“When your feet hurt, you hurt all over,” says an old proverb. You blame bad posture, getting older, bad shoes…but the real culprit of foot pain is a muscle imbalance. You want it to stop. Many of us think expensive shoes or orthotics are the only solution to foot pain.

• But if you want to stop a sagging stomach, do you wear a girdle or start doing those abdominal crunches?
• If you are tired of flabby underarms or thighs, do you wear loose clothing or do you hit the dumb bells and strengthen your triceps and quads?

Feet work by muscles too. If the muscles of the foot are healthy and fully developed, you will not have foot pain. Medical massage addresses the cause of the pain – the muscle imbalance - and it can make pain stop for good.

Feet are your bottom line - as you walk or exercise all your weight bears down on your feet. It's only when our fee start to hurt – toe pain, ankle pain, bone spurs, arch pain, plantar fasciitis - that we realize our feet need attention. Injuries, postural habits, and immobility from being constrained in shoes -- all these can lead eventually to foot pain. Medical massage for foot pain can correct each of these foot problems and stop the pain. (For the science behind this fact, read more about medical massage.)

Can it really be that simple? Massage can eliminate foot pain? Yes! You may believe foot problems are heredity or unchangeable - like flat feet or because your mother had them. But everyone is born with flat feet! It's how we walk and develop the muscles of the foot that creates and supports the arches. Well-developed foot muscles and strong arches are essential - not only to prevent foot pain but also to support the rest of your body, and even to prevent low back pain.

There aren’t any muscles in the foot, you think, so how can medical massage help? The big muscles that drive the foot are in the calf – this is where we work to improve foot pain. Massage can end plantar fasciitis, hammer toes, and all kinds of foot pain and shin splints.

Massage therapy can help almost any soft-tissue injury feel better temporarily. The greater question is, How much better? And for how long? The degree, type, and general history of the injury combined with the schedule of treatment and the willingness of the client to develop awareness and perform self-support like stretches will determine the answer to these questions. But generally for injuries consider 3-5 sessions ( with improvement significant after 1 or 2) and for chronic, longstanding problems consider 8-12 sessions (again with improvement significant after 2 or 3).

Diagnoses – bunions, hammer toes, plantar fasciitis… all describe the body’s response to biomechanical problems in the muscles and connective tissues (tendons, ligaments, and fascia).

These are all types of foot pain that Massage therapy can help:

(Note: reciprocal inhibition and nmt techniques can help or correct foot problems – but these are specific protocols aimed at your foot issue, medical massage as I use the term. Please don’t think a whole-body, feel-good massage will make significant progress on foot pain.)

• Pronation (over-pronation) - One of the most common sources of foot pain, a pronated foot sends ripple effects up the leg to cause hip pain and pain along the outer side of the thigh. It can be the underlying postural cause of many of the foot conditions below.
• Bunion - Podiatrists often tell their patients that wearing shoes too tight is the cause of bunions. While this can add to the problem, the direct cause of bunions is tight muscles in the foot that pull the big toe toward the other toes, throwing the joint out of alignment. The body tries to support the mis-aligned joint by filling in with calcim, causing the bunion. Two of the muscles that becomes tight and pull the toe are the adductor hallucis and the flexor hallucis longus (from keeping your feet in plantar flexion too often). When this muscle (and others like it) become tight and overused, they will shorten and start to pull the big toe with them, causing the toe to move toward the other toes. Stretching of the calf muscles is a very good way to help with the pain. It will also help with the range of motion in the ankle. As the stress moves off the area, the bunion can dissolve. Although it may not ever be 100% straight, the pain will go away.
• Hammer toes - Hammer toes are caused by a muscle imbalance that makes the ligaments and tendons of the middle toes (not the big toe or the little toe) unnaturally tight. The result of the tight ligaments is a toe joint that curls downward. some toe exercises that you can do at home to stretch and strengthen the muscles. For example, you can gently stretch the toes manually. You can use your toes to pick things up off the floor. While you watch television or read, you can put a towel flat under your feet and use your toes to crumple it.
• Mid-arch pain- pain under the inner side of the arch while walking or rising onto the balls of the feet to reach for something is most likely problems with the muscles of the big toe.
• Plantar fasciitis – Plantar fasciitis can be excruciating foot pain. The pain can be in the bottom of the foot, or in and around the toes, or in the mid-arch. One clear indication is if the pain is considerably worse in the morning, making it almost impossible to walk when first getting out of bed. Plantar fascitiis is a form of tendonitis, where the muscle tightness pulls on its tendonous attachment causing an overload that produces inflammation, usually at the point where the fascia is attached to the heel bone (calcaneus) or the toes. The result is pain. Since it is difficult to rest the feet, the inflammation grows worse. The inflammation process may cause heel spurs, yet heel spurs do not cause the initial pain or problem. Rather they are the result of prolonged muscle tension. If untreated, however, heel spurs will add to the pain when walking.
• Flat feet- did you know we are all born with flat feet? The foot arches are created by the proper pull of muscles in the calf as we learn to walk. Several factors can inhibit the development of arches, and injuries/surgery can also affect the arch in later years.
• Heel spurs - the result of prolonged muscle tension. If untreated, heel spurs will add to the pain when walking. If caught early, and if the muscle imbalances causing tension are eliminated, heel spurs can disappear naturally just as they appeared. But it does require time and rest, as it happens at about the same rate.
• Tendonitis – cause is a muscle becoming too tight, or short, from repetitive use. This constant overuse of the muscle causes memory loss in the muscle, and the muscle fibers tightness becomes ingrained in the memory patterns of the brain as “normal.” After a period of time, the muscle begins to pull some of the fibers off of their attachment sites. Restricted circulation causes inflammation.

  Medical Massage for the feet
  

  Medical massage is a different experience from your usual full body relaxation massage. A typical hour session will focus about 45 minutes specifically on the presenting issue – the muscles of your foot, and there will be an assessment before and after. You should wear shorts or loose workout clothing, and be prepared to learn some stretches and exercises to do between sessions.

  Do I have to stretch forever? The long term… If the problem occurs from an injury that heals incompletely or poorly, once the muscles are returned to their natural state you most likely won’t experience future issues with foot pain.

  If the problem occurs through repetitive-use syndromes, then if you return to whatever overuse pattern then it can return. For some, knowing and understanding the problem means you return to the stretching program at the early signs. For others, a journey begins to explore altering the pattern with movement therapies like Feldenkrais, or a search into why you respond to stress in a certain way. Rolfing is very good at this. Patterns often have an emotional component, developing under emotional stress as opposed to anything physical. Releasing the emotional memory is usually enough to allow the body to change its muscle memory pattern.

Shoes and Orthotics: The Good and the Bad

Many people use shoes as a way of taking care of their feet. They believe that if you wear the best, ergonomically correct shoes, your feet will be fine. But while it's certinly important to wear soft soles to cushion your joints from the impact of walking on cement, that doesn't replace caring for your feet in a way that maintains full function in all their muscles and bones.

Sneakers - Huge amounts of money go into designing and manufacturing the best sneakers for different sports. But because sneakers support the foot muscles everywhere, they never get activated and don't do any work. Essentially, when you put on sneakers, you're putting your feet to sleep - then working out. It's great to have these specialized sprot shoes, because they are comfortable and they do stabilize the foot and ankle during exercise. But remember that the feet are c0nnected to the rest of the body. If you exercise without consciously working your foot muscles in a way that fully activates the leg muscles they're connected to, you're likely to develop knee and hip problems that ultimately will affect your back.

So make sure your foot bends when yuou walk, and that you can point and flex your toes, in any pair of sneakers you buy. But beyond that, give your feet their own workout, separately from whatever you do wearing sneakers. That will keep them strong, flexible, and properly aligned.

What About High Heels? - Here's some good news: If your feet are really strong and healthy, you should be able to wear any kind of shoes without permanent damage. It's true that heels - medium as well as high- affect your alignment by shifting weight to the ball of the foot. So you wouldn't want to wear them all day, every day. But your should be able to wear them for short perious without causing foot, or back, pain - as long as each time you wear them, you work the negative alignment that heels create out of your whole body, as well as your fee, so you don't get stuck in poor posture patterns.

Orthotics- Another common measure for relieving foot problems is an orthotic, a support inserted into a shoe. But orthotics aren't really a cure - they are a band-aid. Othotic devices support the arches, but do nothing to correct the cause of the problem (Inactive and tight muscles). Rather than enabling the foot to return to healthy flexibility, they make the structure dependent on the orthotic. That being said, they can be an intervention if your foot problems are severe, or caused by injuries where the foot needs help healing. But the point of an intervention is that it is temporary, and does not replace the attention needed to return the muscles to a fully-functioning, healthy flexibility.

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