then it’ll help their painful symptoms. There’ll be less pressure on the bursa so less swelling and less pain. The ice and anti-inflammatories will also temporarily reduce the swelling so less pain is produced. The pain-killers will affect the pain receptors so that less pain is felt. Cortisone will also block pain perception. The footwear will help support the foot only while it is being worn. But none of these will treat the cause. So when our patient feels better enough to get back to the gym in their unsupportive footwear and once again begin to overload the forefoot because of their gait, guess what’s going to happen? You got it – the bursa will become irritated from the pressure again, it’ll swell, and just like that the pain is back.

So, what should be done to fix the problem and keep the pain gone?

It’s pretty simple really – you treat the cause. In order to find the cause, of which there are often multiple causes or contributing factors, you need a professional assessment using the right diagnostic equipment. That’s where we come in. Let us describe this in a way that refers back to our patient…

Our patient comes in and we get their full history, including learning that they have recently joined a gym and are going four times per week. We look at their shoes and quickly see that they’re not doing anything to keep the foot stable and supported. We conduct tests to determine the muscle strength and function, the range of motion available through the joints of the feet, and any abnormalities associated with the bones, joints and tissues. We conduct a video gait analysis and explain the abnormal gait patterns we’re seeing, the loading of the forefoot, and how their tight calf muscles are contributing to this (yep – they’re related too). 

We use a pressure plate which lights up bright red through the forefoot, right where the pain is. We palpate the area and get a feel for the involved and damaged structures (it could also be the joint capsule, ligaments, bone and much more). If we have any uncertainty, we refer for an ultrasound or x-ray. But in this case, we’re very confident as we see this every day, and the symptoms line up perfectly. We diagnose bursitis beneath the 2nd and 3rd metatarsophalangeal joints.

And then… We form a treatment plan that will fix the cause.

The treatment will relieve that pressure from the forefoot with every step they take. It’ll help the bursa heal and return to its original healthy and functioning self. It’ll mean they can continue getting fit while no longer irritating that bursa by altering their gait and the way their foot moves. It’ll loosen up the tight calf muscles which were a contributor to this problem. The bottom line is. It’ll get them pain-free and able to realise their full potential.

So if you’ve got a pain or problem with your feet, please make sure that you’re treating the cause of the problem and not just the symptoms! This month is Foot Health Month in Australia and we’re on a mission to raise the awareness of the expert role that Podiatrists play in lower limbs – and this is just one of the many ways we help. If you’d like to get on your way to being pain-free on your feet, give our team a call on 07 4638 3022 or book online here.