Arch, Foot Pad, and General Foot Pain when Standing Up and Not Moving Around

Hey, everyone. I was advised to post this here instead of the Facebook group, so I’ll copy/paste what I said there:
Note: I’ve seen half a dozen doctors, nerve pain doctors (no idea the term), foot specialists, etc.

I’m aware this is a long shot and this doesn’t replace an actual medical professional, but I’ve already seen countless doctors and basically just gave up when they all did as none of them could tell me who else to go see and couldn’t figure it out on their own. I figure I can ask here and see if anyone has dealt with it.

When standing, my feet hurt, always. Like they ache and complain at me from the time I stand up until I sit down and it gets progressively worse the longer I stand. It’s been this way since I was a child. My first job at 16 I had to quit because standing for even 8 hours a day was unbearable. It’s not from a low pain tolerance either, I have a sleeve of tattoos and it wasn’t a bad pain. I’ve received numerous injuries in my life, was a skateboarder, and even crashing skateboards into my shins wasn’t a big deal pain wise. But standing? Standing is the devil.

I’ve worn orthotic inserts from the stores, custom orthotics from specialists that were absurdly expensive, and the inserts that allegedly solve the problem of foot pain by correcting foot posture. None of these have made any real change in the foot pain. Minor relief, but nothing substantial.

I’ve even been prescribed specific types of anti-depressants in the past just in an attempt to manipulate my nerves somehow. That didn’t change anything at all.

I’ve seen a physical therapist who gave me stretches to do on my IT band, said I had weak and tight arches, and told me to do some various arch exercises. None of these have helped at all either. I did them for weeks and nothing.

I even had a doctor do knee injections of some kind to see if that helped, nothing.

I’m wary to call it plantar fasciitis or metatarsalgia, but the pain is always in the arch and the foot pad. It’s a deep ache like I’ve been standing all day long and my feet are just done. Stretching my toes back always feels incredible and gives instant relief, but the relief goes away instantly when they’re no longer stretched.

My Achilles tendon isn’t tight and I have good flexibility when stretching them. The front of my shins is always very tight, however.

Walking does not cause even a little pain. I can walk for hours and for miles without any discomfort. It is simply standing still that hurts.

Did I just do one of these things wrong at some point? Am I just cursed with painful feet and there’s no hope? Is there even a word for this?

Side note: I used to have a ton of knee pain too, but lifting has completely eliminated that so I have no idea if it’s related or not.

I’m 5’7, 190 lbs, and 28 years old.

Hey, redirected myself here after seeing your Facebook post. For background I am a podiatrist. Without examination it’s hard to say but I have treated plenty of patients with similar histories to you, who have exhausted all the typical approaches, with no success. There is a chance that because it is standing and not moving that is the issue it could be a circulation problem. You described you foot as “high arched” that goes “flat”, typically feet like this have very high peak plantar pressure across 2-4 metatarso-phalanges joints and central-medial heel, these high pressure affect tissue perfusion and skin blood flow. I’m not sure where you are based but if you can find a practitioner (university clinics are good for this) who can measure static and dynamic pressure preferably with an in shoe device and measure ankle and toe blood pressure, and laser flowmetry.
Generally orthotics can be useful in this situation to redistribute peak plantar forces, assuming this is the issue, avoiding shoes with thinner, stiffer soles can help.

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I have the same problem, I have mentioned before that I think it’s due to poor circulation. Doc said I have a weak pulse and I may have Raynaud’s Syndrome . I have tingling in hands and feet and trouble regulating temperature in both , it’s either too hot or too cold . I don’t like to paint nasty pictures or narratives in my head but it feels as if there is no cushioning in between my heel and the ground .

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Thanks for posting this thread. How familiar are you with our content on pain?

It sounds like you have been supplied a lot of narratives over the years since dealing with this, which is unfortunate. I don’t think this means you’ve done anything wrong.Nor do I think you are cursed. The word would be catastrophizing. I’d recommend against letting your mind jump down that rabbit hole.

To your example of pain tolerance and tattoos - this gets at context dependent experience of pain perception.

If the context is centered around the uncomfortable feeling is necessary to get to the end goal (tattoo) then we are much more willing to accept the experience (this also gets at goal relatedness of pain perception).

Given the persistence of this issue and the number of clinicians previously seen, I’m skeptical there’s any serious underlying tissue issue here but it will be difficult to give advice without a consultation.

All of this aside - what has training looked like recently?

What are your thoughts about what you are experiencing?

How long can you stand before noticing symptoms?

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Anything else I can do to increase blood flow if that is the issue? Just being in better shape I imagine?

My training went from StrongLifts 5x5 (I know) to starting The Bridge last week. I don’t do any foot specific exercises anymore. I’ve lost 6 lbs and am down from 196 to 190 on a deficit from my training and macro tracking. If I am standing up and know I’m not going to be moving around, I notice symptoms immediately. It does sort of have a circulation feel to it, like when you do a hand stand and the blood flow is restricted on your hands. I’ve wondered how much of it is contributed by my thoughts as I have long dreaded standing still. Any time I know I’m going to be standing still I feel some amount of stress and anxiety. If I’m going to walk, not any really. I work as a teacher, so any time I have to just stand up and do nothing like during assemblies, pep rallies, or do some sort of lunch or breakfast duty I feel that stress too. The longer I know I’m going to stand, the more I dread it as it begins. The worst is during football season when I have to work chains on the sidelines and am basically standing still 90% of the time for 2-3 hours. I usually have to take some ibuprofen and sit down the next day just to recover from it. I am completely unfamiliar with your content on pain. The image I get in my head is like what Lut said, that it feels like there’s no cushion in my foot. It feels like I’m missing something there that should be cushioning my foot somehow.

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Anybody have anything?

Apologies for not responding to this sooner. I want to start by linking to Mike’s piece on pain in general which can be found here. It is a longer piece, but will likely help to give a framework through which to discuss this. Overall, there seems to be two parts to this, the first one which you have self-identified as when you start worrying things are going to hurt, the probability of something hurting tends to go up. Unfortunately the advice to just tell you to “not worry” is equally effective with telling your significant other to “calm down” when they are agitated. Some strategies with which to address this is to look to increase capacity for how long you can stand and look at it from this manner. When symptoms come on, they likely are the same intensity, but if you can get from where you can stand for 15 minutes to 30, that is how we typically quantify improvement. Mostly, this is done through some basic strengthening programs such as those typically given for plantar fasciopathy.

​​​​​​https://www.youtube.com/watch?v=gnMMlwj78lI

It seems simple and it is highly likely you have done some of this before. My normal adage though is “no one has ever been too good at the basics.” If this has been going on for 12 years we unfortunately are unlikely to fix it overnight. Once again though, if we can start increasing the amount of time you are able to stand without having symptoms that is the progress we are looking to make.