Often pain in the foot, is caused by tightness of the calf muscles. Spending too much of your day in high heels can result in tight calf muscles.  The body adapts to the demands that are placed upon it.  If you wear high heels the distance between the heel and knee is decreased and the calf muscles will contract in order to compensate for this shorter distance.  Then when you put on your flatter shoes and try to walk the tight calf muscles interferes with the ability of the ankle joint to function as it should to provide pain-free walking.

The goal of treatment for someone with tight calf muscles is to first reduce the strain in the calf muscles and bring the floor up to meet the heel.  This is usually accomplished with a heel lift inside the shoe that is used temporarily as the calf muscles are slowly being stretched thru exercises.  The patient may also require a custom orthotic to support the arch.  The orthotic may incorporate what is called a metatarsal pad that fits just behind the heads of metatarsal bones (long bones of the foot) to take the load off of the ball of the foot.  The long term treatment however involves stretching exercises and making sure the patient is placed into appropriate footwear.  In addition your doctor may prescribe what is called a dorsal night splint which holds the foot in a dorsiflexed position as you sleep to facilitate stretching of the calf muscles.  Let me describe some simple techniques that are used to stretch the two main calf muscles, the soleus (sole-ee-us) and the gastrocnemius (gas-trock-knee-me-us).

To stretch the gastrocnemius muscle you stand facing the wall with your feet about 12 inches from the wall.  Step back about 6 inches with one leg.  Then while keeping your rear knee straight, your forward knee slightly bent, your back straight and both heels on the floor, lean into the wall.  When you feel the muscle start to stretch hold the position for 10 seconds. Do this stretch ten times in a row for each foot and repeat 3 times per day.

To stretch the soleus muscle stand facing the wall as described above for stretching the gastrocnemius with one foot further back.  However this time squat down as if in a seated position while keeping your hands on the wall for balance.  When you start to feel the muscle stretch as you lean toward the wall, hold the position for 10 seconds.  Do this stretch ten times in a row for each foot and repeat 3 times per day.

These stretching exercises together with a temporary heel lift and possibly a dorsal night splint will reduce the pain in the ball of the foot as our biomechanics improve.  If however these measures do not improve your symptoms you may want to consider a custom foot orthotic.