For most of us these are unprecedented times. The lockdown has forced many of us to stay at home or, for the most vulnerable, in complete isolation. Managing aches and pains at home when medical treatment is difficult to access is really important. This is a self-help guide for some of the most common aches and pains for legs and feet based on the best latest medical advice.
Plantar fasciitis is the most common cause of heel pain, usually causing pain on the bottom of the heel on your first step in the morning, or after rest. This is usually caused by doing too much too quickly, after too doing little for too long. It’s often caused by taking up a new activity, but can be caused by a change in footwear which makes the muscles and ligaments in the foot work harder.
Good supportive footwear, such as trainers, should be used as much as possible. This can be helped with an arch support, as long as it fits the contours of the foot. Managing the amount of exercise also helps. Total rest is not advised for most people; a slight reduction initially and gradual increases work best.
Short term symptom relief can be had by rolling the foot on a hard ball or frozen bottle, but long-term results come from strengthening exercises for the calf and foot. Slowly raising up on tip toes and slowly lowering yourself back down and repeat, increasing the number of repetitions you can do slowly over time is the best and proven effective.
For many people, the most common leg pain is caused by knee pain from cartilage tears or osteoarthritis. The knee is especially prone to damage with a heavy workload over a lifetime. The protective cartilage in adulthood has a poor blood supply, making repair of injury slow at best. Whilst surgery is common, what can we do to help ourselves?
Exercise is the most important way to help. Gradually increase your exercise every day or even take multiple short bursts of activity every day to help keep the joint flexible and the muscles strong. Complete rest is known now to make the damage worse, but if you’re not used to running around, just start with a short walk and build from there.
Another proven way to help your knees is by maintaining a healthy body weight. Even being a few pounds overweight means your knees have to work that bit harder. In patients with osteoarthritis it’s been proven that losing just four pounds will reduce knee pain by 1 out of 10, and eight pounds by 2 out of 10, and so on. Every few pounds lost adds up.
As many of us are working from home or self-isolating, we may suffer from painful swollen ankles. There can be many reasons for feet and ankles to swell, and whilst an injury which needs medical attention may cause swelling, it can also be caused by inactivity.
The key in these cases is to get the circulation pumping when you’re active, and rest with your legs raised when sat still. Short regular brisk walks are best; imagine walking as if you had a train to catch, rather than window shopping on your local high street. This encourages the veins in the feet and legs to pump the fluid back up the legs.
When you’re at home, the same can be achieved by raising onto tip toes repeatedly, really squeezing the calves at the top, while waiting for the kettle to boil or your toaster to finish.
Compression tights are available from pharmacies and through your GP. If swelling does not resolve, is in one leg only, or is painful, please seek medical attention.
Lateral hip pain
While an injury to the hip joint can feel different to each person, pain on the outside of the hip is common and rarely caused by the joint itself. This is known as greater trochanteric tendinopathy, or bursitis, and is basically swelling or inflammation of the tendons on the outside of the thigh bone. It can be caused by a change in activity, but usually as a result of the gluteal muscles and tendons not being strong enough for the chosen activity.
When we assess lateral hip pain in clinic, or study gait, we can see the pelvis begin to drop each time the person stands on one leg, stretching and compressing the tendons.
The answer to this is to strengthen the gluteal muscles. There are many exercises for this, for example laying on your side on the floor or bed at home and slowly raising and lowering your top leg. Slowly increasing the number of repetitions you can perform over time.
Another exercise is to stand barefoot in front of a mirror and practice balancing on one leg. Concentrate on not allowing the pelvis to drop and maintaining balance, slowly increasing the amount of time you can hold for each day. Remember if your balance isn’t good, have a chair close by to hold if you need.
Published on 03 June 2020