Instep pain

introduction

Not only footballers and competitive athletes are affected, but also amateur athletes who are in the training have overworked. We're talking about Pain in the instep, more precisely called "instep". Of the Back of the foot is - similar to that hand - a complicated structure of many bone, Muscles, Tendons and Nerve tracts. Some of them are very superficial at this point and are therefore particularly exposed to external influences.

In addition, the foot and the Arch of the foot a structure of the human body that is exposed to great forces throughout its life. After all, that's a burden every day entire Body weight on them. So it's no wonder that our feet hurt from time to time. In particular the Instep, also called instep or instep in sport, often causes pain. The various causes and forms of therapy are discussed below.

causes

There are many causes of instep pain, which is as good as ever with one overload or one Improper loading of Foot related. This is often the case with Track and field athletes or Marathon runners. A change of the is often enough Footwearto suddenly cause pain. It is not that easy for the shoe industry to produce the “perfect” shoe because everyone knows Back of the foot individually different. So some runners have one special high, strong instep, while others have a relatively lowhave blunt arches. But both should fit the same shoe, which is not always possible. Athletes often have to try on several shoes before they can find one that really fits. Also a Rash on the back of the foot can cause pain.

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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

  • Lumedis - your orthopedic surgeon
    Kaiserstrasse 14
    60311 Frankfurt am Main

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Further information about myself can be found at Dr. Nicolas Gumpert

Therefore, a fitting in the Specialty shop to guess instead of buying the shoe online. However, the pain often only occurs after a few Trainings on. It is not for nothing that athletes find a really fitting shoe a real blessing.

In addition to sports, there are also other causes of instep pain: For example, can Obesity (Overweight) favor pain. That's because on the one hand more tissue surrounds the foot. This makes it permanent enlarged and "no longer fits into any shoe". On the other hand, of course, there is a much higher weight on the foot and an additional burden on it. Small inaccuracies of fit, which a person with a normal constitution would still tolerate, become painful in obese patients Bruises. The pressure points can cause it to Nerve compressions come at the instep because the annoy very superficial about the in this area bone run away. Nerve compression always leads to pain and Numbness up to the complete Failure of the muscles and sensation.

In the course of being overweight, it can also lead to a so-called peripheral arterial disease (short PAOD) come. It will be peripheral Arteries of the body - as they also take care of the feet - are blocked by deposits and prevent the feet from being supplied with fresh, oxygen-rich blood. This results in cold, pale, pulseless Feet that are extremely painful.

Figure pain instep

Figure instep pain

Instep pain

  1. Instep, instep
  2. Short toe extender -
    Extensor muscle digitorum brevis
  3. Anterior tibial artery -
    Anterior tibial artery
  4. Small rose vein -
    Vena saphena parva
  5. Large rose vein -
    Great saphenous vein
  6. Short big toe extensor -
    Extensor muscle hallucis brevis
  7. Long big toe extender -
    Extensor hallucis longus muscle
  8. Dorsal artery -
    Arteria dorsalis pedis
  9. Tarsus-Metatarsal Joints -
    Articulationes tarsometatarsales
    Causes of instep pain:
    A. - Arthritis (inflammation of the joints)
    Gout (deposits of urinary
    acid crystals) or rheumatic disease
    B - tendinitis,
    Tendinitis
    (Tendovaginitis)
    C - edema
    (increased liquid permeability),
    Swelling on the instep
    D - osteoarthritis
    (Cartilage abrasion, joint wear)
    Therapy:
    E. - Suitable footwear,
    extensive warm-up for
    Stretching the tendons
    F. - Cooling and heat therapy
    G - PECH rule -
    Break, ice, compression, elevation
    H - NSAIDs (nonsteroidal
    Anti-inflammatory drugs) -
    Ibuprofen, paracetamol

You can find an overview of all Dr-Gumpert images at: medical illustrations

There is also a large group of chronic or systemic diseases such as gout, diabetes, rheumatism and arthritisthat can cause pain all over the foot. Pain that occurs selectively on the instep, however, is more for Tendinitis in the foot or Trauma typical.

Tendon inflammation can easily occur as a result of long-term, excessive strain and manifest as sharp starting pain that subsides a little with continued movement. This is that too deceptive tendinitis, one is inclined to ignore it, which worsens the problem.

Trauma - so Fractions or Torn ligaments - do not always have to be related to a direct event and can also arise over weeks and months. Often fragmentations become smaller Pieces of bone not even noticed and only become a problem after a long time. This means that tape approaches can slowly move out of the bone tear away so that they are not directly associated with a particular movement. The pain often becomes noticeable gradually over months until it becomes too severe at some point. Unfortunately, the pain often only goes as slowly as it came.

Here mostly only helps to pause and to save - an exercise of patience when preparing for a competition. Suddenly occurred Swelling however, on the instep are more a sign of an acute process: swelling - too Edema called - arise from increased Liquid permeability finest Blood vessels. Through the Capillaries more fluid escapes from the vessel into the tissue and settles there. It comes to Water in your feet. As a result, the affected part of the body swells. Edema can result from one as described above Inflammatory response be. But injuries can also lead to ruptured vessels and subsequent blood leakage into the tissue. The tissue usually appears reddish, later black.

A Torn ligament on the foot becomes noticeable by discoloration of the surrounding tissue and sudden, severe pain. The tissue turns reddish due to the exuding blood. After 2-3 days, the clotted blood settles close to the gravity Sole of the foot and is now bluish-black. Swelling also occurs within hours, which usually disappears after a week or more. Torn ligaments mostly affect the foot area lateral ligaments, after a classic "Twist“With your foot. But the instep can also be affected.

  • Torn ligament at the ankle
  • Torn ligament on the foot

Pain due to tendon problems

Tendons are structures that connect muscles to bones. There are a multitude of different muscles in the foot, each of which attaches its tendon to certain bones.
Especially when it's too punctual pain at the instep Should be discussed whether a Tendinitis (Tendonitis) or one Tendinitis (Tendovaginitis) could be the cause of the discomfort.

This inflammation is often caused by a chronic overload or friction the tendon. This overload on the instep can be due to unsuitable footwear and excessive training.

Typical of pain that occurs in the context of tendinitis is that it is very strong at the beginning of the movement and then slowly gets better (Starting pain). It is also typical that at the beginning of the disease the pain is only felt weakly and then increases as the disease progresses.

A detailed anamnesis (doctor-patient conversation) and a physical examination can often clarify whether the individual pain is a symptom of tendinitis. Further investigations with the Ultrasonic, roentgen or MRI (Magnetic resonance imaging) mostly serve to rule out other diseases, which can also be responsible for the complaints. A Immobilization of the tendon as well as taking Anti-inflammatory and pain relieving drugs is usually enough to completely heal the tendinitis.

Further information can also be found at Tendonitis in the metatarsus

Time of day-dependent pain

Pain in the instep can also come from the joint.

Pain at the instep occasionally occurs not only depending on the situation, but also depending on the time of day on. Often the question is asked why the pain just after Get up or at night occur. If the pain occurs for a short time after getting up and then disappears again, one speaks of a "Starting pain". Everyone who is active in sports has experienced this at least once in their life, if that training was very intense and demanding during the lecture. The training is still “in your bones”. However, if the onset of pain becomes a habit after getting up and is not related to heavy exercise, it may be a sign of a Joint disease be. The two main representatives are here arthrosis and arthritis. While arthritis-related pain usually resolves within 15 minutes, arthritis pain lasts longer than half an hour.

Osteoarthritis refers to a (mostly age-related) degenerative Joint change in the course of an excessive wear. Arthritis is one more inflammatory Process associated with swelling, redness, and pain. If the pain occurs at night, so that the person concerned wakes up, it is more likely to be on traumatic To think done. After the injury itself, the body pours adrenaline from which the Vessels constricts, but also suppresses pain at the same time. Only in the course of the evening does the pain take full effect. To Sports injuries should always be the PECH rule must be observed: P stands for Break, E for ice, C for (K) Compression and H for Elevate. This will reduce the swelling, protect the body part and prevent further stress. Should the pain become too severe, a doctor or one Emergency room to be visited.

Injuries to the instep are rarely life-threatening, but some operations can only be performed immediately after the injury or weeks later after the swelling has completely subsided. If severe pain occurs at night after a previous injury, an idea should always be given in the hospital should be considered.

  • arthritis
  • Joint inflammation
  • Symptoms of osteoarthritis

External pain

Pain in the outer area of ​​the instep can be caused by different diseases, depending on the quality of the pain and relevant accompanying symptoms.
Very often, pain on the outside of the instep is caused by injuries and accidents. In particular, when “twisting ankle” inwards, injuries to the ankle joint very often occur, which then lead to pain in the area of ​​the outer instep. There is almost always a strain or tear of one or more ligaments, which are located on the outside of the instep of the foot when twisting inwards.

Read more about this under

  • foot bend over
  • Torn ligament foot

In the course of the disease, pain is particularly prominent, which makes normal movement and the occurrence of the foot impossible. In addition, swelling and bruising on the instep are not uncommon.
Accidents can also lead to broken bones in the foot, causing pain on the outside of the foot.

Read more about this under Broken bone foot

But not only accidents and injuries can be responsible for the pain on the outside. In addition, unsuitable footwear, excessive strain or degenerative and inflammatory diseases can lead to complaints there. One of these causes is likely to apply, particularly if the course of the accident cannot be remembered. A doctor can often clarify which cause is individually responsible and initiate appropriate therapy.

Read more about this under: Pain on the outer edge of the foot

Internal pain

If pain occurs in the inner area of ​​the instep, different diseases can be responsible. First of all, it is important to find out whether a specific event can be held responsible for the occurrence of the pain.
For example, if the complaints occurred directly after an accident or a certain sporting activity, different diseases are shortlisted. Injuries to the foot can cause discomfort on the inside of the instep. Here are special Strains and injuries of certain ligaments to call. When twisting to the outside, ligaments on the inside of the back of the foot are stressed and in the worst case can tear. In addition to the severe pain, there is usually a bruise in this case. It can result in accidents too Broken bones come with similar symptoms.
However, the inside of the back of the foot can also be due to athletic overload Cause pain. This is often a wrong footwear the cause. Muscle and tendon irritations call you painful inflammation emerged.
Also can systemic diseases exist, which in addition to the complaints on the foot usually also cause other complaints on the body. Last but not least, older people in particular should be examined whether Wear and tear on the joints represent the cause of the discomfort.

Pain after jogging

One of the most common causes which is responsible for the development of pain in the area of ​​the instep are consequences of a Overloading muscles and tendons in this area.
Such overload is usually caused by physical activity, especially jogging and running. In this sport, every step puts an enormous strain on the muscles, tendons and joints of the foot.
If then a wrong footwear is worn, complaints often arise, which can be attributed to an overload of these structures.
If you experience discomfort on the back of your foot after jogging or running, this is usually one Tendon or tendinitis, bursitis or so-called ganglion formation (see also: ganglion) in front.
If certain muscle groups in the foot are weak, the strain can also cause discomfort. As a rule, the inflammation can be healed through consistent rest and, if necessary, drug therapy. However, patience is often required and it is not uncommon for a more or less long break in sports to be necessary in order to definitely cure the disease. An orthopedist and / or sports medicine specialist can often identify the individual cause of the pain and recommend suitable therapy.

Pain after getting up

The type of pain can be described not only with its quality (sensation of pain - burning, stabbing, etc.), but also with the time it occurred. Specific pain at the instep, which occurs immediately after getting up, provides an indication of which disease could be the cause of the complaints.
In particular stand here Joint disease how arthrosis, rheumatism or in rare cases other systemic diseases such as Lupus erythematosus suspected of causing pain immediately after getting up. A Inflammation of vessels Cause complaints of this kind. But also through Inflammation and overuse Any discomfort caused can be particularly prominent after getting up.

Swelling of the foot

Swelling on the foot and instep are relatively common. They can be caused by different causes.
In the context of various heart, liver or kidney diseases and as a side effect of certain drugs, it can for example Water retention (Edema) come in the legs and feet. Due to its anatomical position and gravity, the foot is usually the first part of the body to be affected by this type of water retention. This type of swelling can also occur through prolonged standing activity without moving the legs and feet. It must be noted that this type of swelling rarely with pain goes hand in hand.
Swelling and pain often arise with Inflammation in the area of ​​the instep (see also: Inflammation in the foot). The body's own inflammatory messengers in the blood and tissue store water from the blood vessels in the tissue as part of an inflammation. In contrast to edema, this type of swelling is not so easy to push away.
The pathological leakage of blood can also lead to swelling. Often caused by accidents with broken bones Bruisingcausing swelling at the instep. Here, too, pain and swelling go hand in hand as symptoms.

therapy

For pain in the instep that occurs after to jog occurred, usually only a few days helps Break and, if necessary, changing the Footwear. The To run should be omitted until the symptoms are completely free, otherwise the pain chronic and much longer compulsory breaks become necessary. Unfortunately, at least athletes stick to this advice, which in a certain way is understandable. Often home remedies are used to accelerate healing. cooling and Heat therapy may also contribute to healing to a certain extent, but the most important prerequisite for recovery is relief of the instep. This also means doing without jogging for a while and possibly doing less stressful sports, such as swim or To go biking to switch. Is the cause not in the running, but in one chronic degenerative Process like that rheumatism, must be shared with the Family doctor Treatment concepts are developed in order to make the course of the disease as painless as possible. This will also be NSAIDs (non-steroidal anti-inflammatory drugs how Ibuprofen) or Paracetamol used. If taken over the long term, these are combined with a Proton pump inhibitor how Pantoprazole combined. This prevents over-acidification of the stomach, which often occurs after long-term use of NSAIDs.

Conclusion

Suitable Footwear, extensive Warm up to stretch the Tendons and a healthy level of self-assessment are essential for being healthy to jog. Is there a chronic Before the disease, comprehensive therapy concepts must be drawn up for treatment. These usually go through Starting pain noticeable after getting up. To step sudden If there is swelling or nocturnal pain, this may be a traumatic event. In order to avoid consequential damage and to clarify the pain, an idea is at doctor or necessary in the hospital. An easy X-ray image usually already provides information about the cause.