Pandemic increases and worsens cases of foot pain; see how to treat

In March 2020, Krista Fahs started working from home. As she sat down at her table, the 53-year-old computer store saleswoman dropped her usual sneakers. She found herself doing laundry, playing with the cat and even visiting neighbors without wearing shoes. “I was barefoot all the time,” she said.

After a few months of working from home, she began to experience a twinge of pain in her heel, but dismissed it until last month, when it became too intense to ignore. Even lying in bed, she felt the pain throbbing. “This is ridiculous,” she remembers what she thought. “I didn’t know how I was going to sleep.”

The start of the pandemic coincided with a sharp decline in foot trauma, said Dr. Robert K. Lee, chief of foot and ankle foot surgery at Santa Monica Medical Center at the University of California, Los Angeles, but his practice soon returned to life. filled with patients like Fahs who complained of foot pain. “I thought, ‘Oh, so this is the effect of the pandemic on feet across the country,'” Lee said.

There is no hard data on the increase in foot pain, but Dr. James Christina, executive director of the American Podiatric Medical Association, said it has been a clear trend for many of its 12,000 members.

One of the associates, Dr. Rock Positano, co-director of the Foot and Ankle Non-Surgical Service at the Hospital for Special Surgery in New York, saw foot pain increase so much — from 20% to 30% — that he called the phenomenon a “pandemic foot.” “.

Now with the easing of restriction measures, people are eager to get their pre-pandemic bodies and hobbies back, and are taking to the streets, said Dr. James Hanna, a podiatrist and president of the New York State Podiatric Medical Association. Many are exacerbating existing foot injuries or creating new ones.

“People thought they could just pick up where they left off or try something they haven’t done for a few years,” he said, “but their feet aren’t ready for what their bodies want to do.”

By instituting a few simple measures, Hanna reassures owners of sore feet that the pain can be relieved and prevented.

Overuse injuries

Some of the most common foot ailments occur simply because the feet were put under increased strain during the pandemic. Maybe you chose to walk long distances instead of using public transport, or you went barefoot at home. “People don’t realize how much mileage they do walking and standing in their homes,” Positano said.

Fahs was diagnosed with one such overuse injury, plantar fasciitis, in which the ligament under the foot that supports the arch inflames, and is often felt as pain in the heel. “I knew what it was because my brother, sister and one of my best friends had it recently too,” she said.

Metatarsalgia is another overuse injury, also caused by inflammation, but in the joints of the toes, which causes pain in the sole of the foot.

For those who have started ambitious running routines with flexing, Achilles tendonitis has been a common diagnosis. The Achilles tendon connects the calf muscle to the heel bone and with a sudden increase in use it can become irritated and swell.

These injuries can affect more than the health of your feet. If left untreated, they can evolve and cause knee, hip and back pain. “People think they’re falling apart, but they’re not,” Positano said. “They’re using their feet too much.”

fragile feet

Overuse injuries aren’t the only reasons people have been experiencing foot pain lately.

Dr. Priya Parthasarathy, a podiatric surgeon in Maryland, has also noticed an increase in toe and foot fractures. Some are caused, she said, by accidentally kicking furniture — a result of being indoors and barefoot more often — or tripping over pets and falling awkwardly.

“You see one, then you see two, three and four cases,” she said of these pet-related fractures, “and you think, ‘Wait, there’s definitely a connection here.'”

Opening the toes

Meanwhile, Dr. Judith F. Baumhauer, an orthopedic surgeon at the University of Rochester Medical Center, has been removing more bunions, which are bony bumps at the base or side of the big toe. Without shoes to support it, the foot can widen and anatomical structures can change. Among other problems, this can make bunions worse.

“They let their feet do whatever they wanted,” Baumhauer said, “and now that they have to get back to work, their feet are rebelling.”

More weight on the foot

Baumhauer said the weight gain in the pandemic could also be to blame for greater foot discomfort. She explained that even a few extra pounds have an impact. “It’s literally simple physics,” she said, explaining that the foot supports four times the force of our body weight when walking. Losing or gaining 2.5 pounds would be a change of “10 pounds in the ankle and foot,” she said.

Jacqueline M. Dylla, an associate professor of clinical physical therapy at the University of Southern California, explained that one of the biggest triggers is people doing too many activities too quickly. Many have unknowingly suffered atrophy and loss of bone density due to inactivity, which makes it difficult to stabilize on uneven surfaces.

“Smaller injuries are causing more catastrophic problems,” she said. “I have patients who look like they’ve been in a car accident,” she added, “but they just sprained their ankle while walking.”

Even young children, after a year or two of going to virtual school, are having trouble getting back into sports. “You have a kid sitting at home every day for a year who goes straight to cross-country,” Parthasarathy said.

how to help your feet

Podiatrists say one solution to foot pain can be quite simple: wear supportive shoes. That means a semi-rigid sole, roomy toe cap and a small heel lift. Check the proper fit at a shoe store, and if you don’t want to wear street shoes at home, buy a pair specifically for indoor use.

If you’re wearing older shoes, make sure the soles aren’t too worn, as they may have degraded too much to provide substantial support. Insoles can also be added for more arch support.

Dylla said it’s also essential to prepare our bodies for renewed activity by strengthening them first. This means exercising your feet with finger and arch movements. “There’s a belly exercise,” Dylla said, “arching is a foot exercise.”

Dr. Hanna said it’s best to start slowly. “If you’re going to start walking, do a moderate pace for short distances,” he said. “If you tolerate it well, experience a faster pace over longer distances.”

Podiatrists also say that stretching is crucial for preventing and treating sore feet. “Proper warm-up is key,” Hanna said.

In the morning, just before going to the bathroom, Hanna recommends flexing your feet, pulling your toes toward your body. Then she pretends her fingers are a pencil and writes the alphabet. “If you do that,” he said, “you’ll activate all your joints and you’ll be much less likely to get hurt.”

Although the calf seems farther away from the sole of the foot, stretching it plays an essential role in painless walking. “When your calf and Achilles tendon are tight,” Lee said, “it creates a lot more stress for all the joints in your foot.”

He suggests getting into a lunge position – one leg positioned forward with the knee bent and the foot flat on the floor – with your hands against the wall and feet flat on the floor. You should feel the stretch in the calf of your back leg. He suggests doing this several times throughout the day.

Massaging the arch area can also prevent injury by keeping the bottoms of your feet flexible. Lee advises reaching for a tennis or golf ball while sitting at a table or watching TV.

“Roll your foot over the ball and massage that area to loosen the fibers,” he said.

However, if you are experiencing heel pain, consult a doctor before stretching. In some cases, Positano said, there can be undiagnosed injuries to the plantar fascia that stretching can aggravate.

If you are experiencing any persistent foot pain, make an appointment with a podiatrist. There are many simple ways for doctors to relieve pain and prevent chronic problems from developing. If you are uncomfortable, seek care, Baumhauer said, “because we have a lot of tricks up our sleeves.”