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Planning Retirement Online

Home Exercise and Rehab

February 2014

 

Gina John

Gina John is a Pilates Practitioner and Registered Osteopath who has spent many years offering help and advice, especially to the over 50 age group.

She is founder of The Osprey Clinic in the St. Johns Wood area of London and now specialises in Home Exercise and Rehabilitation Programmes. For further advice on exercising safely, and a selection of exercise films for general fitness and medical conditions, visit the website: www.home-exercise-rehab.com


 


 

This month: Easing Pain in the Soles of your Feet.

 
Q: I’ve recently had to give up my regular walks because of pain in the soles of my feet. The symptoms are at the base of the heel bones and would start after about 20 minutes of a gentle walk. Initially, the pain stopped once I sat and rested, but in the last 2 weeks the symptoms continue when I’m just relaxing on the sofa. Also, my feet are usually stiff on first getting out of bed.  Please advise me on how I can resolve these symptoms, as I’d like to get back to my regular walks again!

A: After walking for around 20 minutes, if the limb muscles and the sole of the foot fatigue, pressure will be placed on other structures of the foot. When pain ensues at the base of the heel bone, it is because a band of ligament termed the ‘Plantar Fascia’, which stretches to the base of the toes, becomes overstretched.

While walking, forces generated from the movement of the body are transferred along the outside of the heel bone and reach the big toe via the forefoot. Rotation occurs through the mid-foot towards the medial arch to facilitate this process. If the limb muscles are not sufficiently strong for the duration or intensity of the walk, and therefore are unable to provide adequate control for the transference of forces through the foot, forces travel towards the medial border of the foot, via the arch instead of via the outside border and the forefoot. This causes strain on the Plantar Fascia. Typically, pain occurs on the inner aspect of the heel bone at the insertion point of the Plantar Fascia.

This condition is termed Plantar Fasciitis, meaning an inflammation of the Plantar Fascia. There may be several contributory factors in developing the condition. Some people have excessive mobility in the small joints of the foot or have ligament laxity which results in poor stability for the foot during weight-bearing activities. Excessive weight gain or just standing or walking for long periods increases the pressure on the feet, thereby stressing the foot ligaments. Tight calf muscles and other lower limb muscle imbalance will also have a bearing on how the foot copes with weight-bearing activities.

It is important that footwear provides adequate arch support, but if you have flat feet, dropped arches or high arches you should seek consultation for orthotics.  These are inserts for the shoes which provide medial arch support and help to control the biomechanical forces passing through the feet.

There are several types of orthotics which can be considered. Fully moulded orthotics cost several hundred pounds, whereas prescription or custom-made orthotics start from around £50. Orthotics are fitted by podiatrists as well as some osteopaths and physiotherapists. The therapist will evaluate your symptoms, take measurements of your feet and weight bearing and take account of your lifestyle and the demands on your feet. You will then be advised on which type of orthotics will be most appropriate. It is inadvisable to buy orthotics from high street chemists if you have foot symptoms, as it is likely that proper evaluation of your condition and a bespoke solution will be required to resolve the problem.

Exercise is essential in strengthening the foot muscles as well as addressing muscle imbalance of the limbs. However, it is important not to exercise if you experience pain as you are likely to increase the severity of your symptoms. Seek evaluation and treatment from a podiatrist, physiotherapist or osteopath if you are unable to exercise. A course of treatment comprising Ultrasound, foot massage and cold therapy can be effective in reducing your symptoms and to enable you to start exercising safely. Additionally, anti-inflammatory gels can be massaged daily into the feet, or after weight-bearing activities to help your symptoms to subside.

The following exercises are appropriate to strengthen and condition your feet and limb muscles to help you to resume regular walks again.

Scarf Scrunching:
Placing the end of a scarf or Theraband under one foot at a time and trying to scrunch up your toes, to gather up the scarf. And, then point your feet and circle your ankles, 10 x clockwise and 10 x anticlockwise. This exercise is aimed at strengthening the small muscles in the sole of the foot.

Figure of 8:
Hook a scarf or Theraband around the foot and make a ‘figure of 8’ against the resistance of the band. Repeat 10 times on both feet. This exercise is aimed at strengthening the tendons around the ankle which provide control for the heel and middle of the foot while walking.

Leg Stretch
Lie on the floor or a bed and hook the right foot in the scarf or Theraband. Straighten the knee as far as possible and pull up the leg to maximise the stretch to the back of the leg. Keep the leg in position as you repeatedly point and flex the foot, up to 20 times.  Repeat the stretch to the left leg.

 

When your symptoms have resolved and before returning to longer walks or more challenging weight-bearing activities, add the following exercise:

Bend Stretch Rise:
Stand about 1-foot away from a wall and place the left hand on the wall. Keep the left foot lifted from the floor and bend the right knee, keeping the foot flat on the floor. Then straighten the knee again and rise up onto the ball of the foot. Lower the heel back to the floor again and repeat the exercise 15-20 times. Then, repeat the exercise on the left leg, with the right hand on the wall for support.

 

See all Gina's Home Exercise and Rehab features


Please send your questions for Gina John to answer in next month’s column to:
info@home-exercise-rehab.com



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