Working from home has become the standard for millions of Americans due to COVID-19, and it’s a trend that many believe will continue past this pandemic. People who previously spent hours on their feet or frequently moving around throughout the day suddenly find themselves sitting stationary at a computer or desk for hours on end. The effects of prolonged sitting are a well-known health hazard and can directly affect the foot and ankle in particular.
As a podiatrist, I’ve seen an increase in conditions related to these changes — so, what are we to do? Below are a few common foot problems associated with work from home life and more importantly, pointers on prevention to help you move better.
The most common complaint I see is pain in the bottom of the heel known as plantar fasciitis. In a nutshell, this refers to inflammation of the ligament that spans the bottom of your foot — it attaches your forefoot to the heel bone (calcaneus). The other side of your heel bone is attached to your Achilles tendon and the calf muscles. Tight calf muscles cause a continuous pull on the Achilles which uses the calcaneus as a lever to pull on the plantar fascia.
So, if your calf muscles are always tight, then your plantar fascia is constantly under strain and will develop inflammation. Sitting with your knees bent and toes pointed down is the shortest possible configuration for the calf muscles. Days of sitting like this causes the muscles to shorten which tightens the Achilles tendon and plantar fascia. Patients often complain of a sharp pain in the bottom of the heel when they get up after sitting. Though the pain improves as they get up and move around, it returns when they sit back down.
The key to prevention is regular stretching of the calves to restore muscle length. A quick online search for plantar fascia stretches will give you a range of options. Proper chair height, routine walks around the house and use of a standing desk can also help.
Achilles tendon pain
For very similar reasons, people can develop pain and inflammation in the Achilles tendon. This is usually seen in people who walk or run for exercise but not exclusively. It’s caused by the sudden transition from sedentary hours to cyclical stress in the setting of tight muscles. Once the tendon develops micro tears or degeneration, it is slow to recover due to the poor blood supply of the Achilles.
The body responds to stress by strengthening bones and tendons. Spending more hours sitting can cause your muscles, tendons and bones to lose some structural integrity.
Many people use running as a way to combat anxiety and relieve stress. If you are one of those people, remember to listen to your body and not your mind. You may be able to run through a painful tendon for a few days but eventually, it will catch up. Proper warm-ups of the calves, hamstrings and lower back, slow increases in distance and rest when needed are the best ways to prevent issues with the Achilles.
Humans are built to walk, run and stand. The unnatural act of sitting not only weakens our bodies but also restricts circulation and slows our metabolism. Your heart and gravity help get fresh blood down to your feet. It’s the job of veins, muscles and lymphatics to get that blood back up to your heart and lungs. When we sit down, the muscles don’t fire as strongly and pump blood through the veins.
In addition, extra belly fat can compress the veins in the groin and increase venous pressure in the legs. The lymph system picks up the extra fluid in our body tissues and has a similar mechanism of flow. When these systems become stagnant, you get swelling of the legs and feet that can stretch the skin, cause local inflammation from dying red blood cells and eventually lead to enlarged veins that can become painful.
A common side effect of this swelling is nerve entrapment. There are few places in the leg, ankle and foot where nerves travel through tight spaces. Engorged veins and swollen tissues can pinch these nerves and cause shooting pains into the leg, arch or toes. Similar to carpel tunnel syndrome of the wrist, tarsal tunnel syndrome occurs when the tibial nerve gets constricted in the ankle. Prevention once again includes routine walks around the house, compression stockings up to the knee and regular exercise.
If your foot or ankle pain does not improve with these simple tips or begins to worsen, make an appointment to see a specialist. Postponing care can lead to longer recovery, so it’s important to listen to your body and seek expert help when needed. Find a doctor near you today.
About the author
Andrew Bruyn, DPM, AACFAS, is a podiatrist on the medical staff at Baylor Scott & White Clinic – Buda Medical Center. As the son of a podiatrist, Dr. Bruyn has been exposed to foot and ankle treatment from an early age. He quickly began to appreciate the importance of lower extremity care as he became a runner and triathlete and ultimately decided to follow in his father’s “footsteps.” After residency, Dr. Bruyn joined his father in practice for two enriching years before his love of the Hill Country brought him and his family back to the Austin area. Dr. Bruyn welcomes patients from all walks of life, including pediatrics, geriatrics and athletes. Schedule an appointment with Dr. Bruyn today.