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pain in lateral arch/bottom of foot

Posted by Rebecca on 5/11/01 at 16:07 (047509)

I wondered if anyone has experienced pain in the lateral (outside) part of the arch or bottom of the foot? I have significant pain there in addition to the regular insertion point/heel pain and it's getting worse. There is a point of tenderness on the bottom of my foot just in from the knobby bone on the lateral side and then pain radiating up toward the toes from there. The pain follows the same typical pattern; really bad when I get out of bed and first-steps pain after sitting or resting that is made worse by activities like going to Costco. I've complained about it several times to my pod but he hasn't seemed too concerned, he's more focused on my upcoming (may 21) hallux limitus surgery of my other foot. He said it might be a tear in the ligament. Should that be verified in some way? He also wants me to see an orthopedic surgeon to get his opinion on possibly doing surgery to correct my cavus foot deformity, as he calls it. Sounds way too scary for me! All this foot pain is getting me very down. I used to be a runner but now must be satisfied with swimming and bike riding. Even hiking has become out of the question. I feel like I'm slowing becoming an invalid and it's scaring me… Sorry this got so long!

Re: pain in lateral arch/bottom of foot

Dr. Zuckerman on 5/11/01 at 18:03 (047522)

This could be the peroneal longus tendon it runs along the outside of the foot and then dives deep into the foot under the pf and insert in the base of the first met- cuneiform. Very important tendon to help hold down the entire big toe joint when walking. Could be part of the cavus foot deformity abnormal function when walking

Re: pain in lateral arch/bottom of foot

bg cped on 5/11/01 at 19:02 (047529)

What area are you in? If you have you tried orthotics ? If they didnt help and you have a true cavus foot (I assume you do if your pod wanted you to have them corrected with surg) you should read the paper on cavus feet, there is info on orthotics, shoes, and surgical correction. Donna sl posted a link to it the other day on here. Making an orthotic for that foot type can be hard, but they can work great. I would think of that first.

Dr Z hunch about peroneal is a good one. This can be agravated by an orthotic with a high arch or medial post. also by wearng a heavy duty motion control shoe. What are you wearing on your feet? are you wearing orthotics now also?

Re: pain in lateral arch/bottom of foot

Rebecca on 5/11/01 at 20:47 (047542)

Thanks for the response! I have read the article about cavus feet and unfortunately I understand very little of it. It pretty technical. I wear custom orthodics that are rigid and 3/4 length in Etonic running shoes which are supposed to be very stable. When not in those, I wear Birkenstocks. What do you think?

Re: pain in lateral arch/bottom of foot

Rebecca on 5/11/01 at 20:52 (047543)

What can be done to help this? How is it diagnosed? What should I say to my pod? I'm a little concerned about this because in a week I supposed to have surgery on the other foot for hallux limitus (which is also killing me) and this foot will have to become my 'good' foot for a while. I was kinda of hoping to resolve one problem at a time, but could this be a problem? Thanks so much for your time!

Re: pain in lateral arch/bottom of foot

bg cped on 5/11/01 at 21:23 (047545)

Again I will ask what area you are in. If you have a true cavus foot and your orthotics have a high arch, meaning they touch it firmly. Is there extra material glued on or built up under the inside heel or under your great toe joint (under where you would get a bunion? This is hard to explain or describe.
Most people with cavus foot have a plantarflexed 1st ray. If your orthotic has posting (build up) under your inside heel or under the joint behind your big toe this can give you big trouble and make that joint hurt, if it is rigid posting under that area will really agravate it.
If you could get a picture of your foot standing from the front and back, and a picture of your orthotic from the back and a bottom view it would help, perhaps you can post it on the picture board? if this is against the rules then dont. I am not making a dx, just want to see if your orthotics could be contributing. If when they made them they told you 'you have a high arch and need lots of support' they could be incorrect. Perhaps DR Z may be able to help also. I have seen too many cavus feet get more problematic with the wrong correction.

Re: pain in lateral arch/bottom of foot

Rebecca on 5/11/01 at 21:47 (047546)

bg cped, I live in Southern California. The orthotic is very high in the arch. When I hold it against my foot with out weight it fits against my arch perfectly. I was indeed told that my arch is very high (a 9.5 out of 10 were his words) and that the orthotic would help distribute the weight throughout my foot. It's a rigid shell with a black heel that stabilizes and makes it level. They are 3/4 in length so there is anything under the great toe joint, in fact, it was cut away on the left one because it was really aggravating my bad toe joint on that foot. Does that help?

Re: pain in lateral arch/bottom of foot

bg cped on 5/11/01 at 22:14 (047548)

That helps some, and cutting it out is the right approach. What happens if you wear a good cross trainer without the orthotics? you may also want to wear a light hiking boot for a few days without the orthotic, I dont mean heavy duty boot. The fact that the arch is real high and you were 9.5 out of 10, try going without it and see

Re: To Rebecca pain in lateral arch/bottom of foot

Pauline on 5/12/01 at 09:50 (047576)

You mentioned that your doctor suggested you see an orthopedic surgeon for one of your problems, why not take him up on his suggestion and go before you have anything done to either foot. Use it as a second opinion. You can alway reschedule the surgery he has planned and it will allow you to have a second opinion on that one too. Hope things get better for you.

Re: To Rebecca pain in lateral arch/bottom of foot

Rebecca on 5/12/01 at 10:27 (047578)

Hi Pauline, The referral to the orthopedic surgeon has been made about a month ago but they are backed up six months, so I won't be getting to see anyone for quite a while. I feel very desperate to resolve at least one of my foot woes. It started with pf three years ago and has gone downhill ever since. At least my pf isn't really bothering me right now because I had an injection a while ago. I used to be a runner but now can only manage non weight bearing exercise. It bums me out.

Re: pain in lateral arch/bottom of foot

Rebecca on 5/12/01 at 10:32 (047579)

Actually my feet feels the best when I wear my hiking boots. They are good quality, light boots. I always feel a little guilty when I wear something other than my running shoes with the orthotics, because I've been instructed to wear those and only those at all times! Are Birks a good or bad idea? Thanks for your time!

Re: To Rebecca pain in lateral arch/bottom of foot

Pauline on 5/12/01 at 11:13 (047588)

Rebecca,
The wait for those Ortho's usually is long. It makes one want to visit
every type of Dr. you think you 'might' need in the future just to become a patient, then if and when you need them they get you in within the week.
New patients always wait, unless there is bone sticking through the skin.
They really get you in fast for that, of course, only after visiting the ER
first.

It sounds like you have been through quite a lot. I hope your planned surgery goes well and you find the solution to your other problem. Best of luck.

Re: pain in lateral arch/bottom of foot

JudyS on 5/12/01 at 11:18 (047591)

It amazes me, bg, that you continue to target cavus foot/orthotic problems so perfectly! Especially when my pods seem to have a bit of trouble in that area. It took me a very long time to convince them that my custom orthotics, especially at the first ray edge, were creating a whole different problem for me. One of them cut the corner of the orthotics at that edge but I fear it was too little too late.

Re: To Rebecca pain in lateral arch/bottom of foot

wendyn on 5/12/01 at 12:05 (047593)

Rebecca - I think Pauline is right in her direction that you should seek a second opinion from the orthepedic surgeon. I understand you are in a log of pain - but sometimes waiting (even the 6 months) for a second opinion can pay off.

I got stuck waiting for all kinds of things...and in the mean time found ways to help myself. I could have had surgery - when in my case it now may never be necessary.

I'm not saying you'll get better all by yourself - but I too would give that second opinion some serious thought - BEFORE I let anyone at me with a knife.

Re: Bad day for typos

wendyn on 5/12/01 at 12:09 (047595)

Rebecca - you are not in a LOG of pain - you are in a LOT of pain. I type too fast.

I wonder what a log of pain would look like?

Re: pain in lateral arch/bottom of foot

bg cped on 5/12/01 at 14:14 (047599)

thanks judy my hat size went up about 2 sizes. Rebecca if you could ask on here for any orthopedic foot specialists in you area. You should not have to wait 6 months. Perhaps if when you call you dont say it is a second opinion but you are having severe foot pain and want it figured out. see if they recomend thje same treatment and give you same diagnosis.
sometime a hiking boot will immobilize your foot and make it more comfortable, if that is what happens when you wear your hikers keep wearing them, and it is a good indicator that certain foot support helps. If nothing made it better that is not a good sign.

Re: pain in lateral arch/bottom of foot

Rebecca on 5/13/01 at 22:19 (047680)

Unfortunately, my health insurance is Kaiser and you can't just call and get an appointment with anyone. It's all through referals. You wouldn't beleive what I went through and how long I waited to see the pod I'm seeing now. Or maybe you would... Anyway, I appreciate your advice alot.

Re: pain in lateral arch/bottom of foot

bg cped on 5/14/01 at 06:55 (047694)

Rebecca I saw your post on the other page about the posibility of peroneal tendon. The lateral aspect the outside border from the front of your heel going towards your toes, including that 'bump' everybody has on the side of the foot. That is an extremely sensitive area, especially for a cavus foot. In your other post you mentioned you had extremely high arch, and your orthotics were hard with a high arch. You also mentioned you had a brooks shoe that was very stable.

This is not a diagnosis of your foot, just advice on footwear. All you describe is familiar with cacus foot having to much 'support' with shoe and orthotic. Look up on net or call running shoe store and see if your shoe is a 'motion control' or 'pronation control' If it is a brooks beast or addiction and you have a cavus foot it is wrong.

I am not an expert on Brooks, they are very good shoes but if it is a firm stable shoe it is not for your foot type. Too much support, firm shoe with a firm high arch orthotic can also aggravate the peroneal tendon. I would try to wear your hiking boot, without your orthotic, just wear it for a while and see if it feels better. Your Dr would prob appreciate the info if it did make it better. If you have hallux limitus the boot should make it feel better also.

Keep making a stink with your hmo

Re: pain in lateral arch/bottom of foot

Rebecca on 5/14/01 at 11:04 (047713)

bg cped, actually the shoes I'm currently wearing are Etonic 'Stable Pro' which the running store guy called one of the safest, most protective shoes they sell. The store I went to takes fitting and selling shoes very seriously and they spend a lot of time with you. You know, I trying so hard to do the right thing and be a good patient. But I'm getting worse, not better! It's very hard to get good advice, though I think everyone involved means really well... I will wear my boots and see what happens.

Re: pain in lateral arch/bottom of foot

Donna SL on 5/14/01 at 14:22 (047724)

Rebecca,

The Etonic stable air pro has a plastic medial post in the shoe. This shoe is considered a mild motion control shoe, made for pronators. It will cause you to supinate more, and therefore put more pressure on the lateral side of your foot. I would advise you to stop wearing the shoe.

Donna

Re: pain in lateral arch/bottom of foot

Dr. Zuckerman on 5/11/01 at 18:03 (047522)

This could be the peroneal longus tendon it runs along the outside of the foot and then dives deep into the foot under the pf and insert in the base of the first met- cuneiform. Very important tendon to help hold down the entire big toe joint when walking. Could be part of the cavus foot deformity abnormal function when walking

Re: pain in lateral arch/bottom of foot

bg cped on 5/11/01 at 19:02 (047529)

What area are you in? If you have you tried orthotics ? If they didnt help and you have a true cavus foot (I assume you do if your pod wanted you to have them corrected with surg) you should read the paper on cavus feet, there is info on orthotics, shoes, and surgical correction. Donna sl posted a link to it the other day on here. Making an orthotic for that foot type can be hard, but they can work great. I would think of that first.

Dr Z hunch about peroneal is a good one. This can be agravated by an orthotic with a high arch or medial post. also by wearng a heavy duty motion control shoe. What are you wearing on your feet? are you wearing orthotics now also?

Re: pain in lateral arch/bottom of foot

Rebecca on 5/11/01 at 20:47 (047542)

Thanks for the response! I have read the article about cavus feet and unfortunately I understand very little of it. It pretty technical. I wear custom orthodics that are rigid and 3/4 length in Etonic running shoes which are supposed to be very stable. When not in those, I wear Birkenstocks. What do you think?

Re: pain in lateral arch/bottom of foot

Rebecca on 5/11/01 at 20:52 (047543)

What can be done to help this? How is it diagnosed? What should I say to my pod? I'm a little concerned about this because in a week I supposed to have surgery on the other foot for hallux limitus (which is also killing me) and this foot will have to become my 'good' foot for a while. I was kinda of hoping to resolve one problem at a time, but could this be a problem? Thanks so much for your time!

Re: pain in lateral arch/bottom of foot

bg cped on 5/11/01 at 21:23 (047545)

Again I will ask what area you are in. If you have a true cavus foot and your orthotics have a high arch, meaning they touch it firmly. Is there extra material glued on or built up under the inside heel or under your great toe joint (under where you would get a bunion? This is hard to explain or describe.
Most people with cavus foot have a plantarflexed 1st ray. If your orthotic has posting (build up) under your inside heel or under the joint behind your big toe this can give you big trouble and make that joint hurt, if it is rigid posting under that area will really agravate it.
If you could get a picture of your foot standing from the front and back, and a picture of your orthotic from the back and a bottom view it would help, perhaps you can post it on the picture board? if this is against the rules then dont. I am not making a dx, just want to see if your orthotics could be contributing. If when they made them they told you 'you have a high arch and need lots of support' they could be incorrect. Perhaps DR Z may be able to help also. I have seen too many cavus feet get more problematic with the wrong correction.

Re: pain in lateral arch/bottom of foot

Rebecca on 5/11/01 at 21:47 (047546)

bg cped, I live in Southern California. The orthotic is very high in the arch. When I hold it against my foot with out weight it fits against my arch perfectly. I was indeed told that my arch is very high (a 9.5 out of 10 were his words) and that the orthotic would help distribute the weight throughout my foot. It's a rigid shell with a black heel that stabilizes and makes it level. They are 3/4 in length so there is anything under the great toe joint, in fact, it was cut away on the left one because it was really aggravating my bad toe joint on that foot. Does that help?

Re: pain in lateral arch/bottom of foot

bg cped on 5/11/01 at 22:14 (047548)

That helps some, and cutting it out is the right approach. What happens if you wear a good cross trainer without the orthotics? you may also want to wear a light hiking boot for a few days without the orthotic, I dont mean heavy duty boot. The fact that the arch is real high and you were 9.5 out of 10, try going without it and see

Re: To Rebecca pain in lateral arch/bottom of foot

Pauline on 5/12/01 at 09:50 (047576)

You mentioned that your doctor suggested you see an orthopedic surgeon for one of your problems, why not take him up on his suggestion and go before you have anything done to either foot. Use it as a second opinion. You can alway reschedule the surgery he has planned and it will allow you to have a second opinion on that one too. Hope things get better for you.

Re: To Rebecca pain in lateral arch/bottom of foot

Rebecca on 5/12/01 at 10:27 (047578)

Hi Pauline, The referral to the orthopedic surgeon has been made about a month ago but they are backed up six months, so I won't be getting to see anyone for quite a while. I feel very desperate to resolve at least one of my foot woes. It started with pf three years ago and has gone downhill ever since. At least my pf isn't really bothering me right now because I had an injection a while ago. I used to be a runner but now can only manage non weight bearing exercise. It bums me out.

Re: pain in lateral arch/bottom of foot

Rebecca on 5/12/01 at 10:32 (047579)

Actually my feet feels the best when I wear my hiking boots. They are good quality, light boots. I always feel a little guilty when I wear something other than my running shoes with the orthotics, because I've been instructed to wear those and only those at all times! Are Birks a good or bad idea? Thanks for your time!

Re: To Rebecca pain in lateral arch/bottom of foot

Pauline on 5/12/01 at 11:13 (047588)

Rebecca,
The wait for those Ortho's usually is long. It makes one want to visit
every type of Dr. you think you 'might' need in the future just to become a patient, then if and when you need them they get you in within the week.
New patients always wait, unless there is bone sticking through the skin.
They really get you in fast for that, of course, only after visiting the ER
first.

It sounds like you have been through quite a lot. I hope your planned surgery goes well and you find the solution to your other problem. Best of luck.

Re: pain in lateral arch/bottom of foot

JudyS on 5/12/01 at 11:18 (047591)

It amazes me, bg, that you continue to target cavus foot/orthotic problems so perfectly! Especially when my pods seem to have a bit of trouble in that area. It took me a very long time to convince them that my custom orthotics, especially at the first ray edge, were creating a whole different problem for me. One of them cut the corner of the orthotics at that edge but I fear it was too little too late.

Re: To Rebecca pain in lateral arch/bottom of foot

wendyn on 5/12/01 at 12:05 (047593)

Rebecca - I think Pauline is right in her direction that you should seek a second opinion from the orthepedic surgeon. I understand you are in a log of pain - but sometimes waiting (even the 6 months) for a second opinion can pay off.

I got stuck waiting for all kinds of things...and in the mean time found ways to help myself. I could have had surgery - when in my case it now may never be necessary.

I'm not saying you'll get better all by yourself - but I too would give that second opinion some serious thought - BEFORE I let anyone at me with a knife.

Re: Bad day for typos

wendyn on 5/12/01 at 12:09 (047595)

Rebecca - you are not in a LOG of pain - you are in a LOT of pain. I type too fast.

I wonder what a log of pain would look like?

Re: pain in lateral arch/bottom of foot

bg cped on 5/12/01 at 14:14 (047599)

thanks judy my hat size went up about 2 sizes. Rebecca if you could ask on here for any orthopedic foot specialists in you area. You should not have to wait 6 months. Perhaps if when you call you dont say it is a second opinion but you are having severe foot pain and want it figured out. see if they recomend thje same treatment and give you same diagnosis.
sometime a hiking boot will immobilize your foot and make it more comfortable, if that is what happens when you wear your hikers keep wearing them, and it is a good indicator that certain foot support helps. If nothing made it better that is not a good sign.

Re: pain in lateral arch/bottom of foot

Rebecca on 5/13/01 at 22:19 (047680)

Unfortunately, my health insurance is Kaiser and you can't just call and get an appointment with anyone. It's all through referals. You wouldn't beleive what I went through and how long I waited to see the pod I'm seeing now. Or maybe you would... Anyway, I appreciate your advice alot.

Re: pain in lateral arch/bottom of foot

bg cped on 5/14/01 at 06:55 (047694)

Rebecca I saw your post on the other page about the posibility of peroneal tendon. The lateral aspect the outside border from the front of your heel going towards your toes, including that 'bump' everybody has on the side of the foot. That is an extremely sensitive area, especially for a cavus foot. In your other post you mentioned you had extremely high arch, and your orthotics were hard with a high arch. You also mentioned you had a brooks shoe that was very stable.

This is not a diagnosis of your foot, just advice on footwear. All you describe is familiar with cacus foot having to much 'support' with shoe and orthotic. Look up on net or call running shoe store and see if your shoe is a 'motion control' or 'pronation control' If it is a brooks beast or addiction and you have a cavus foot it is wrong.

I am not an expert on Brooks, they are very good shoes but if it is a firm stable shoe it is not for your foot type. Too much support, firm shoe with a firm high arch orthotic can also aggravate the peroneal tendon. I would try to wear your hiking boot, without your orthotic, just wear it for a while and see if it feels better. Your Dr would prob appreciate the info if it did make it better. If you have hallux limitus the boot should make it feel better also.

Keep making a stink with your hmo

Re: pain in lateral arch/bottom of foot

Rebecca on 5/14/01 at 11:04 (047713)

bg cped, actually the shoes I'm currently wearing are Etonic 'Stable Pro' which the running store guy called one of the safest, most protective shoes they sell. The store I went to takes fitting and selling shoes very seriously and they spend a lot of time with you. You know, I trying so hard to do the right thing and be a good patient. But I'm getting worse, not better! It's very hard to get good advice, though I think everyone involved means really well... I will wear my boots and see what happens.

Re: pain in lateral arch/bottom of foot

Donna SL on 5/14/01 at 14:22 (047724)

Rebecca,

The Etonic stable air pro has a plastic medial post in the shoe. This shoe is considered a mild motion control shoe, made for pronators. It will cause you to supinate more, and therefore put more pressure on the lateral side of your foot. I would advise you to stop wearing the shoe.

Donna