Our feet are subject to a lot of stress in ski boots and in many types of footwear. They are compressed into shoes, or onto toes as in the case of high heels, as well as dynamically working to provide contact between you and the ground.
Compressed or irritated nerves may cause pain in the feet. There are sensory nerves in joints, muscles and soft tissues of the feet. Nerve pain may feel like burning, shooting, or stabbing pain, or there may be a dull ache (can also be a sign of inflammation), or paraesthesia (pins and needles) or numbness. The nervous system sends information from our feet to our brain and from our brain to our feet. The brain itself is a sensory organ, it interprets the pain in our feet, but that is another topic.
Nerve irritation or entrapment may occur anywhere along the nerve from the spine to the foot, and it does not need much pressure; 10mmHg mercury is all it takes, that’s as much as a tea spoon of sugar! Nerves can be irritated as they exit the spine or anywhere along their path. Images below show how some of the nerves travel to and in the feet.
Trigger points in muscles can also cause pain. Trigger points are hyper-reactive points in muscles causing them to knot and often referring pain away from the painful spot. Tight hamstrings or a previous knee injury can restrict the sliding of nerves through the muscle tissue as they make their way to the feet (see image below).
Physiotherapists are trained to find and treat the source of nerve irritation or compression.
Common types of foot pain caused by nerve entrapment or irritation (neuropathy or neuralgia)
- Heel pain
- Arch pain
- Toes or between the toes
- Outside border of foot
- Top of foot
How physiotherapy can help?
Early treatment, and better still prevention, ensures an early resolution of pain from nerve irritation. The longer the pressure or irritation on a nerve, the longer it may take to resolve, but sometimes it is very quick.
- Reduction of inflammation
- Nerve glides
- Strengthening and stretching , restoring muscular balance
- Massage to release entrapment points
- Laser or dry needling
- Home exercise program
Advice on footwear and working with boot fitters to get the best out of your ski boots.