We all have an arch which composes the complex bony-ligament structure that extends from our heel bone to the ball of our foot. This sophisticated support mechanism absorbs shock, supports our body weight while standing and protects the many muscles, tendons and neurovascular structures that occupy the bottom of our foot. The middle of our foot contains 10 bones, 9 joints and countless ligaments. When any of these structures are damaged, it typically manifests as pain to the top of the foot. Its equally important to know that our feet were not engineered to wear shoes. The bottom of our foot is designed to absorb thousands of steps a day. In contrast, the top of our foot contains no cushioning structures. Therefore, when a shoe presses on the top our foot, the fragile nerves that give sensation to the top our foot can be crushed between the bone and the shoe. Conditions that affect the top of the foot/instep include, but are not limited to:
- Tarsometatarsal arthritis, synovitis
- Metatarsal Stress Fracture
- Peroneal nerve entrapment, aka Anterior Tarsal Tunnel Syndrome
- Extensor tendinitis
- Ganglion cyst
- Dorsal exostosis, bone spur
