Author: Rob Stanborough, PT, DPT, MHSc, MTC, CMTPT, FAAOMPT

Think about the number of hours our feet are used either to stand, walk, run or kick. We shove them in all kinds of footwear giving little thought to the mechanics of the joints or other tissues.

We usually don’t even think about our feet until something goes wrong and they hurt. There are a number of painful foot dysfunctions people are aware of such as gout, bunions, plantar warts and blisters.

But one that is often missed yet still give people trouble is the compression of interdigital nerves.

Between the toes are small nerves that supply the muscles and neighboring tissues. When the foot functions normally there is enough space for the nerves to do their job without any problem. But when the ligaments of the foot become overstretches or the mechanics of the foot starts to be altered, these nerves can get compressed resulting in very specific symptoms.

One of the symptoms is numbness in the ball of the foot and/or into the middle toes. Sometimes it even feels like burning. But one of the symptoms that can go misdiagnosed is the sense that something is in your shoe, such as a small pebble or that your socks are all bunched up. You may then take your shoe off and examine your feet only to see there is nothing wrong.

There are a variety of conservative ways to treat this problem, in combination or isolation. First, the joints need to be checked for proper mobility and muscles for adequate strength. The joints can be manually treated and exercises prescribed for the muscles. Second, footwear should be inspected for fit and wear patterns.

Tight and restrictive shoes, even if they are your favorite, can compress the foot, bones and nerves causing problems.

Third, orthotics can be inserted into the shoe to help support the foot. Inserting a simple tarsal bar or tarsal post, although initially feels strange, it can lift the foot just enough to make room for the nerves, prevent compression and soon ignored.

There are simple solutions to many foot problems, but its deciphering through the symptoms that can be tricky.

There are 26 bones in the foot and 33 joints, some moving more than others.

It is a complex structure that is taken for granted. If you have foot pain or problems, start the New Year with getting a consult and maybe treatment. Don’t’ wait. These types of problems only get worse with time and do not go away on their own.

Rob Stanborough is a physical therapist serving St. Augustine for over 10 years. He is president and co-owner of First Coast Rehabilitation, as well as co-author of Myofascial Manipulation: Theory & Application, 3rd ed by Proed

Inc. He is certified in manual therapy, a Fellow of the American Academy of Orthopaedic Manual Therapists and has presented on the topic of soft tissue dysfunction in a variety of venues.

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