Shoe inserts can relieve upper foot pain
caused by tarsal coalition

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August 5, 2017
A. Weinberg, Contributing Columnist

When your feet go out on you, the sensation is the worst.

They are your trusted friends, the ones that carry you around the
world. They are a method of transport, an excuse for stylish sneakers
and other shoes, and the first part of your body that reminds you to
get up and move, because all of a sudden, they’re cold.

Feet, however, have feelings too. They have lots of nerve endings and
quite a lot of tendons. When these are compromised or when fractures
or skin irritation occurs, they understandably complain.

The top of your feet are the most vulnerable because they are more
exposed to the world, and can be plighted with a variety of conditions.
The underlying causes tend to be more varied than just something
breaking or being sore, as feet are especially complex beings.

If you are sitting here reading this with foot pain, and wondering what
in the world is happening, why did they all of a sudden start acting up,
keep on reading. Statistically speaking, if you are North American, you
will be one of the 75% that experiences sore feet.

Spoiler: The most likely cause is a pair of bad shoes. Get yourself some
analysis and probably some arch support.

There are specific conditions, however, that have only partially to do
with footwear. So if you are asking yourself, “What’s the worst that
could happen to the top of a foot?”, keep on reading. We’ve also got
some cures in there for you.

. Extensor Tendonitis and Massage
Extensor tendonitis tends to be a pretty painful experience, when the
tendons get swollen. In addition to physical therapy, one method for
pain relief can be massage.

According to the book Therapeutic Exercise: Foundation and
techniques by Carolyn Kiser and Lynn Allen Colby, massage can heal
inflamed tissues, including tendons by the use of gentle, localized
massage. Make sure to consult your doctor to see what kind of
massage/massage therapist would be the best for your specific case.

Stress Fractures and Activity Modification/Crutches

In a 2011 report, Deepak Patel from the Rush-Copley Family Medicine
Residency recommends reducing the level of activity and mostly resting
the foot after it first fractures. Patel also suggests non weight-bearing
crutches for pain relief and pneumatic bracing to facilitate healing.
When the fractures are healed, you can gradually increase the level of
general activity, but try to mostly stay off your feet when the fracture
first occurs.

Sinus Tarsi Syndrome and Adjustment/Physical Therapy

Sinus tarsi syndrome is a persistent anterolateral ankle pain, that
usually happens in reaction to traumatic injuries to the ankle.

The discomfort is especially common for dancers, volleyball and
basketball players, overweight people, and those with foot deformities.
In his 2009 report, Kevin Hegleson, physical therapist from Idaho State
University, recommends adjusting the foot position by bracing or
taping, or using a foot orthosis.

Physical therapy is good to practice in conjunction, with balance and
proprioceptive training and muscle strengthening exercises. Of course,
it also helps to get your weight as close as possible to the
ideal body
weight for your height

Hammer Toe and Good Shoes

Hammer toe is often caused by wearing narrow shoes with little to no
arch support. The condition manifests as an abnormal bend in the
middle joint, as the toe bends downward to look like a hammer, usually
on the 2nd, 3rd, or 4th toe.

Georgeanne Botek, DPM, recommends using non-medicated padding
with the proper shoes made wider to accommodate your foot shape.

Gout and Diet Changes

Gout is a weird thing because the condition was much more common in
earlier eras. The disease occurs when dysfunctional metabolism of uric
acid causes arthritis in the smaller bones of the feet.

The good news is that there are some elements you can eliminate from
your diet to improve things right away.

Eliminate aAnything containing fructose and sweetened beverages,
according to a 2014 report from B. Alvarez-Lario from the Hospital
Universitario de Burgos in Spain. Alvarez-Lario also mentions that
skimmed dairy products can be a protective factor against the pain of

Pinched Nerve and Rest/Creams

Also called neuroma, a pinched nerve occurs in the foot sometimes due
to high arches or flat feet. The sensation may feel tingly and numb like
pins and needles. According to the National Institute of Neurological
Disorders and Stroke, relaxing the foot and allowing the area to heal is
the best remedy. Just don’t do anything. For pain management, they
recommend topical lotions and creams containing L-arginine.

Athlete’s Foot and Foot Soaks/Baths

Athlete’s foot is no fun: The condition can present as thick, cracking
skin, an itchy rash, discolored toenails, or all of the above. Luckily,
there are some easy home remedies that can relieve the irritation and

Gary Cole, dermatologist and doctor from the University of California in
Los Angeles recommends vinegar soaks and Clorox baths. To make a
vinegar soak, Cole recommends 1 part white household vinegar to 4
parts water.

For a Clorox bath, put ¼ cup of household clorox bleach into a bathtub
of water. Shampoos such as head and shoulders and Selsun Blue may
also be helpful. Spot test them to see if they work for you.

Ganglion Cyst and Electroacupuncture

The ganglion cyst is a non-cancerous lump that commonly develops on
the joints. Electroacupuncture is a new technique that has been proven
to work for some people suffering from the condition.

In a 2013 report, E. Woitzik from the Canadian Memorial Chiropractic
College reports one such case, a 45-year-old female cyclist who
developed a ganglion cyst on the top of her foot after a training period.
She was treated with high-frequency electroacupuncture in 4
consecutive sessions over 4 weeks.

After the therapeutic intervention, the problem was solved. Be sure to
ask your doctor and/or physical therapist if regular or
electroacupuncture could work for you.

Tarsal Coalition and Casting/Shoe Inserts

Tarsal coalition occurs when a bridge forms between the tarsal bones
of the foot that shouldn’t be there. The most common type of tarsal
coalition is called calcaneonavicular coalition.  To confirm the condition,
a radiography is usually necessary, or sometimes magnetic resonance.
According to C. Li from Tongfi University in Shanghai, China, the best
course of action is to do casting as an initial treatment. Soft shoe
inserts can also be a good option for easing discomfort.

Tibialis Anterior Tendonitis/Ice Massage and Exercise

The anterior tibialis is the part of the body responsible for moving the
foot towards the front of the ankle.

According to a 2009 report by A.D. Beischer from the Victorian Foot
and Ankle Clinic, the condition predominantly affects overweight elderly
women. The discomfort may present as midfoot pain and nocturnal

To heal, avoid any regular exercise like running or walking and
especially avoid steep inclines. Substitute with bicycling or swimming.
Ice massages are also a good option, according to G.J.Davies in their
1989 book Sports Medicine of the Lower Extremity

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