How to stop chronic foot/ankle pain?

April 5, 2009 9:40 AM

Flat feet + bow legs + active lifestyle = near-constant foot pain. What can I do to make my feet ache less?

My feet are flat as boards, and my ankles pronate badly. Also, with my ankles together I can fit a full fist and a half between my knees. And I'm very active - gym, biking, rock climbing, etc.

So the net result is, my feet and ankles ache badly pretty much all the time. they often hurt outright, right from first thing in the morning.

My knees used to give me all the problems - I've had both operated on (ACL and meniscectomy) - but now it's my feet and ankles that hurt much more, and it's getting worse every year. (me: 36 y.o. male) I'm worried because I have my father's feet and he can barely walk now, even after numerous foot/toe operations.

I basically slam my heels down when I walk, and they hit at a slight outside-in angle. I've worn orthotics for years. Most of the pain is in my arches and the bones around the front and sides of my ankles. There's a line of incredible tightness from my big toe all the way down the back of each foot. When I kneel on my heels like a monk - the rare times that's not too painful to stand - my arches cramp up instantly. Jogging? Forget about it.

My orthopedist says there's nothing I can do to help short of major surgery (if that), besides wear my orthotics, but I find that hard to believe.

When I lie on my stomach and have my wife stand on the bottoms of my feet, that feels great. Foot massages are orgasmic, but expensive. Same with the chiropractor/myofascial person I've gone to a few times: feels great for a few days, then everything tenses right back up.

Are there any stretching or strengthening exercises I can do to release some of the weird, misaligned tensions in my feet and ankles? And, down the road, what sort of surgical options are there? Can you build arches and straighten knees?

posted by El Curioso to health & fitness (7 answers total)

For bicycling, Look brand pedals are well known for allowing a fine tuning of "float", which allows you to shift the horizontal angle of the foot in the pedal while riding. I recently switch from the Shimano SPD style clipless pedals to the Look style (older, pre KEO), and it pretty much eliminated knee / ankle / foot pain from bicycling, because I have a greater freedom to adjust the angle as I ride. If you are not using clipless bicycle shoes at all, this will be a vast improvement not only in cycling comfort, but also in the amount of power you can deliver to your bike. I am sure I don't have to tell you that different brands of shoes are appropriate for different feet, so be sure to try different brands and styles.

Another tip for making bicycling more comfortable is that a vast majority of bicyclists ride in too high a gear. I know it feels silly, and might look a little silly at first as well, but really your pedaling should be at around 100 rpm. Your lungs and heart have much more room to improve in strength without pushing the limits of injury than your legs do. I thought shifting up to a higher gear allowed me to go faster until I got my cycle computer, and I discovered that as long as I was not spinning so fast that I was losing control of the bike, I could go at least as fast spinning the cranks quickly as I could pushing harder, and I could sustain the spinning for a longer stretch of time. Pushing hard is appropriate for sprinting, but for sustained speed spinning is your better bet.
posted by idiopath at 10:02 AM on April 5, 2009

As a former ballet dancer, I know a couple of exercises that you can use to make your feet and ankles stronger and more flexible. However, I have no idea if they'll help with your problems. I guess it can't hurt to try!
The girl who made the animation has wickedly good arches, so don't feel discouraged if you're nowhere near her. However, those 3 exercises, done regularly, definitely helped me strengthen my feet.
Do the relevés (1rst exercise) in first position (like in the picture) and second (feet farther apart). Try them with your legs turned out as much as you can, then parallel, then turned in. The last one with help with your ankles. Focus on keeping your knees and your ankles aligned.

For cramps: again, this might be a little too basic for you, but bananas are full of potassium, and potassium is great for getting rid of cramps. If you're not 100% sure that you're getting enough potassium, try eating a banana a day for a month or two and see if things don't improve.

This might go against what your orthopedist has said, but what about walking barefoot? Helps you develop stronger ankles, and allows you to do random relevés and foot stretches throughout the day. Also, it might help you to not slam your feet down when you walk. Try to be conscious of how you're putting your feet down. Heel first, then lower the foot evenly, rolling down through the middle of the foot.

Play with your feet. Rub them, stretch them, roll your ankles. It might not solve all your problems, but I can guarantee that actually using the full range of motion of your feet/ankles can only help. I think that most people neglect their feet, and that even those who don't have your anatomical problems could use a little TLC.
posted by snoogles at 10:03 AM on April 5, 2009 [1 favorite]

sometimes, i have bouts of foot cramping. i like to (one foot at a time, for focus) point my toes as hard as i can regardless of the cramp-like pain it causes, and meanwhile use the knuckles of my fist to rub and massage the arch esp along the outside (it makes that pain more bearable). it becomes successively easier and less painful, until i am left with a pleasant warm feeling. the foot cramps don't come back for a long while.

also, like snoogles mentioned, i walk barefoot as often as possible, making sure to walk on my toes with my heel very slightly raised. i think my feet feel special when they are more than just a stub on the end of my leg.

as to ankle pain and pronation, every time i start a new pair of shoes (usually timberlands and adidas) the pain subsides. i think this is due to uneven wearing on the shoe. i've been interested in trying those "inverse heel" shoes.
posted by vaguelyweird at 11:05 AM on April 5, 2009

I use the first four exercises listed under "other exercises for the feet" here, and it keeps my feet from hurting while running. No idea if it will work for you. My feet have only ever hurt during the actual activity, not after.
posted by Airhen at 11:23 AM on April 5, 2009 [1 favorite]

I have (self-diagnoses) plantar fasciitis and little feels better than sitting down and rolling my feet over a golf ball. Might help you too. It's probably worth a try anyway.
posted by bluedaisy at 11:24 AM on April 5, 2009

I was born with severe bi-lateral clubbed feet which needed 4 surgeries to get "somewhat" foot shaped feet. I had no arch, corrected by orthotics, and have bowed legs as a result. I found that, over the years, since my feet are not by any means normal, orthotics have been the most helpful solution to solving the various problems and often severe pains caused by my unusual foot/leg structure.
posted by sundri at 12:49 PM on April 5, 2009

You and your orthopedist should be working with a sports podiatrist or possibly a specialised physiotherapist (since you don't need someone else to prescribe orthotics). There may be exercises you can do, shoes you can wear, ways you can modify your gait and movement, but if you do the wrong thing it will make it worse (which is why you shouldn't be taking advice from us about exercises). A podiatrist should be able to to do this stuff, focus more on rehabilitation and improving your day to day life, and will understand your orthotics. Get a recommendation from your orthopedist if you can (since you want them involved too) and see if ther's more possible than what he's suggesting.

Also FWIW, I overpronate severely and spending any time walking around without orthotics is a surefire way to days of pain (it literally tears the muscle in my right thigh). Just as an example for how random advice from strangers is a Bad Thing. There are other types of professionals out there with a slightly different focus to the one you're seeing, see if one of them can help you.
posted by shelleycat at 2:18 PM on April 5, 2009