Gemma Hert
Does Pain In The Foot's Arch Require Surgical Treatments ?

The most common causes of arch pain are repetitive activities, such as walking or running too far; jumping; or standing on hard surfaces for long periods of time. Injury, such as tears in the ligament called the plantar fascia. The natural aging process. Biomechanical defects of the foot, or abnormalities we are born with, such as very high or low arches, or pronation (a turning out of the foot, causing us to walk more on the inner border of the foot). Plantar fibromatosis, a benign growth on the ligament that supports the arch.

Foot Arch Pain


The arches are the primary structures of the body that absorb and return force to and from the body to the outside world when we are on our feet. When something happens to these structures, pain and injury may result. There can be many causes of arch pain. Direct force trauma, ligament sprains, muscle strains, poor biomechanical alignment,stress fractures, overuse, inflammatory arthritis or the tightness or lack of tightness of the joints in the foot may all cause pain in the arch. Injury to the plantar fascia is a common cause of arch pain. The plantar fascia is the thick, connective tissue which supports the arch on the bottom of the foot. It runs from the calcaneus (heel) forwards to the heads of the metatarsals. When the plantar fascia is damaged, the resulting inflammatory response may become a source of arch pain.


The groups of muscles that support the arch can be divided into two groups. The muscles on the top of the arch start on the front lower leg and help to lift the arch, and the muscles that help pull the arch on the bottom of the foot are located the on back of the lower leg. Muscle injury may be indicated when pain is felt when the foot is fully extended, flexed, or turned in or out. Pain may also be felt when working the foot against resistance. Bruises are the result of a direct-force injury to the body. A bruise can occur to the foot by a variety of causes, such as having your foot stepped on or by stepping on a rock. The tissues that compose the arch do not provide that area of the body much protection. Blows to the foot that result in pain, discoloration, swelling, and changes in how you walk may indicate more serious damage.


In a person of any age, the doctor will ask about occupational and recreational activities, previous foot trauma or foot surgery and the type of shoes worn. The doctor will examine your shoes to check for signs of excessive wear. Worn shoes often provide valuable clues to gait problems and poor bone alignment. The doctor will ask you to walk barefoot to evaluate the arches of the feet, to check for out-toeing and to look for other signs of poor foot mechanics.

Non Surgical Treatment

Tight arches, overpronation and flat feet as well as tight calves all lead to inflammation of the connective tissue that forms this arch of your foot. This condition, plantar fasciitis, can be very painful, from your first step in the morning. Fortunately, treatment is easier than most. No operations, no fancy pulsed waves, no night splints necessary. Good arch supports? full length flexible (not hard) orthotics are key. Stretches of the calf relieve arch tightness as the heel bone acts like a fulcrum pulling back the arch tissues if too tight. Regularly perform the gastroc and soleus stretches that you learned at the gym. If lazy, buy "Pro-Stretch" on line which helps you stretch your calves easily. Use it often. You can't stretch too often, only too little. Finally, the magic cure is to roll a golf ball under the arch for half-hour once a day. (I know; a half-hour is a long time to perform one exercise, but that's what it takes. Once you master this exercise, it is easy to do while you work at your desk or are watching a half hour TV program.) This may hurt the first week. Keep going because by week two, after you go over the pain hump, the pain will be gone.

Arch Pain

Surgical Treatment

Cavus foot is caused in part by an over-pull of one of the lateral ankle muscles. A release of this tendon can be performed on the outside of the ankle. Additionally, a transfer of this tendon can be performed to help in correcting deformity of the ankle joint. Often patients will have a tightness of their gastrocnemius muscle, one of the main muscles in the calf. This can increase the deformity or prevent a correction from working. It is addressed with a lengthening of a part of the calf muscle or Achilles tendon. This is often performed through one or more small cuts in the back of the leg or ankle. Finally, the plantar fascia may be tight. The plantar fascia is a cord-like structure that runs from the heel to the front part of the foot. Partial or complete plantar fascia release may be done.


Stretch and strengthen important muscles in your feet, ankles and legs in order to guard against future strain. Make sure to acquire suitable arch supports and inserts if necessary, and that your shoes are shock absorbent and in good condition. Wearing tattered shoes provides no protection, and runners should replace their footwear before exceeding 500 miles of usage. Athletes new to arch supports should gradually build their training routine, allowing their feet to become accustomed to a new stance.
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