Pain in medial arch of foot

Pain under the medial arch of the foot: Why?

Many people experience some pain in the medial arch of the foot. Causes can include an injury of the flexor hallucis, which is a unity of the tendon and a very strong muscle, or structural abnormalities that grow worse with age and activity and start causing symptoms later in life.

The arch of your foot is responsible for keeping us in balance while standing or walking. The tendon spreads itself all the way from the great toe across the medial arch of the foot to the Achilles’ tendon.

There are many causes of an injury to the flexor hallucis and they include excess amounts of body weight pressing onto the toes of the foot. For instance, a big toe carries almost one third of the body's weight in the case of a normally aligned foot. If a person's feet are turned out while walking or standing, the big (or great) toe has to carry even more of your body's weight and injuring the flexor hallucis becomes more likely.

These injuries usually occur in the medial arch of the foot. Sometimes, people may mistake injuries of the flexor hallucis for Achilles’ tendonitis or plantar fasciitis. There are some people who may experience injuries of the flexor tendons of other toes and have a pain not only at the medial arch of the foot, but also in a wide area under and around the arch of the foot.

Arch Pain: Making a diagnosis

You can go to a specialist to receive an appropriate diagnosis or see your family doctor, but you can also start by running some preliminary "tests" yourself to determine the type of injury you may be suffering from.

You can try, for instance a resisted plantar flexion of the great toe, which is a procedure of holding your great toe in dorsiflexion with the thumb. Then you can ask someone to push your toe against you. In case you have experienced a severe injury, you should feel a slight pain after this procedure. If you have just strained the tendons, you can perform some more tests to determine the type of injury.

Another test for determining the reason of the pain in the medial arch of the foot is holding someone else's hands just to maintain balance, and then rising to the balls of your feet. If you happen to have pain in the medial arch of the foot, then the flexor hallucis tendon is strained, but if you have pain in the Achilles’ area, then you need to determine the real reason of the pain.

The last test is facing the fall and leaning against it at about 30 to 40 degree angle, and rise yourself to the balls of your feet. In case you don't feel any pain, you should transfer your weight on your toe that is causing a stress to the flexor hallucis tendon.

Occasional arch pain isn't a big deal, and can happen to anyone who overuses their feet, has gained a little too much weight, or with age. If your arch pain persists and doesn't get better with rest, however, it's important to see a doctor for a diagnosis! To rule more serious conditions, ranging from posterior tibial tendon dysfunction to cavus foot (a very high arch), in or out, your doctor may want to run imaging tests like an MRI scan as well as performing a physical examination.