The Samurai Insoles Blog

Info Your Feet Can Use

Having chronic pain in your heels can really interfere with your life. Being laid up on the couch or suffering through a long work shift begins to wear on a person.

If you're dealing with foot pain, you aren't alone. A survey from the American Podiatric Medical Association found that most adults experience chronic foot pain.

Heel pain is no fun. So we've put together a guide to help you eliminate constant discomfort you experience in your feet. Read on to learn more.

1. Find Out the Cause of Your Heel Pain

If you have chronic heel pain, see a podiatrist if you can. There are several different causes of heel and foot pain. The treatments for those ailments aren't all the same. 

Some possible causes for your heel pain could be Plantar Fasciitis, heel bursitis, Achilles tendonitis, or stress fracture. 

You can put off this visit by seeing if you can alleviate the pain on your own. Often, just a little extra TLC and life style changes can cure the discomfort. 

2. Incorporate Stretching into Your Daily Routine

Stretching is especially effective if you have plantar fasciitis (PF). Fascia is the ligament in your foot that connects your heel to your toes. Think of it like a rubber band. 

If your fascia is strained, it will develop little tears. That's plantar fasciitis. Doctor's can't agree on the exact cause of PF. 

The best way to ease the symptoms is to keep the fascia loose through daily stretching.

Some stretches you can try include:

  1. Put a rolling pin on the ground and roll your feet back and forth. Press down to get in there down to the fascia. 
  2. Take a long towel and hold both ends like a jump rope. Place your toes in the middle of the towel and pull your toes back. You should feel a stretching through your arch. 
  3. Use a towel like in stretch #2. Instead of putting the towel on your toes, rest it under your arch. Pull up so the top of your foot lifts towards you. 

3. Start Soaking and Icing Your Feet 

Alternating Epsom salt foot baths and icing your heels is a great way to minimize swelling and aches. 

Epsom salts contain magnesium. When you soak your feet, the magnesium will absorb into your skin. This will help relieve inflammation that could be causing your heel pain. 

Icing your feet for 20 minutes is another great way to cut down on inflammation. To cut down the cost of buying Epsom salts, ice your feet on days you don't soak. 

4. Use Sports Tape to Create Support 

For temporary arch support, learn how to tape your feet. 

Kinesiology tape or regular medical tape can both be used. Kinesiology tape is the better choice if you plan on being active while wearing it. 

There are many Youtube videos that instruct you on the technique. The basics of it are that you tape underneath the arch and around the heel. 

If you find that taping gives you a lot of relief it might be time to get orthotics. Taping up your feet every day will get old, fast! 

5. Wear Orthotics in Your Shoes

Orthotics are a convenient way to get instant pain relief. 

There are a few kinds of orthotics you can try. A prescription orthotic is created directly from the molds of your feet.

The problem is it's not covered by insurance. Out of pocket, you'll be spending a few hundred dollars. 

Then there's the much cheaper end of the spectrum. These drug store orthotics can require a lot of cutting and fiddling to get them to fit in your shoe.

Online you can find a higher quality OTC orthotic that will fit your shoes and feel just as comfortable. 

6. Switch Out Your Sneakers

Sneakers are not meant to be worn until the soles come off! Even a few months of wearing down of the rubber bottoms will throw your feet out of alignment. 

Make sure you're switching out your shoes regularly. The amount of time depends on how often you wear them and for what. 

Regular runners should be switching out their shoes every 6 months. If you do less high impact sports, you can get away with every 8 months to a year. 

7. Change Your Exercise Regimen 

High impact sports and exercise wear down your shoes. It can also wear down your feet! 

Jumping and running is a great work out. As you get older it's going to put a lot more stress on your feet. Even if you're young, if you have plantar fasciitis, they might not be the ideal exercises for you. 

Try switching over to a low impact cardio routine. Maybe the stair climber or elliptical. You might notice that running isn't worth the pain. 

8. Get to a Healthy Weight 

Often times, heel pain is caused by a sudden, significant weight gain. Your feet aren't used to carrying it and can cause extra stress. 

If your weight gain wasn't sudden, it still might be too much for your feet to handle.  For someone with a very high body mass index, consider getting to a healthier weight. 

While there are more invasive fixes, you might be able to cure your pain on your own. That way you can avoid the cost and recovery. 

9. Try Non-Surgical Treatments

There are some treatments you can try for foot pain right in the podiatrist's office. 

One popular method is injecting corticosteroids directly into the ligament. This will help relieve inflammation and reduce scar tissue. Because it is a steroid, your doctor will probably limit how often you can get this done.

More experimental treatments are also out there. It's a gamble as to whether it will work, and you'll often have to pay out of pocket. 

10. Consider Surgery

Surgery should always be a last resort. Keep in mind that foot surgery can be a long and painful healing process. 

Do your best to exhaust all your other options before you go under the knife. Surgery isn't always the quick fix you expect it to be. 

You Don't Have to Suffer from Foot Pain

Whether you experience pain in your heels, arches, or even ankles and knees, orthotics can help.

If you have any questions about foot pain and how orthotics can help, contact us

We'll get you back on your feet in no time. 

orthotics for tennis

"Could a pair of orthotics really relieve my discomfort?". This is one of the most common questions asked by people with flat feet. Unfortunately, a simple "yes" or "no" answer is often difficult to give in this situation. Many factors can determine if orthotics can relieve the symptoms associated with flat feet, such as arch and heel pain.  It is first important to understand what "flat feet" are, and what is the root cause of the discomfort associated with them.

What Are Flat Feet?

Flat feet are often referred to as "fallen arches", and is a common condition seen in both children and adults. The arch of the foot is formed by a group of tendons and ligaments attached to the heel and foot bones. Tendons in the lower leg and foot must work in conjunction, pulling at the correct times during standing and walking. This aids in forming the arch of the foot. If the tendons do not pull sufficiently enough, or the ligaments of the foot are lax, the foot may be left with a very low arch, or no arch at all. This condition is commonly referred to as flat feet. This lack of internal arch support can cause a variety of problematic complications. In people with flat feet, the standard pressure of gait (walking), or standing, must shift to other portions of the feet that are not designed to handle this type of strain. If left untreated this can cause pain, discomfort, and possibly joint and soft tissue injury.  


Flat foot

Causes Of Flat Feet

Flat feet can be attributed to many causes. They may be present in newborns, develop during childhood, or slowly progress as an adult. Frequently, their is a hereditary component. Other possible causes of progressive flat feet include:

  • Long periods of time walking or standing in high heeled shoes
  • Using shoes with poor arch support
  • Over-stretched, or possibly torn, tendons and ligaments
  • History of fracture or dislocation of the foot bones
  • Muscle damage caused by excessive strain on the feet (This may be caused by obesity, trauma, etc.)
  • Abnormality at birth
  • Nerve conditions and abnormalities
  • Certain health conditions, such as rheumatoid arthritis and muscular dystrophy
The risks of developing progressive chronic flat feet can also increase with obesity, pregnancy, diabetes, and aging.  

Symptoms Of Flat Feet

It is very common for individuals with flat feet to experience discomfort, and sometimes significant pain. This is most commonly manifested as heel pain and arch pain. This may radiate to the ball of the foot as well. Activities such as prolonged standing and walking may be uncomfortable for a person suffering from collapsed arches. There is commonly significant strain on other portions of the foot , as well as restrained proper foot movement. Flat feet have long been suspected in contributing to foot and ankle arthritis, as well as leg, hip and back pain.  

Relief From Flat Feet

The treatments for flat feet range from conservative to surgical, and are often dependent on the severity of the symptoms and underlying cause. In many cases, the symptoms of flat feet can be controlled effectively with conservative, non surgical care. If your doctor confirms the diagnosis of flat feet, they may suggest some of the following:

• Purchasing appropriate shoes that stabilize the heel bone and support the arch of the foot. Be aware that your new shoes should be able to accomodate an orthotic device if one were eventually prescribed for you by your podiatrist. A quality running shoe with a removable insole/liner will often be adequate.

• Using custom-made or over the counter orthotics to control the flattening of the arch while standing, walking and running.

• Regular strengthening and stretching exercises under the supervision of a professional

• Physical therapy

• Ice and/or compression to reduce pain and swelling

• Anti-inflammatory or pain medications Walking in the correct shoes, and possibly using over the counter or custom orthotics, may be greatly beneficial in controlling and preventing pain and discomfort.  

Your podiatrist or physical therapist can often suggest strengthening exercises, and suitable stretches, to prep your feet for increasingly strenuous activity. Please note that effectively treating other conditions that can cause flat feet to become symptomatic, such as diabetes or obesity, is crucial to the long term success of treatment.  In some cases it may be beneficial to avoid strenuous activities and high-impact sports. If over the counter orthotics have been tried and are not effective in reducing the symptoms associated with flat feet, custom orthotic devices may be fabricated by a podiatrist or pedorthist.    




How Do I Pick the Right Over the Counter Orthotic for Flat Feet?

  • It is important to choose an orthotic that is not too rigid. When force is applied to an overly rigid device, the design of the insole or its material may not compress adequately. This transmits the shock generated from your foot striking the ground into the joints of your body. This will commonly lead to ankle, knee and back discomfort.
  • Don't pick an orthotic that is too "cushiony". A flimsy or squishy orthotic may be comfortable at first, but devices such as these often fail to provide adequate support for the arches of the feet. They often are not effective in alleviating the symptoms caused by flat feet.
  • For many years it has been a common practice for over the counter orthotics to be sold by "approximate sizing". This can lead to poor support, and an inadequate fit, for many users. Many people may be "in between" sizes for the large majority of insoles on the market, leading them to believe that an over the counter orthotic may not be effective for them. Therefore, it is imperative to confirm that any orthotic you purchase fits your foot and arch appropriately, regardless of the manufactures' suggested sizing.
  • Podiatrists can often fabricate a custom orthotic that is specifically designed for your foot and your condition. They can also aid you in selecting an over the counter orthotic if that is appropriate for your condition.

Regardless of the orthotics you may ultimately choose, it is generally important to "break in" these types of devices over a prolonged period of time. The foot may not be accustomed to the level of support an orthotic provides, and it may take some time for the muscles and ligaments to acclimate. Check out our homepage for more information about over the counter orthotics for the relief of symptoms associated with flat feet




In the United States alone, approximately 2 million Americans suffer from heel pain each year.  Heel pain is typically located on the underside of the heel, and occasionally behind it.  While this is rarely a symptom of a serious health condition,  it can escalate to the point where normal activity, especially exercise, can be extremely painful.  Although mild pain in the heel area can commonly disappear on its own, severe pain can become persistent and chronic if ignored.

The human foot and ankle are strong mechanical structures comprising of 28 bones, more than 30 joints, and over a hundred tendons, muscles and ligaments. The unique anatomical structure of the feet facilitates complex movements needed for balance and motion. The primary function of the heel, and the soft tissue surrounding it, is to provide strong but flexible support to bear the weight of the body. Physical activities, such as walking, running or dancing, can put a considerable amount of strain on the foot every time it hits the ground.

The heel and its surrounding soft tissue absorb the sudden shock of the impact and help to maintain fluidity in movement.  Shoes and sneakers can augment the heel's ability to deal with these forces. For many people, orthotic insoles (also know as over-the-counter orthotics, prefabricated orthotics, or over-the-counter insoles) can provide even greater support and benefit than shoes alone.

Causes Of Heel Pain

From simple physical activities, such as walking and standing, to more strenuous weight-bearing exercises, such as dancing and jogging, the feet are constantly subjected to significant stresses. Due to their strategic location and function, the heel is vulnerable to damage, injury and pain.

One of the most common causes of heel pain is overuse/ repetitive exertion with inadequately supportive shoes.  In some cases,  increased body weight, the shape and flexibility of the persons foot, or the activity being performed, can neutralize the benefits of an otherwise supportive shoe.  

This can lead to the most common type of heel pain: Plantar Fasciitis.  This type of situation is where an over the counter insole can often excel in providing support and relief.

Plantar Fasciitis

Shoes for runningOften referred to as the "Jogger’s heel", plantar fasciitis is the most common cause of heel pain. It has been estimated that about 10 percent of people will suffer from the condition at least once during their lifetime. The plantar fascia is a flat band of connective tissue that connects the heel bone to the toes. This ligament provides support to the arch of the foot. Excessive stretching and repeated straining of the ligament can cause small tears in the tissue, leading to inflammation and swelling. Supportive shoes can prevent this in some cases, while in others orthotic insoles are useful in reducing this repetitive straining action.

The pain associated with plantar fasciitis is usually experienced on the underside of the heel and is most intense when taking the first few steps after waking up in the morning or sitting for long periods of time. The condition is very common in middle-aged people, however children and the elderly can also develop specific types of this condition for their age.

Plantar Fasciitis is often seen in people with a flat foot shape, or those who exhibit "overpronation".  Overpronation is the technical term describing the abnormal way the foot functions when the arch has flattened too much with activity. While feet should roll slightly inward with each step (pronation), rotating too far (overpronation) in that direction can cause a misalignment of the hip and knee, and a loss of shock absorption. Other causes of Plantar Fasciitis include:

  • Obesity
  • Prolonged periods of weight bearing such as excessive standing, particularly on hard flooring or surfaces
  • Repetitive high impact activity, such as walking or running
  • Ill-fitting or worn-out footwear with poor shock absorption and support
  • Stiff muscles and tendons of the foot and/or calf
  • Inward or outward turning of the heel

Achilles Tendinitis

The Achilles tendon connects the heel to the back of the leg. This tendon is used heavily during high-impact exercises, such as running, racquetball or tennis. Sometimes, due to overuse, the tendon and its surrounding structures can become inflamed at its attachment to the back of the foot, resulting in heel pain.


Bursae are tiny fluid-filled sacs that act as cushions between muscles, joints and tendons in the feet. Excessive pressure or prolonged movement can lead to inflammation of the bursae located behind the heel thus causing pain.

Heel Spur 

Inflammation due to an underlying condition, such as tendinitis or plantar fasciitis, can lead to an outgrowth of bone on the bottom, or the back, of the heel bone.  This is classically referred to as a "heel spur".  It is increasingly accepted that only in rare instances does the actual spur of bone cause pain.  It is more likely the initial condition that lead to the growth of the spur in the first place that actually causing the patient's pain.

Tarsal Tunnel Syndrome

When the tibial nerve in the back of the foot is compressed or pinched it can lead to tarsal tunnel syndrome. Possible causes might be overpronation, inflammation in the area or chronic diseases, such as diabetes or arthritis.

Stress Fracture

An uncommon cause of heel pain, stress fracture of the heel bone or calcaneus usually develops as a result of rigorous sports, exercise or prolonged weight bearing. Long distance runners are most likely to suffer from a stress fracture.

Sever’s Disease

This is a very common heel injury in growing children. Sever’s disease is a painful bone condition that develops as a result of repetitive trauma on the growth plates of the heel bone.

Inflammation Of The Heel Pad

Sometimes, the heel pad can wear out due to heavy impact, obesity, or advanced age. This can also lead to chronic heel pain. In addition, other possible causes of heel pain include bone contusion (bruise), gout, bone cysts and tumors, rheumatoid arthritis, osteomyelitis and neuromas.

Symptoms Of Plantar Fasciitis

The typical symptoms of plantar fasciitis present themselves gradually. In most cases, pain is felt on the bottom of the heel.  Discomfort can also extend into the arch.  The pain is most intense when resuming activity after rest and tends to decrease with continued motion. Plantar fasciitis can also worsen at the end of the day after long periods of standing or walking.  Swelling, inflammation and stiffness are other symptoms that may be associated with this type of heel pain.

Relief From Plantar Fasciitis

orthotics-for-flat-feetThe American Orthopedic Foot and Ankle Society has recommended the use of over-the-counter insoles and stretching exercises as a starting point for heel pain treatment. According to one study performed, approximately 95 percent of women who wore over-the-counter insoles and followed a simple stretching regimen experienced significant relief from heel pain in eight weeks.  This illustrates what many have experienced in the past, that over-the-counter insoles can be used as a highly effective first line of therapy for heel pain with positive results. Upon a thorough history and examination, a podiatrist or orthopedist may recommend a treatment plan combining insoles with some of the following:


  • Stretching exercises and rest
  • Shoes that provide support and can reasonably accommodate an OTC insole
  • Night splints
  • Non-steroidal anti-inflammatory drugs for pain relief
  • Physical therapy sessions to stretch and strengthen the heel, ankle, and calf
  • Corticosteroids
  • Extracorporeal shock wave therapy
  • Surgery may be recommended in rare cases

Choosing The Right Orthotic Insole For Heel Pain

  • All insoles for heel pain are not created equal!  There is a wide variety of materials, designs, and quality when it comes to this industry, often making the buying process frustrating.  It's important to be an informed consumer.
  • Well-designed insoles can provide the arch with firm, yet comfortable, support. It is important to strike a balance between ‘cushiony’ and rigid.  Insoles that are too rigid are unable to compress adequately during activity, failing to absorb the shock from constant impact.  Due to this, rigid insoles can sometimes lead to pain in different areas of the foot, leg, or even body.
  • While soft and squishy insoles may feel very comfortable at first, they typically do not provide enough support and stability in the long run.  Often, tension across the plantar fascia is not adequately reduced with these types of insoles.
  • Finding the right size matters. It is best to purchase insoles that are sold in actual shoe sizes to ensure that they serve their purpose. Insoles need to fit as closely to your shoe size and arch as possible for maximum effectiveness.  Insoles manufactured in a small, medium, and large sizing scheme often provide a suboptimal fit.
  • A podiatrist can also suggest the most suitable over-the-counter insoles for your individual requirements.  Some individuals do require a custom foot orthotic to be fabricated to fit their unique support needs.



One of the most common questions I am asked by people who suffer with flat feet is, "Can a pair of arch support insoles really relieve my discomfort?". It turns out the answer is a little more complicated than a simple "yes" or "no".  First, it's important to note the arch support insoles can not actually "cure" flat feet.  However, flat feet can cause a variety of painful symptoms in the feet.  Many of these symptoms have been treated, and often relieved, by arch support insoles for decades!  One of the keys to correctly choosing an over-the-counter arch support insole is first understanding what "flat feet" are, and why discomfort often accompanies this condition.

What Are Flat Feet?

flat-feetFlat feet, also known as fallen arches, are a common condition seen in both adults and children. Normally, feet have an upward longitudinal curve in the middle called an arch. This arch is formed by a group of tendons and ligaments attached to the heel and foot bones. Tendons in the lower leg , along with ligaments in the foot, work together to pull and form the foot's arch. However, if the tendons do not pull sufficiently enough, there is a low arch or no arch at all. This condition of collapsed arches is popularly known as flat feet. Flat foot can affect one or both feet. The lack of crucial arch support in the foot can cause many complications. In people with fallen arches, the normal pressure of walking shifts to other parts of the feet. If not treated properly, this can cause prolonged discomfort, pain, and in some cases, serious joint and foot problems.

Causes Of Flat Feet

Flat feet can be present in newborns or develop during childhood. In many cases, the condition can be hereditary. Flat feet can also be attributed to many other causes such as: • Wearing shoes with poor arch support • Excessive walking or standing on high heels • Muscle damage caused by excessive strain on the feet • Fractures or dislocation • Ruptured or over-stretched tendons • Abnormality at birth • Nerve problems The risk of developing flat feet also increases with diabetes, pregnancy, obesity and aging.

Symptoms Of Flat Feet

The most common symptoms of flat feet are pain and discomfort, particularly in the arch and heel area (this may be diagnosed by your doctor as plantar fasciitis). Prolonged walking and standing can be uncomfortable in people with collapsed arches. Often, there is a swelling in the inner bottom of the foot. Due to lack of a supportive arch, there can be substantial pressure on other parts of the foot, leading to strained posture and restrained foot movement. A fallen arch can also strain the ligaments and tendons of the foot and leg. Flat feet have been suspected in contributing to back, hip or leg pain, ankle sprains and arthritis.

Relief From Flat Feet

The treatment for flat feet is dependent on the severity of the condition and underlying cause. In many cases, the symptoms of flat feet can be controlled effectively with conservative care. Your podiatrist may  suggest one or more of the following:












• Pain medicationsflat-feet-insoles

• Regular stretching exercises

• Ice and compression to reduce pain and swelling

• Wearing appropriate shoes that support and stabilize the arches

• Physical therapy  

• Using supportive insoles to stabilize the arch and heel area


Wearing the right shoes, and possibly over-the-counter insoles, can be tremendously beneficial in alleviating and preventing pain and discomfort. In addition, taking proper care of the feet and following a consistent home exercise regimen, prescribed by your doctor or physical therapist, can be very effective in prevention and management of the symptoms. A physical therapist or doctor can also suggest suitable stretches to prepare the feet before an intensive activity. It is similarly important to effectively treat or limit conditions that can aggravate fallen arches, such as diabetes or obesity. Avoiding high-impact sports and strenuous activities might be beneficial in some cases. If over-the-counter insoles are not effective in improving the symptoms of flat feet, custom orthotic devices or braces can possibly provide adequate support to the arch area. In some cases, where the damage or pain is severe, a doctor may recommend a suitable surgical procedure to improve foot support and bone stability in the area.


How Do I Pick the Right Insoles for Flat Feet?

insoles-for-flat-feetIt is important to choose an
insole that is neither too rigid, nor too flexible. An insole that is too firm provides little shock absorption during activity. When force is applied to this type of device, the material or design of the insole does not compress adequately, and the shock generated from your foot striking the ground is transmitted back into the joints of your body. This can often lead to back, knee and ankle discomfort. On the opposite end of the spectrum, an insole that is too "cushiony" may feel comfortable initially, but due to the lack of support, these devices often fail to alleviate the symptoms caused by flat feet. These types of insoles are often manufactured from a compressed foam material. It is usually apparent within the first few uses that the support provided is inadequate. It is popular for insoles to be sold in "approximate sizing". Often, this leads to an inadequate fit for many users. Certain individuals may be "in between" sizes for the vast majority of insoles on the market, leading them to believe that an over the counter insole may not be effective for them. For this reason, it is important to confirm that any insole you purchase fits your foot and arch appropriately, regardless of the manufactures' suggested sizing. Regardless of the insoles you ultimately choose, it is important to break in these types of devices over a prolonged period of time. Your foot may not be accustomed to the level of support a new insole provides, and it may take some time for the muscles and ligaments to acclimate. Check out the Samurai Insoles homepage for more information about insoles for flat feet, and to explore the specific qualities of insoles that can provide quick relief.




One of the common conditions I encounter with new patients is ball of the foot pain.  The fancy medical term that serves as a "catch-all" for this condition is Metatarsalgia. Metatarsalgia is a condition that is marked by inflammation and pain in the ball of the foot. The metatarsal region or ball of the foot is the area between the arch and toes. Metatarsalgia is generally not a serious condition, but the symptoms can aggravate to the point where normal activities and exercise can become increasingly painful. Runners and athletes who participate in high-impact sports are at a higher risk for developing the condition. In addition, certain foot shapes might be subject to undue stress in the metatarsal region thus causing pain and discomfort in the front area of the foot just below the toes. Fortunately, most cases of metatarsalgia can be treated effectively with a combination of conservative treatments and use of proper footwear with non-prescription shoe inserts or custom orthotics.

What Causes Metatarsalgia?

The human foot comprises of five metatarsal bones that extend from the arch to joints of the toes. In addition, the ball of the foot is also cushioned by a protective fatty acid padding. The first metatarsal bone is thicker and shorter than the other four. During the push-off phase, while walking, running or jumping, a substantial amount of stress is exerted on the toes and metatarsals. In fact, the first and second metatarsals are forced to bear as much as 275 percent of our body weight while engaging in intense exercise or physical activity. Most metatarsal complications arise due to improper alignment or insufficient padding in the ball of the foot. The specific mechanics of the foot can impact the way that weight is distributed across the area. Any abnormal or uneven impact on the metatarsals can lead to inflammation and pain in the metatarsal heads, the ends of the metatarsal bones that connect to the toes. Metatarsalgia can be attributed to a single factor or combination of several factors including the following: Deterioration of the Protective Fat Padding in the Ball of the Foot The fat pad in the ball of the foot acts as a protective shield to the bones, muscles and ligaments in the foot. However, due to a variety of reasons, the padding can get thinner making the metatarsal bones more susceptible to injury. Some common causes for thinning of the fat padding include: • Aging • Walking with bare feet, high heels or poorly designed footwear • Underlying medical conditions, such as endocrinal abnormalities, rheumatoid arthritis and connective tissue disorders • Downward displacement of the metatarsal head Specific Foot Shapes When the second toe is longer than the big toe, the second metatarsal head can be forced to bear more weight than normal. Also, a foot with a high arch might be subject to excessive pressure in the metatarsal region. Morton’s Neuroma This condition is characterized by a noncancerous fibrous growth between the third and fourth metatarsal heads. Morton’s Neuroma can contribute to significant metatarsal stress in the area that can eventually develop into metatarsalgia. Causes include prolonged use of high-heeled or tight shoes and high-impact activities, such as jogging, tennis or aerobics. Stress Fracture The tiny cracks in the toe bones or metatarsals can be extremely painful and result in an unusual distribution of weight on the foot. Stress fractures can be a common source of metatarsalgia. Hammertoe This condition can be genetic or acquired. Wearing improper footwear, on a continual basis, can prevent the toes from lying flat and cause one or more toes to curl downwards in an abnormal manner. This can depress the metatarsal heads and lead to many complications. Arthritis Metatarsalgia is common in patients suffering from osteoarthritis and rheumatoid arthritis. Osteoarthritis can weaken the metatarsal joints thus contributing to increased sensitivity and pain in the area. Rheumatoid arthritis can lead to deformity in the forefoot region that can eventually cause the dislocation of metatarsal joints. Downward Depressed Metatarsal Head In a normal foot, the five metatarsal heads are perfectly aligned to form the transverse arch. As weight is placed on the ball of the foot, the arch flattens to support the body and ensure that the pressure is distributed evenly all over the foot. In cases where a metatarsal head is depressed and sits lower than the rest, it is forced to carry more weight than usual thus causing pain and inflammation in the area. The metatarsal head might drop further towards the bottom of the foot upon repeated trauma and protrude outwards. The increased pressure on the skin, from the depressed metatarsal head, can deplete the protective fat padding and lead to the development of painful calluses. High-heeled shoes and foot injuries can cause one or more metatarsal heads to drop. In addition, biomechanical irregularities, such as pronation or flexible foot, can also lead to metatarsalgia. Avascular Necrosis Often affecting younger patients, this forefoot condition develops after an injury and can get progressively worse if not treated properly. Excess Weight Most of the body weight is transferred to the forefoot during any physical movement. Excessive pounds can result in more pressure on the metatarsals and contribute to the onset of metatarsalgia. Intense Training It is not surprising that runners are at the highest risk for developing metatarsalgia. High-impact sports can put an abnormal amount of stress on the metatarsals, leading to increased sensitivity in the area.

What Are The Symptoms Associated With Metatarsalgia?

The most common symptom associated with metatarsalgia is pain in the ball of the foot that is concentrated in the sole area just behind the toes. The pain might be concentrated only around the big toe or in the area around the second, third and fourth toes. The pain can be described as sharp, burning or aching in nature. Other symptoms include: • Pain that worsens with activity and improves upon resting • Tingling or numbness in the toes • Sharp or shooting pain in the toes • Discomfort and increased pain upon walking barefoot • Increased pain when flexing the feet • Pain that radiates from the ball of the foot to the toes • An usual feeling that can be likened to walking on pebbles or being bruised by a stone • Painful calluses The symptoms are more likely to develop gradually over a period of months. However, in some cases, they can appear suddenly after an unusual surge in strenuous physical activity or high-impact exercise. Treatment and Prevention of Metatarsalgia It is normal to experience foot pain after a rigorous workout or a long day of standing. However, if the pain lasts for more than a few days, it is best to seek prompt medical attention. While treatment for pain in the ball of the foot can vary depending on the underlying causes, a doctor might suggest a few conservative approaches at first. • Relative rest with low-impact activities to reduce the pressure on the ball of the foot • Ice compression to reduce swelling, inflammation and pain • Non-steroidal anti-inflammatory pain medications • Maintaining a healthy weight • Refraining from barefoot walking on hard surfaces • Using callus pads to reduce discomfort • Modification of existing lifestyle to promote healing • Wearing heels with a reasonable height of no more than an inch • Wearing appropriate shoes that are suitable for the patient’s foot type, stride and sport • Shock-absorbing insoles to cushion the feet • Metatarsal supports and pads to elevate the dropped metatarsal heads and help redistribute the weight across the arch and metatarsal shafts • Over-the-counter and custom orthotic devices to improve foot function and minimize metatarsal stress If symptoms persist and the condition does not improve with conservative treatments, the doctor might recommend surgery.

Using Arch Support Insoles To Treat Metatarsalgia

Arch support insoles are one of the most effective aides in deflecting stress and treating pain and discomfort in the ball of the feet. They can be custom built from a plaster cast or foam impression of the patient’s feet. Custom orthotics are precisely constructed with high-quality shock absorbent materials to stabilize the feet, provide support to the metatarsals and arch, reduce uneven pressure and eliminate pain in the area. They are designed to fit inside most standard shoes. Custom-made inserts can be very beneficial to patients suffering from metatarsalgia due to their unique advantages. Increased Support for High Arches Custom orthotic inserts are specifically built to support high arches. They are designed to provide adequate support to the arch thus allowing it to bear a normal amount of weight and reduce the pressure on the ball of the foot. Rebalancing of the Foot In a foot with dropped metatarsal heads, the body weight is unevenly distributed across the weight-bearing surface. A custom insert can be used to raise the dropped metatarsal heads and restore them to their normal position. This will help redistribute the weight more evenly. Padding the ball of the foot alone might not be effective enough. Custom-made orthotics are designed specifically to provide the exact amount of elevation to the affected metatarsal head. The primary purpose of the treatment is to allow the arch to heal and restore its shock-absorbing capabilities. Providing a Layer of Protection Without the Bulk Custom orthotic insoles are made of unique materials that are specifically designed to mimic the natural fatty padding in the ball of the foot. They provide protection to the metatarsals by absorbing pressure and shock. Correcting Foot Stride and Walking Patterns Orthotic aides can be instrumental in reducing the damage caused by unusual walking patterns that can affect the normal distribution of weight across the foot. Using appropriate orthotic devices, as recommended by a doctor, can significantly eliminate the underlying factors contributing to metatarsalgia while alleviating the symptoms at the same time.



Dealing with foot pain can be a draining, frustrating experience.  There are some well known foot conditions that are notorious, and widely mentioned in health and fitness articles as far as the eye can see.  These include heel spurs, bunions, and hammertoes (oh my!).  However, one type of foot pain is much less well known.  For this reason, this type of foot pain is often ignored by the sufferer for long periods of time, sometimes leading to chronic severe discomfort.  What is this mysterious and pesky condition?  Outside of the foot pain! 

tendonitis-of-peroneal-tendonsOutside of the foot pain

Outside of the foot pain can be caused by a variety of issues.  Some of these include sprains, strains, stress fractures, soft tissue masses, arthritic conditions, and nerve impingements. However, it has been my experience that outside of the foot pain is most commonly caused by a condition known as "peroneal tendonitis"

What the heck is Peroneal Tendonitis?

The ankle has two peroneal tendons which connect the muscles of the lower leg to the outside and bottom of the foot.  These tendons can become irritated and inflamed for a variety of different reasons.  This condition can make physical activity involving the feet extremely difficult, and long term damage of the tendons can develop if treatment is not sought in a timely fashion.


How does peroneal tendonitis develop?

Athletes who compete in sports that require repetitive foot ainsoles-for-flat-feetnd ankle motions may irritate the peroneal tendons in the foot or ankle.  Runners, beginners and seasoned veterans alike, are particularly prone to this condition.  Other sports that require foot and ankle movement that put the peroneal tendons under considerable strain include golf, basketball, tennis, hockey and skiing Footwear that has become worn, or does not fit appropriately, may also put the wearer at risk for this injury.  Worn athletic shoes may no longer provide adequate support the tendons and ligaments within the foot require while performing high impact activities.  Injuries can often occur as a result of this. Overall foot shape may predispose certain individuals to peroneal tendonitis as well.  It is a popular notion that individuals with a high arched foot type are the most common sufferers of outside of the foot pain.  While this is likely accurate, people who have an overpronating foot type (flexible flat foot) can also develop this condition. Athletes who experience an injury to the ankle or foot can develop peroneal tendonitis secondary to the original injury.  The most common scenario of this occurring is with chronic ankle sprains.  This increases the importance of proper rest and rehabilitation after experiencing this type of injury.  Your physician, podiatrist, or physical therapist can assist you in achieving this.  Ankle bracing or arch support insoles can be helpful in preventing re-injury when activity is resumed.

Treatment options

Some treatment options your doctor may use to treat peroneal tendonitis include:orthotics-for-flat-feet
  • The use of ice after the initial injury may alleviate pain and control inflammation
  • With the supervision of your physician, anti-inflammatory medications can also aid in reducing swelling and pain to the area.
  • Arch support insoles, or less commonly orthotics, can control inefficient and painful motion of the foot and ankle.  Controlling abnormal frontal plane motion of the ankle, heel and foot can alleviate the outside of the foot pain felt with peroneal tendonitis.
  • Exercise regimens and schedules should be adjusted to allow healing of the affected area.  Avoid repetitive motions of the foot and ankle during physical activity for a few weeks.  Always have your physician approve your exercise program.
  • Ankle or foot bracing may also be helpful in restricting the motion of the ankle and foot, allowing the injured areas to heal.  It may only be necessary to wear a brace during intense physical activity.
  • Physical therapists can equip their patients with the knowledge and techniques needed to achieve healing of this area.  Stretching, range of motion, and strengthening exercises may be provided to recondition the injured area.  Occasionally, secondary modalities may be useful such as ultrasound, electrical stimulation, or Graston techniques.

Arch Support Insoles

sore-foot-insoleArch support insoles and orthotics are commonly used in the treatment of pain on the outside of the foot caused by peroneal tendonitis.  These insoles are placed in the shoe, once the shoes factory liner is removed, to control ineffective and inefficient motions of the foot and heel.  This is often helpful in reducing the discomfort associated with peroneal tendonitis. It has been suggested by some that arch support insoles may even be effective in reducing the recurrence of outside of the foot pain once it has been resolved.  By controlling abnormal movement of the foot and ankle, arch support insoles may prevent peroneal tendonitis from becoming a chronic issue.





In rare instances, surgery may be recommended as a treatment for this condition.  Generally, this is limited to severe situations where tearing or bone spurring has occurred in or around the tendons.  This can occur if the initial injury is particularly severe, or if the condition is left untreated for a very long period of time, causing irreversible damage.  When this is the case, conservative treatments have generally been ineffective in providing relief.  By consulting with your doctor in a timely fashion, and following the instructions for treatment, surgery for peroneal tendonitis can by avoided in the vast majority of cases.

Long term outlook

Commonly, individuals suffering from pain on the outside of the foot fully recover from their symptoms.  However, this recovery time can be prolonged and arduous for some.  Preventing re-injury once healing has been achieved is paramount.  Strengthening exercises, stretching, and arch support insoles can be of value to avoid further tendon inflammation in the future. As always, never begin any treatment plan for any condition without the supervision and guidance of your physician.

Feet in work boots

Heel pain is an attention grabber. It can debilitate you. It will make you miserable. It will also make your family miserable. After all, you will likely complain about it for months before seeking treatment. The explanations of heel pain are many, only rivaled by the number of treatments you can find online. So what is causing the pain in the bottom of YOUR heel? You should discuss your individual situation with your doctor. However, by having basic knowledge of a few fundamentals, you will be able to have a more educated discussion regarding your condition.

Heel pain is generally caused by an abnormally high amount of stress being exerted across a specific ligament located on the bottom of the foot. This ligament is called the “plantar fascia”. The plantar fascia is a broad, thick ligament similar to a rubber band. This ligament is attached to the heel bone and stretches along the bottom of the foot across the arch. The other end of this ligament then attaches to the ball of the foot.

The location of “typical” heel pain is either directly under the heel itself, or in the area where the arch meets the heel. This is precisely the attachment of the plantar fascia to the heel bone. Unfortunately, this is also the weakest portion of this ligament, and therefore the most commonly injured area. When the plantar fascia is stretched beyond its normal length, microscopic tears can develop. This can happen over many years, in one attention grabbing event, or anywhere in between. Inflammation, pain, and tightness in the heel and arch then follow.

Plantar fascia inflammation, commonly known as plantar fasciitis, may be aggravated by walking barefoot, wearing shoes that lack enough support to remove strain from the plantar fascia itself, or by chronic irritation that can accompany impact activity such as walking, running, and jumping.  Read more about support versus shock absorption when choosing insoles here.

Plantar fasciitis is treatable. Conservative treatment has a high success rate of curing heel pain. Unfortunately, the recurrence rate for plantar fasciitis is also quite high. This can be reduced by wearing supportive shoes, and possibly augmenting this support with arch support insoles. A relatively small number of cases of heel pain require advanced treatments such as surgery, laser treatments, or cryotherapy.

Only your doctor can determine if you are a candidate for these types of treatments. Don’t delay evaluation and treatment! The longer heel pain is left untreated, the longer the recovery time will be.

flat foot

Flat foot or pes planus is a deformity of the foot that results in a flattened arch, occasionally with the sole of the foot resting almost entirely on the ground. Flat feet, commonly referred to as fallen arches, affect an estimated 20 to 30 percent of the general population. The condition can be asymptomatic and painless in many people. Yet in some others, the symptoms might range from mild discomfort to considerable pain that can intensify upon prolonged activity. Treatment for flat feet comprises of wearing well-fitting shoes that provide optimal support to the arches. Using the right footwear can be instrumental in alleviating the pain and discomfort experienced with flat-footedness. Understanding the underlying causes and symptoms of the condition can be instrumental in picking the right pair of shoes.

What Causes Flat Foot?

Flat foot is observed in both children and adults. The condition is quite common in infancy and early childhood.  In many children, a healthy arch develops while the body develops and matures.  In adults, flat foot can be inherited from early life, or acquired due to other factors.  Some of these factors can include:
  • Injuries including muscle damage, ruptured tendons or fracture
  • Significant weight gait
  • Prolonged or repetitive weight-bearing or high-impact activities, such as running, standing, walking or jumping
  • Wearing poorly fitted shoes with inadequate arch support
  • Health conditions, such as diabetes, rheumatoid arthritis, stroke or cerebral palsy

Other risk factors for adult-acquired flat foot include obesity, normal aging and pregnancy.



What Are The Symptoms Of Flat Foot?

The most common symptoms are pain and discomfort, sometimes accompanied with swelling in the inner bottom of the foot. The lack of a supportive arch can put undue pressure on other parts of the foot during weight bearing thus restraining movement and affecting the posture. Fallen arches can cause damage to the tendons and ligament of the foot. They can also contribute to hip and back pain, arthritis and sprains.

How Can Flat Foot Be Treated?

Treatment is based on the underlying causes and severity of symptoms. A doctor might suggest simple conservative care that includes one or more of the following: • Compression with ice to reduce swelling and pain • Rest • Pain medications • Simple stretching exercises or foot gymnastics • Over-the-counter insoles or custom orthotics for arch support 


boots for flat feet

5 Tips For Choosing The Right Shoes For Flat Foot

Treatment for fallen arches may consist of wearing comfortable shoes that provide stability to the arch and heel area. A doctor might also recommend appropriate arch support insoles or custom orthotic devices that can be inserted into the shoes. The primary objective of footwear for flat feet should be to provide cushioning, control pronation (help balance the feet in a neutral position) and reduce friction of the foot within the shoe. Relying on soft arch supports that provide cushioning alone may be ineffective, as they will not be able to provide the strong support that the arches need. Finding suitable shoes can pose a challenge for people with a flat foot. The arch of the foot serves as a shock absorption system. Generally speaking, flat feet roll inward and overpronate, thus hampering the natural shock absorbing capabilities of the arch. Shoes with added support are technically designed to provide reinforcement of the inner portion of the foot and make up for the absence of a normal arch. When looking for the right shoes, it is important to review their technical specifications to ensure that they provide the added support, stability and control needed.  There are various different types of shoes to consider, some may be more effective than others.

1. Casual Shoes May Need Some Support Reinforcement

An option for some with mild flat feet may be as simple as wearing a comfortable casual shoe with proper arch support and a firm heel counter.  Several companies manufacture shoes to these standards, but it is important to test them out individually before making a decision.  Since there is such a large selection of casual shoes from a broad range of manufacturers, often it is difficult to find an appropriately fitting, quality pair.  Arch support insoles can also be used to augment the arch support in some casual shoes.  Purchasing shoes with a removable factory insole that can later be replaced with an arch support insole may be helpful.  Wearing shoes without proper support such as flip-flops, high heels, clogs, and "docksiders" generally are not appropriate for people with flat feet.

2.  Orthopedic Shoes Are Great, If You Can Tolerate The Stiffness

Another option for those with a more severe flatfoot deformity would be to purchase high-quality orthopedic shoes with hard-heel counters and steel shanks. Many reputable companies also offer orthopedic shoes with other unique features, such as built-in orthotic insoles, heel-locking mechanisms, stiff heel counters and well padded collars.  Unfortunately, the firmness of many of these types of shoes can make them uncomfortable for those unaccustomed to this.  Their style and appearance (or lack thereof) can also deter people from purchasing them.



3.  Stability Running Shoes Can Be A Home Run

People with flat feet tend to turn their ankles inward while running and walking. This can put a considerable amount of strain on the knees, ankles and feet thus possibly increasing the risk of injuries. Today, there are running shoes available with added stability control to control this pronation as well as provide significant cushioning. Most leading brands of running shoes manufacture their own lines of stability running shoes.  Generally, running shoes are light-weight, breathable, and well cushioned.  Due to the soft synthetic upper that has become standard with most running shoes manufactured today, they also can be very forgiving of other deformities common in people with flat feet, such as bunions and hammertoes.  This makes stability running shoes an excellent choice for those with mild or moderate flat feet.  Additionally, over the counter arch supports can be added to this type of shoe to further control over pronation of the foot if necessary.

4.  Motion-Control Running Shoes Work, But Don't Over Do It.

In cases of severe pronation, motion control running shoes can be an ideal solution, as they are designed to provide more support and control than stability running shoes. They are crafted specifically to keep the ankle straight while moving and comprise of a dual-density foam that is injected right below the medial side of the arch.  While this can often be an ideal choice for some with moderate to severe flat feet, the large amount of motion control found in this type of shoe can occasionally be difficult to adjust to, and is sometimes felt to be too restrictive.  It is imperative to try these types of shoes for yourself before purchasing them for this reason.  A stability running shoe with a reinforcing arch support insole may be a better option for those who can not tolerate the restrictiveness of a motion-control shoe.

5.  Beware of Sandals With "Arch Support"

Yes, there are many new "Doctor Recommended" types of sandals out there with more arch support than traditional sandals.  For many people, the arch support built into these sandals is enough for their foot to function properly.  Unfortunately however, because sandals inherently lack some of the most important structures of a regular shoe that also provide support, ie. a back and laces, they still may not be supportive enough for someone with flat feet.  If you give some of these sandals a try, be sure to start slow and only wear them for short periods of time in the beginning to be sure they are supportive enough for your feet.

shoes with insoles for running

Choosing the right running shoe isn't always a simple task, but investing the time to find the best running shoes to keep your feet happy is always time well spent.  Keep these "rules of engagement" in mind when buying a new pair of running shoes:  

1)KEEP SHOES TIED "JUST RIGHT" Shoes should be properly laced without restricting the foot's movement. Note any chafing or fit issues in the store. Improper fit or lacing won't improve on the road.

2) RUNNING SHOE DESIGN AND MANUFACTURER COMPATIBILITY According to a spokesperson for the Shoe Review Committee of the American Academy of Podiatric Sports Medicine, design characteristics and shoe dimensions differ by manufacturer. Comparing these features can help you identify the "likely suspects" of brands and models you should be picking from.  This can help avoid sore feet in the long run.  If your feet are comfortable with a certain brand of athletic shoe, the odds are higher that another style in the same brand will be comfortable as well. You can also ask your podiatrist about the running shoes they recommend for you.  There's likely a specific shoe that could benefit you if you have a foot condition (heel pain, arthritis, sore feet, etc).  Occasionally, over the counter arch support insoles can be of benefit if your doctor has recommended them for your type of foot.

3) GETTING FIT Joe Pulleo and Patrick Milroy ("Running Anatomy") say that running shoe fit is often a subjective assessment. Consider how your shoes fit now and how much mileage your running shoes must support over the next training season. Aches and pains in the legs and feet can occur several days after buying new running shoes. That's because some shoe fit issues surface relatively quickly after purchase. "A shoe model (that's) not correct for a runner's biomechanics, weight, flexibility or foot shape: discomfort or injury will occur within the first 100 miles of running."

4) CHECK FOREFOOT FLEX APPEAL The flexibility of the forefoot portion of new running shoes is crucial, says Simone Payment ("What Happens to Your Body When You Run?").  This portion of the shoe actually determines the compatibility of the shoe to your foot. To test flexibility, bend the shoe (holding the forefoot and heel). Then, compare the "flex point" of foot with that of the shoe. The shoe should not bend in any other spot but the ball of your foot.

5) THE TIME HAS COME--FOR NEW SHOES If existing running shoes have already logged 300 to 500 miles, it's time to buy new shoes. According to "Running Well" authors Sam Murphy and Sarah Connors, prolong the life of running shoes with good care. Don't wash them in the washer or rinse after a run. Allow wet shoes to dry naturally, away from radiators, before the next use.

BEWARE OF THESE RUNNING SHOE-BUYING MISTAKES Chances are you've already made some of these mistakes. Remember, buying a gorgeous pair of bright green running shoes that don't fit isn't just a financial mistake:

MISTAKE #1: Choosing form or style over function. Stores catering to runners understand that runners love fashion. However, experienced running store owners often suggest the shoes they believe fit you best, say authors Jeff Galloway and Barbara Galloway ("Women's Guide to Running") The wrong shoes can also cause serious problems, e.g. stress fractures and strains.

MISTAKE #2: Forget to ask about running club, employer and other discounts. Let's face it. Running shoes are expensive. Don't be afraid to ask for loyalty discounts.

MISTAKE #3: Buy the wrong size running shoe. Running shoe sizes vary by design and manufacturer. Be aware that your size may be very different from one brand and style to the next.

MISTAKE #4: Purchase running shoes without enough time to find the right shoes. Don't shop for running shoes without the time to try on enough shoes and ask questions.  If you're more alert and energetic in the morning, take that into consideration before shopping.

MISTAKE #5: Buying online one pair at a time. Some online shoe retailers ( is one) offer free shipping and free returns on most purchases. Not sure which size is right for you? Order the same shoe in multiple sizes. You can always try them all on when they arrive, and simply return the sizes that don't fit.


ankle taping or bracing

If you play sports or you’re a runner, chances are you’ve had a few ankle injuries that kept you off the field for a few weeks – and maybe put you on crutches for a while.  Ankle sprains are the most common type of injury that takes a runner or athlete out of the game, but overuse injuries including tendonitis, heel pain, and stress fractures may not be far behind. Unfortunately, a sprained ankle can cause ongoing discomfort even after healing – and it can be a source of ongoing problems. That’s why many sports medicine doctors often recommend supporting the ankle by taping it or wearing an ankle brace during sports activity following an injury.  But, which is better – athletic ankle taping or bracing?  

Ankle Taping vs. Bracing: Which is Better?

Both ankle taping and wearing an ankle brace during sports can reduce the risk of an ankle injury – but an ankle brace is generally considered the best choice for ankle joint protection. A study published in the Clinical Journal of Sports Medicine compared the two forms of ankle protection by following 300 football players over a six-year period. They found that wearing an ankle brace was twice as effective for avoiding injury as athletic ankle taping.  

Taping Ankle Injuries vs. Wearing an Ankle Brace

Wearing an ankle brace has some benefits over taping an ankle. Taping is more time-consuming than putting on a brace and there’s greater room for error. If the ankle isn’t taped properly, it won’t offer enough support to reduce the risk of injury. Once an athlete gets on the field, the ankle tape loosens up and doesn’t provide enough ankle support. According to a study published in the Journal of Bone and Joint Surgery, athletic tape loses up to 40% of its support after only ten minutes of exercise. Ankle braces are thicker and more rigid than athletic tape, which means more support for the ankle. Ankle braces also lose some of their support after exercise, but they can be easily readjusted, which takes less time than re-taping the ankle. The cost of an ankle brace can vary greatly depending on  the material, quality, and whether the device is custom or over the counter.  This may sound like a larger investment, but it’s more cost-expedient when you consider how often an ankle has to be taped, and the overall costs of possible re-injury.  

The Bottom Line?

If you want to avoid an ankle injury, athletic ankle taping helps, but it’s not as effective or as cost-effective as using an ankle brace. No matter which you choose - if you’ve had an ankle sprain, give your ankle some support.   References: J. Bone Joint Surg. 44-A: 1183-1190. Clinical Journal of Sport Medicine: October 2000 - Volume 10 - Issue 4 - pp 291-296. Rehab Management. February 2002. “Bracing vs. Taping”
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