​Pain in the bottom of your foot – what could it be?


We had Alex from Airrosti come talk to the group after our sunday long-run at The Loop Running Supply. She went over common foot pain and causes and some self therapy options.  While this isn't quite as good as being there in person, here are her notes!

Alexandra Rios, PT, DPT
1301 W. 38 th Street, Suite 102, Austin, TX 78705

Please note: this is not an exhaustive list. Please consult a medical professional for an exact diagnosis.

Plantar Fasciitis (pain just off of the heel, usually closer to the inside of your arch)
 What is it?
o Plantar fascia is not a muscle, it is fascia that supports the arch.
o Plantar fasciitis: microtears/inflammation in plantar fascia
 How do I know if I have it?
o Pain with first steps in the morning or with first steps after prolonged rest.
o Pain with prolonged activity
o Stretching big toe back might elicit symptoms
 Causes?
o Obesity, excessive pronation, flat arches, high arches, tightness of calf muscles, limited
dorsiflexion excessive running, excessive standing

 Treatment?
o Calf stretching, foam rolling calf, lacrosse balling calf
o Arch strengthening if you have a flat arch or over pronation
o If arch is too high, then appropriate shoe that provides cushion, comfort, flexibility
o Roll plantar fascia with the lacrosse ball

Neurogenic (pain on the inside of the arch)
 What is it?
o Pain due to nerve compression/irritation (could be coming from a variety of places, from
your lower back due to a herniated disc or due to nerve entrapment somewhere along
your leg)
 How do I know if I have it?
o Foot pain will be influenced by low back movements or leg movements, or tapping on
where the nerve is compressed/irritated

o You might feel burning, numbness, or tingling. Even just standing can be painful. Pain
with first steps in morning usually not a chief complaint.

 Causes?
o Herniated disc: L5-S1
o Peripheral nerve entrapment (for example: tarsal tunnel [having flat arches, causing
compression through tunnel], medial or lateral plantar nerve compression)

 Treatment?
o Depends on where pain is coming from.
 If it’s from your low back, you need to do exercises to get disc back into place (ie
McKenzie exercises), also working on core and glute strength can be helpful.
 If it’s a nerve entrapment lower down, we need to work the tissues around the
nerve and alleviate where compression could be coming from
 Nerve glides

Fat Pad Syndrome (Pain directly on the heel)
 What is it?
o Fat pad gets injured or in same way stretched out, losing the cushion over the
 How do I know if I have it?
o Deep ache in heel, feels like a bruise
o More pain walking barefoot, especially when walking on hard surfaces
 Causes?
o Stepping on a stone while running, landing hard
 Treatment?
o Ice
o Maybe taping
o Wear a heel cup
o Limit walking around barefoot, especially on hard surfaces

erik stanley