Footwear and swollen nerve between toes
The physiotherapist assesses your condition by evaluating your footwear and providing advice regarding changes in your shoes.
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It’s appropriate that you wear shoes with a wide forefoot so that the small long bones in your feet do not get squeezed in the footwear.
You may also place a soft cushion under the ball of your affected foot to take the pressure off your foot and swollen nerve. The soft cushion usually lifts and spreads the small long bones in the forefoot and helps to relieve pain.
The adjustments you make to your shoes ensure that you can walk with less pain or discomfort. Hence, you would be able to perform your basic everyday activities such as walking.
It’s required that you put a halt on activities which involve vigorous movements so that you do not aggravate the condition.
It’s also advisable to avoid wearing ill-fitting or tight shoes and high heels, as wearing these will only worsen the pain and increase the pressure on the nerve in the affected foot.
If you have flat feet, then you may need to wear an orthotic device to correct the position of your foot.
Flat feet or fallen arches decreases your foot’s ability to have enough stability when you walk, stand or run. It may also make your condition worse and, therefore, ought to be corrected during rehabilitation.
Therapeutic exercises
Exercises are individual - focused and graduated specifically to ensure that your foot is not re-injured or your condition does not worsen.
The exercises are also drawn up based on your functional goals and your previous daily activities. Exercises begin as soon as the pain or discomfort reduces considerably.
You may begin stretches for the muscles in your leg especially your calf muscles and the muscles of the affected foot. Performing stretching exercises helps in reducing the pressure in the nerve under your feet.
The stretches also provide enough mobility and flexibility in your affected foot. The muscles of your affected foot are also strengthened to be able to correctly support your foot arch.
Strengthening your legs muscles ensures that your muscles are able to work appropriately and enable you to engage in your functional activities.
• Sit in a comfortable chair and place your affected heel in your hand. Also place your other hand on the ball of your foot and gently pull it towards the rest of your body.
Hold the position for at least 15 seconds and relax. You may repeat this as often as you can throughout the day.
• Place both hands on a wall; ensure that your hands are at the level of your shoulders. Move your unaffected foot close to the wall and your unaffected foot away from the wall.
Slowly bend the knee of your unaffected foot whilst you straighten the other knee and lean into the wall. You need to ensure that your heel stays down or touches the floor throughout the stretch.
You should feel a mild stretch in your calf muscles, hold the stretch for about 15 seconds and relax. You may repeat this as often as you can throughout the day. The stretch should not cause pain.
• Sit in a comfortable chair and place the ball of your affected foot on a towel with both ends off the towel in your hands.
With your straightened knee, gently pull the towel - ball off your foot towards your body and hold the stretch briefly for 15 seconds. Relax and repeat this throughout the day.
• Lie down or sit in a chair to perform this exercise. Slowly move your affected foot in circular motions clockwise and anticlockwise. You should feel a mild stretch in your leg muscles as you make those movements.
The movements should not cause you pain and you may repeat as often as you can throughout the day.
• Place a towel on the floor and put your affected foot on it. Try to lift the towel off the ground with your toes and hold the towel for 15-20seconds and relax.
You may repeat this throughout the day. You may also strengthen the muscles in your foot by using your toes to pick small objects for example pens or small stones.
The writer is a Senior Physiotherapist at the 37 Military Hospital
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