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The response to the question below was authored by Marc Mitnick DPM
pain on inside of foot
by Anne
(South Korea)
I have pain in my left foot, centre/right side of foot bottom, close to the arch. Rubbing it (like in massage) makes it hurt more in the short term, but feels better after I stop. Sometimes standing on it, it starts to get stabbing sharp pain. It doesn't feel flatter than my other foot, though maybe it is and I don't notice it. Most days not walking on it it feels line, but walking or standing on it makes it ache or throb with discomfort more than pain. I have started running, spinning class, hot yoga, and weight training. I am overweight after the birth of my son a year ago, but I have lost all my pregnancy weight AND extra weight from prepregnancy. I am still considered overweight, but not morbidly obese for my height. I am now under 80kgs. I am 32 years old, and I am 5 foot 8 inches tall. I am doing everything I can, I exercise about an hour and a half a day, both cardio and weight lifting, to reduce my weight and prevent (as much as possible) future diabetes, as I had gestational diabetes which disappeared after the birth, though my sugars are still high and my doctor recommended more exercise and monitoring diet.
ANSWER
Hi Anne,
Based on your description of where the pain is occurring the first thing that comes to mind is the possibility of a strain on the tibialis posterior muscle where it attaches into the navicular bone. See foot anatomy for a picture of the tendon and where it attaches into the bone and see if this corresponds to your pain.
Another possibility
In any event, most of these problems are caused by a foot that flattens out too much, thus putting excessive strain on the tibialis posterior tendon where it attaches into the navicular. You do not mention how long this has been going on but the birth of your son could have exacerbated this problem for two reasons. One, if you put on a lot of weight it would create a greater strain on the tibialis posterior which attempts to keep the arch elevated.
Additionally, hormonal changes that occur during pregnancy has a tendency to "relax" ligaments particularly in the foot and this could have forced the foot to flatten out more which would have lead to this type of pain.
If this is your problem, massaging the foot is fine but it is not going to solve the problem. You will need to get an orthotic particularly one that actually supports the arch enough so that it does not continually flatten out. In doing so this takes the strain off the tibialis posterior tendon and allows the tendon to heal.
This is particularly necessary if you are exercising regularly, which you state you are, because exercise puts even more strain on the tendon and it will never get better on its own.
If you would like to try an orthotic then see a doctor who specializes in foot problems, although you can certainly buy one in a store or on line but just make sure it actually supports your arch.
Marc Mitnick DPM
DISCLAIMER:
ADDITIONAL REFERENCES
University of Rochester Medical Center
American Academy of Pediatrics
Columbia University Department of Rehabilitation
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