Pain and point tenderness are the immediate indicators that something is wrong in a specific area. The onset of pain, whether suddenly or over time, is an important indicator of the cause of the problem. The following questions are also important.
Is there pain with movement of the affected area?
Is it affected by weight-bearing?
Does it change your walking gait?
Bones of the foot are joined together by ligaments. A sprain occurs when the ligaments that hold the bones together are overstretched and the fibers tear. Point tenderness and looseness of a joint are indicators of a sprain.
Injury to the bones of the foot can be caused by a single blow or twist to the arch or also by repetitive trauma that can result in a stress fracture. Fractures are indicated by a focal point of pain that may be exquisitely tender on the bone. There may be a distinguishable lump or gap at the site of the fracture. A rotated toe or forefoot may also be a sign of a fracture.
Muscle and tendons move the body tissues around the joints. A strain occurs when a muscle or group of muscles are stressed to the point where there is tearing of the muscle fibers. The muscles and tendons of the foot may be strained by overstretching, overuse, overloading, bruising, or even being lacerated. Weakness in contraction of a joint, difficulty in stabilizing body parts, and pain working against resistance are signs of muscle problems. Swelling, tenderness, loss of function, and discoloration over and around the injury of can be symptoms of a strain.
Bruises are most commonly the result of a direct impact injury to the body. A bruise can occur to the foot by a variety of causes, such as having your foot stepped on or by stepping on a rock. Blows to the foot that result in pain, discoloration, swelling, and changes in how you walk may indicate more serious damage such as fractured bone.
Pain and tenderness associated with planter fascia strains are usually felt on the bottom of the foot between the heel and the base of the toes and may occur either as a specific or general area of tenderness. Plantar fascia pain may be increased or decreased by stretching of the arch. In mild cases of plantar fasciitis, the pain will decrease as the soft tissues of the foot "warm up," however, pain may increase as use of the foot increases. In more severe cases of plantar fasciitis, pain may increase when the arch is stressed. Often the sufferer of plantar fasciitis will feel pain in the morning until the plantar fascia warms up. Foot pain at night may be a sign of plantar fasciitis but may indicate another problem.
A sensation of rubbing or burning on the surface of the foot is usually the first signs of a blister. Itching and burning sensations between the toes or around the foot indicate a skin infection or athlete's foot. Pain and redness at the edge of a toenail are usually the result of an ingrown toenail.
As discussed above, foot pain may have a variety of different causes. Proper evaluation and diagnosis of foot pain is essential in planning a treatment. A good general guideline is to compare the injured side to the uninjured side. Injury may present itself as distinguishable lump or gap felt at that location or a "crunchy" feeling on that spot caused by inflammation. The types, causes, and severity sharp pain versus a dull ache also are good indicators of the seriousness of the injury.
- Four grades of pain
- During activity
- Before and after, and not affecting performance
- Before, during, and after athletic activity, affecting performance
- Pain so severe that performance is impossibleup with your doctor until you are better.
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