Heel pain and Plantar Fasciitis are closely related. Plantar Fasciitis is an inflammation caused by excessive stretching of the plantar fascia (the tissue that extends the entire length of the bottom of the foot). Heel Pain is a common condition in which weight bearing on the heel causes extreme discomfort, usually at the point where the Plantar Fascia attaches to the heel bone. Plantar Fasciitis is one of the most diagnosed foot ailments. Please ask your health care professional if Birkenstock footwear or arch supports may be part of your foot pain solution. Also, feel free to contact your local Birkenstock retailer about their healthy footwear recommendations. Birkenstock has many products that can help with Plantar Fasciitis and Heel Pain.

Symptoms:
With Plantar Fasciitis, the bottom of your foot usually hurts near the inside of the foot where the heel and inside arch meet. The pain is often acute (“hot poker” sensation) either first thing in the morning or after a long rest, because while you are resting, the plantar fascia contracts back to its original shape. As the day progresses and the plantar fascia is adequately stretched, the pain often subsides.

Causes/Risk Factors:
Plantar Fasciitis often leads to heel pain, heel spurs, and/or arch pain. The excessive stretching of the plantar fascia that leads to inflammation and discomfort can be caused by the following:

• Additional or excessive weight on the foot, usually attributed to weight gain or pregnancy
• Wearing shoes without any arch support or proper arch support
• Over-pronation (flat feet) which results in the arch collapsing when bearing weight
• A foot with an unusually high arch
• Tight calf muscles
• Aging
• Exercise error of “too much, too soon, too fast”

Prevention & Treatment:
The key for the proper treatment of plantar fasciitis and heel pain is determining what is causing the excessive strain and stretching of the plantar fascia and/or the heel discomfort. Ask your health care professional to help you find the best solution for your condition. In many cases, they suggest changing your footwear or wearing an arch support as a first step toward recovery. You can help reduce the strain and stress on the plantar fascia by following these simple instructions:

• Don’t go barefoot – not even in the shower
• Try stretching exercises in bed before you get up, focusing on your Achilles tendon, calf, and toes. Lay on your back with legs outstretched. Move your toes toward your head and hold for 30 seconds. Relax feet. Repeat 4-5 times.
• Ice your heels (or the painful area) to reduce inflammation. Freeze a 12-16 oz plastic water bottle. Place the bottle on the floor and gently roll your foot over bottle between heel and toe for 5 minutes 3 times per day.
• Wear shoes or orthotics (arch supports) that support your arch and heel and have proper shock absorption in the heel
• Maintain a healthy weight
• Avoid running on hard or uneven ground

A bunion is a prominent bump on the inside of the foot on the big toe joint. Corns are a localized, tender, sharply defined area of thickened skin over a bony prominence usually caused by trauma. They sometimes have a central cone-shaped core whose point can press on a nerve below causing pain. Calluses are an accumulation of dead skin cells that harden and thicken over an area of the foot. They are the body’s defense mechanism against excessive pressure and friction. Calluses are normally found on the bottom of the foot, the heel and the inside of the big toe. Bunions, corns, and calluses are common foot ailments associated with improperly fitted footwear. Birkenstock has many products that can help with bunions, corns, and calluses. Please contact your local Birkenstock retailer for their healthy footwear recommendations.

Symptoms:
Bunions are 10 times more common in women than men and often “run in the family”. A person with a bunion may have inflammation, swelling and soreness on the side surface of the big toe. Numbness and tingling may occur from the pressure created on the nerve in the big toe. Corns will most likely be seen on the top or sides of the toes and often will be tender and cone shaped. Calluses will appear where the foot is subject to high pressure and will be a thick hardened patch of skin.

Causes/Risk Factors:
Bunions, corns and calluses can all be caused by tight and/or poorly fitting footwear. Each can also be caused by the following:

Bunions:

• Flat feet or over-pronation leading to increased pressure on the big toe joint
• Footwear that is too narrow and/or too short
• Constrictive shoes in the toe boxes area
• Footwear with a tapered toe box not only can cause bunions but can also cause them to worsen to the point of needing surgery to repair

Corns:

• Footwear with elevated heels or tight-fitting footwear, stockings or socks
• The foot sliding forward in a loose-fitting shoe
• Bony prominences
• Toe deformities

Calluses:

• Excessive pressure on a specific area of the foot
• Footwear with elevated heels and/or shoes that are too small
• Flat feet, high-arched feet, excessive weight, and loss of the fat pad on the bottom of the foot

Prevention & Treatment:
Ask your health care professional (physician, physical therapist, podiatrist etc.) to help you find the best answers as to what is causing your pain. You can reduce the risk and discomfort of these conditions by following some simple guidelines:

Bunions:

• Wear footwear with a wide toe box which will decrease pressure on the big toe joint
• Avoid heeled footwear which places more pressure on the forefoot
• Wear footwear or arch supports that offer good medial and metatarsal arch support to decrease pressure on the big toe region
• Substitute to activities such as walking or swimming (ie. instead of running) to decrease symptoms and stress on the forefoot
• Maintain a healthy weight
• If the bunion is in an early stage, soaking your feet in warm water may provide temporary relief

Corns & Calluses:

• Avoid heeled footwear which places more pressure on the forefoot
• Wear footwear or arch supports which provide proper support and aid in weight distribution
• If the soft corn is between the toes, wear toe separators
• If it is a hard corn, wear a corn pad
• Gently use foot buffer after bathing to reduce the thickness of calluses

Metatarsalgia is a general term used to denote a painful inflammatory foot condition in the metatarsal region of the foot (the area just before the toes, or the ball of the foot). This ball-of-the-foot pain is often located under the 2nd, 3rd, and 4th metatarsal heads or occasionally at the 1st metatarsal head (near the big toe). Morton’s Neuroma is an abnormal function of the foot that leads to metatarsal bones squeezing a nerve usually between the 3rd and 4th metatarsal heads. A neuroma is an irritation resulting from this abnormal pressure or a repetitive trauma. Birkenstock has many products that can help with Metatarsalgia and Morton’s Neuroma. Please contact your local Birkenstock retailer for their healthy footwear recommendations.

Symptoms:
Metatarsalgia is often described as “walking with a pebble in my shoe”. Calluses may be present under the metatarsal heads (ball of foot) and will be variable in location, size and shape. A person suffering with Morton’s Neuroma will feel extreme tenderness at the ball of the foot. Some will feel a “red hot poker” burning sensation. Numbness may also occur with a “pins and needles” sensation.

Causes/Risk Factors:
Metatarsalgia and Neuromas are fairly common foot ailments. Some typical causes for each are listed below:

Metatarsalgia:

• Often a result of an imbalance between the outside and inside arches of the foot
• Usually due to excessive pressure on the metatarsal heads (ball of the foot) over a long period of time
• Often caused by improper fitting footwear such as women’s dress shoes and other restrictive footwear. This condition occurs 5 times as often in women than men
• Footwear with a narrow toe box (toe area) causes the ball-of-the-foot area to be forced into a minimal amount of space
  Shoes with elevated heels
• Participating in high impact activities without proper footwear or arch support
• As we get older, the fat pad in our foot tends to thin out making us more susceptible to pain in the ball of the foot
• Osteoarthritis

Morton’s Neuroma:

• Often caused by pointed-toe footwear, high heels and footwear with a narrow toe box
• Constricting shoes can pinch the nerve between the toes causing discomfort and extreme pain
• Over pronating while walking
  Having flat feet
• Tight Achilles tendon
• Obesity
• Loss of fat pad under foot

Prevention & Treatment:
The first step in the treatment of most forefoot conditions is determining what is causing the problem. Check with your medical professional (family doctor or podiatrist) to help you find the best solution for your pain or discomfort. You can reduce the risk and discomfort of Metatarsalgia and Morton’s Neuroma by following these simple guidelines:

• Choose footwear with a higher, wider toe box (toe area) to allow the foot to take on its natural shape
• Choose footwear with a deep heel cup, pronounced metatarsal support, add additional padding if needed
• Avoid standing for long periods on hard surfaces
• Ice the ball of the foot which may reduce the inflammation
• Gently stretch the Achilles tendon and calf muscles
• Choose footwear with a higher and wider toe box (toe area) to allow the foot to take on its natural shape
• Choose footwear with a pronounced metatarsal arch support and add additional padding if necessary if needed to unload pressure and relieve pain

Hammer Toes can occur in all but the big toe and occurs in women nine times more frequently than in men. It is a toe that is raised and may cause pressure and pain. In claw toes, the toe curls under so the tip (end) of the toe is pressed against the bottom of the shoe. Ingrown toenails usually affect the big toe. They are a result of the nail growing downward into the skin and nail bed. These Toe Ailments are common and are usually associated with improperly-fitted footwear. Please contact your local Birkenstock retailer about their healthy footwear recommendations. Birkenstock has many products that can help with Hammer Toe, Claw Toe, and Ingrown Toenails.

Symptoms:
With hammer and claw toes, the toes will be bent upward from the middle joint. Claw toes may have tenderness on the tip of the toe. With ingrown toenails, you may experience infection of the skin around the nail, irritation, redness and sensation of warmth from infection as well as skin swelling around the nail.

Causes/Risk factors:
Hammer Toe, Claw Toe, and Ingrown Toenails are all common Toe Ailments. The common causes for each are listed below:

Hammer & Claw Toes:

• Muscle imbalance that causes the ligaments and tendons to become unnaturally tight.
• Conditions such as Diabetes, Arthritis or chronic inflammation
• May be associated with neurological conditions such as Cerebral Palsy or Muscular Dystrophy
• Poorly fitting and constricting footwear
• Abnormally long toes

Ingrown Toenails:

• Tight shoes that cause excessive pressure on the nail bed
• People who have Arthritis or other conditions where the toes are susceptible to ingrown toe nails
• Trauma to the toe from pounding while running, stubbing the toe or having the toe stepped on

Prevention & Treatment:
Check with your health care provider (family doctor or Podiatrist) to find the best solution for you. You can reduce the risk by following these simple guidelines:

Hammer & Claw Toes:

• Avoid high heels
• Wear shoes with a roomy toe box
• Perform foot muscle stretch and strengthening exercises
• Place metatarsal pads behind toes to reduce pressure
• Surgery if more conservative measures don’t significantly reduce pain

Ingrown Toenails:

• To prevent future ingrown toenails, cut nails straight across so the toenail corners are visible
• Soak feet in warm salty water, dry, apply antiseptic and bandage the toe
• Consult your health care provider if toe becomes infected (red, warm, yellowish drainage)