How to move: with foot pain

Foot pain is a common, disabling condition associated with older age and obesity and is more prevalent in women than in men. A 2008 study found that foot pain affects nearly one in five people aged 18 years and over in Australia.

Dr Kade Paterson, a researcher at the Centre for Health, Exercise and Sports Medicine at the University of Melbourne and certified sports podiatrist, says in younger to middle-aged adults, plantar heel pain is the most common condition, affecting around 5-8% of the general population.

But as people age, the most common cause of foot pain is osteoarthritis of the big toe and the ankle joints, says Prof Kim Bennell, an academic physiotherapist and the director of the centre.

Some illnesses can also affect the feet, such as diabetes or poor blood flow, says Prof David Hunter, a rheumatologist at Royal North Shore Hospital and the University of Sydney.

Because the feet are involved in most types of exercising, foot pain can deter people from physical activity. But exercise, Bennell says, strengthens the muscles, improves flexibility and balance, and helps with weight loss, reducing the load on the feet.

It also provides psychological benefits. “Exercise makes people feel better,” says Hunter. “Pain might still be present but can be better tolerated.”

Exercise can help reduce foot pain in many ways, but it is essential to consult a podiatrist, doctor or a physiotherapist before you begin.

The class: tai chi and yoga
There is evidence that tai chi and yoga classes can help reduce foot pain, Bennell says.

Tai chi and yoga are excellent, holistic workouts that can strengthen and improve the whole body,” says Paterson. These barefoot practices can help strengthen the feet’s muscles and increase stability.

Tai chi and yoga classes can also improve balance, essential to avoid falls and further injuries, especially as people get older. “The balance benefits that come with tai chi and yoga are an additional benefit that we don’t see with some of the other workout classes,” Paterson says.

“Classes have the benefit of social participation as well,” adds Bennell. “People with persistent pain can often find it helpful to be in a group setting.”

The move: calf raises
“My number one go-to exercise is some form of calf raises,” says Josh Butcher, a podiatrist and APA musculoskeletal physiotherapist. Although it can be challenging for many people, he says, calf raises are great for improving calf strength, stabilising the foot and preventing injuries.

“If you have great calf strength, it means you don’t have to compensate through other muscles or other joints within the foot,” he says. “You’re using your body’s natural spring mechanism to propel forward and move.”

Calf raises are a simple exercise you can easily slip into your day-to-day life. Stand upright with your feet hip-width apart. Push through the balls of your feet to raise your heels, keeping the knees extended but not locked. Hold for one second, then lower slowly back to the ground.

This exercise has many variations, and you can slowly increase the intensity over time. You can begin with seated calf raises if standing causes too much strain. You can progress with weighted calf raises by holding weights in your hands or a single-leg calf raise by lifting one foot off the floor and holding on to a chair for balance.

“[Calf raises] strengthen the big muscles that are outside of the foot and run into the foot. They also work out the little muscles that live inside the foot,” says Paterson. “It’s a really good all-round exercise to support foot function and can have pain-relieving effects.”

However, he says calf raises might exacerbate some forefoot conditions, such as neuroma or bursitis, so it is essential to modify the exercise if necessary.

The activity: walking and running
“Walking is always a good exercise for [foot] osteoarthritis,” says Bennell. But even a short stroll might feel excruciating to someone with severe foot pain, so starting with short easy walks is recommended.

Running is also an excellent activity for foot pain, especially if you already are a runner, Bennell says. But pacing yourself is critical.

“Running is really good for foot pain,” says Butcher. “It just has to be done really well as it can lead to further injuries if you do it incorrectly. Starting with a couch to 5km run programs is always preferable.”

He also recommends getting footwear checked by a recognised running-shoe shop.

“Provided that the pain is not getting too bad or lasting too long, then certainly running is fantastic,” agrees Paterson. “But if you find this weight-bearing exercise makes your pain worse, then you can look at non-weight-bearing options like swimming or cycling.”

The hard pass: not too fast
While exercise has several benefits, all experts agree that people with foot pain should avoid doing too much too quickly. “Ease into it,” says Butcher.

After months of lockdown, people are eager to get out and move more, he says, but overloading your feet too suddenly might exacerbate foot pain.

“Having some pain during exercise is OK and expected,” says Bennell. “But if you are getting much worse symptoms that don’t settle down by the next day, then obviously whatever you are doing is a bit much and you need to back off.”