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Jayson Goo, ATC, MA, CKTI, a National Athletic Board Certified Athletic Trainer, graduated from the University of Hawaii and earned his master's degree in human performance with a specialty in corrective therapy from San Jose State University. Jayson also is an active Certified Kinesio Taping Instructor.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The foot is an intricate structure of 24 bones that form two crossing arches of the foot. The longitudinal arch runs the length of the foot, and the transverse arch runs the width. The ankle joint is formed by the interaction of the foot and the lower leg, and the toes are on the far side of the foot. The bones of the foot are primarily held together by their fit with each other and connected by a fibrous tissue known as ligaments. The muscles of the foot, along with a tough, sinewy tissue known as the plantar fascia, provide secondary support to the foot. The foot has internal muscles that originate and insert in the foot and external muscles that begin in the lower leg and attach in various places on the bones of the foot. There are also fat pads in the foot to help with weight-bearing and absorbing impact.
The foot is the foundation of athletic movements of the lower extremity. Pain indicates that there is something wrong with either the interaction of internal structures of the foot or with the how the foot is interacting with external influences. How and when the pain occurs and the locations of the pain are the primary clues to what may be causing the pain. When there is pain, the body reacts by changing the way it moves or functions in an effort to reduce the pain. Biomechanical changes or disease may prevent the normal movement and cause further injury.
Foot pain may be caused by many different conditions or injuries. Acute or repeated trauma, disease, or a combination are the most common causes of foot pain. Trauma is a result of forces outside of the body either directly impacting the body or forcing the body into a position where a single or combination of forces result in damage to the structures of the body. Poor biomechanical alignment may lead to foot pain. Wearing shoes that are too tight or high heels can cause pain around the balls of the feet and the bones in that area. Shoes that are tied too tightly may cause pain and bruising on the top of the foot.
Injuries such as ligament sprains, muscle strains, bruises, and fractures typically occur suddenly (acutely). Sprains, strains, bruises, and fractures may be the result of a single or combination of stresses to the foot. A sprain of the foot or ankle occurs when ligaments that hold the bones together are overstretched and their fibers tear. The looseness of ligaments in the joints of the foot may lead to foot pain.
The muscle's bursa and fascia of the foot can be strained by overstretching, overuse, overloading, bruising, or a cut (such as by stepping on a sharp object). Achilles tendonitis is a common injury of the tendon that attaches at the back of the heel.
Injury to the bones and joints of the foot can be caused by a single blow or twist to the foot, or also by repetitive trauma that can result in a stress fracture. A blunt-force injury such as someone stepping on your foot may result not only in a bruise (contusion) injury but also damage to the muscles and ligaments of the foot. Direct blows to the foot can cause bruising, breaking of the skin, or even fracturing of bones. Metarsalgia is the irritation of the joints of the ball of the foot. "Turf toe" is a common athletic injury in which the tendon under the joint at the base of the big toe is strained. Trauma to the toenail can cause pooling of blood under the nail and the temporary or permanent loss of a toenail. Repetitive trauma to the bones, muscles, and ligaments can result in extra bone growth known as spurs or exostosis.
Injuries to both the skin covering and the internal structures may also be caused by multiple small repetitive traumas. Micro-trauma injuries can be caused by running on uneven surfaces, surfaces that are too hard or too soft, or shoes that have poor force-absorption qualities or fit incorrectly. Repeated overstressing of the same structure of the foot may cause stress fractures, tendonitis, plantar fasciitis, and acute and chronic osteoarthritis.
The arches of the feet absorb and return force to and from the body to the outside world when we are standing on our feet. Injury to the plantar fascia is a common cause of arch pain. The plantar fascia is a tough fibrous sheath that extends the length of the bottom of the foot and lends support to the arch. When the plantar fascia is damaged, the resulting inflammatory response may become a source of arch pain. High and low arches (flat feet) may cause pain because of strain to the feet.
Footwear can be a contributor to foot pain. Poor fitting shoes in the short term can cause blisters, calluses, bruising and be a source of athlete's foot. The long-term effects may be bunions, corns, irritation of nerves and joints, misalignment of the toes, and the source of microtrauma injuries to the foot.
Disease, viruses, fungi, and bacteria may also be the sources of foot pain. Diabetes, Hansen's disease, and gout are common diseases that affect the foot. Disorders of the nerves to the feet may cause numbness and burning sensation in the feet known as peripheral neuropathy.
Plantar warts commonly found on the bottom of the foot are caused by a virus and can cause irritation. Athlete's foot, which is caused by a fungus, also can lead to foot irritation. A common cause of foot pain is the ingrown toenail. Ingrown toenails occur when the edges of the nail grow through or into the skin, resulting in irritation and sometimes leading to infection.
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