Heel/Arch/Knee/Foot Pain

Often when a person experiences heel, arch, knee or foot pain it is associated with complications of poor foot function. Typically, an orthotic is the prescribed medical device to address these issues. An orthotic is custom-made and is uniquely designed for a specific foot and NO ONE ELSE’S. For this reason, an orthotic is not the same as an over the counter arch support.

There are generally two types of orthotics:

A functional orthotic: which is designed to control or limit abnormal motion in the foot. It is typically prescribed for conditions such as heel pain (plantar fasciitis) shin splints, ankle, knee or lower back pain.

An accommodative orthotic is designed to cushion and to redistribute areas of high pressure on the bottom of the foot. This type of orthotics is able to limit the occurrence of corns and calluses and ulceration. An accommodative orthotic is well suited for diabetic and arthritic patients, as well as for those who have structural deformities of the foot.

Heel Spurs

This is a painful condition caused by calcium deposits on the base of the heel putting pressure on other areas of the feet. High impact sports that strain the arch and throw off the natural balance of the foot, like squash and running are the most common causes. Even quick weight gain can be the culprit. Chiropodists or podiatrists may recommend using “non weight bearing” devices such as orthopedic shoes, a walker, crutches, or even a wheelchair or rest. These can help healing by relieving pressure on the injured part of your foot.

Plantar fasciitis (Heel Pain)

What is it?

Commonly known as heel pain.

Inflammation of the dense band of tissue called the plantar fascia that extends from the bottom of the heel bone to the base of the toes (ball of the foot).

How do you treat it?

To alleviate the stress and pain on the fascia, the person can take shorter steps and avoid walking barefoot.

Activities that involve high impact, such as jogging, should be avoided.

Passive stretching techniques can speed up the healing.

Orthotics placed into well-fitting supportive shoes can help to cushion, elevate, and support the heel.

R.I.C.E: Rest, Ice, Compression (adhesive strapping), Elevation.

How do you prevent it?

If possible, avoid standing for prolonged periods.

Correct shoe style that matches your foot type, i.e.: Flat feet, normal feet, and high-arched feet.

Stretching exercises in your calf and foot.

Healthy body weight.

Prescription orthotics to properly align the foot to prevent stress on the fascia

Workplace Athletes

Your ability to use your feet safely, with ease and comfort, is vital if you are to remain a valuable and productive worker. However, a large number of workers are exposed to injuries due to prolonged periods of standing and walking. For example, a person who picks orders in a warehouse may walk up to 10 miles or more in an 8 hour shift. Another worker in the same warehouse may be required to stand in one position for at least six hours during a shift. These individuals are often thought of as workplace athletes, especially when considering that these workers perform the same tasks five to six days a week often working overtime. There are many careers that may employ workplace athletes.

Some of them include:

Postal workers

Bank tellers

Parking meter attendants



Factory workers

Construction workers


Workplace athletes are susceptible to many of the same types of overuse injuries, such as regular athletes. Postural and foot pain are frequent complaints, in addition to an increase in callous formations and ingrown toenails One treatment option for overuse in a factory environment is the anti-fatigue mat, which is designed to reduce the forces encountered by the lower extremity and spine. Although anti-fatigue mats do reduce the incidence of reported injuries, they are not successful for everyone.

Why should some individuals find relief and not others? The formula for success is unclear and while it is easy to see how forces might be reduced during walking, how such forces work in more static, standing jobs is less clear.

Risk Factors

What are the risks for non-traumatic lower extremity or back injury on the job?

Individuals who engage in long periods of standing and walking are at risk for injury. But this alone cannot explain why some individuals suffer injuries and others do not. The type of job and the flooring can be potential risk factors. For example, jobs that do not allow the individual to switch among several positions may have higher risks.

The type of shoes worn is also a consideration. Poorly fitted shoes and work boots may aggravate calluses and ingrown toe nails. They may also accentuate a structural abnormality of the foot.

Obesity is another potential risk because it affects the forces exerted on the spine and lower extremity joints during both walking and standing.

Previous injury to a specific area that never really recovers may also be a risk for chronic workplace injury.

Perhaps the greatest risk is structural abnormality of the foot and lower extremity, such as a flat foot, excessive pronation or supination.

In considering risk factors, it is important to remember that a single risk factor usually does not lead to injury. A combination of risk factors is usually involved.

In the U.S. there are about 120,000 job-related foot injuries. One third of them are toe injuries.

You can’t take your feet for granted, and your concern for them cannot be divided. It should continue off the job, as well as at work.

Possible Treatment Plans

A Chiropodist is able to treat foot problems of the workplace athlete.

Ill fitting footwear, (such as work boots) and poor foot structure may be the cause of corns, calluses and ingrown toe nails. Regular, routine treatment by a Chiropodist can easily relieve the pain and discomfort caused by corns and calluses.

Ingrown toe nails can also be managed with regular treatments. Surgical removal of all or part of the toe nail may be an alternative.

More complicated problems such as heel, knee or back pain require a thorough evaluation by the Chiropodist to determine the underlying factors causing the pain (see risk factors). These types of problems often require a combination of treatments which may include:

icing the affected area


laser therapy


orthopedic footwear


referral to other medical disciplines

The best treatment plan for any foot problem is prevention. Most foot problems can be avoided by following these simple recommendations:

Bathe your feet daily and dry them thoroughly.

Check you feet frequently for corns, calluses and cracks.

Keep your feet warm.

Trim your toenails straight across, slightly longer than the end of the toe.

Proper fitting footwear considering both length and width.

At the first sign of a problem (pain or discomfort) see your Chiropodist. DO NOT wait until symptoms become severe.