Arch pain can come from tendons, ligaments, bones, or muscles. Because the arch plays a central role in supporting your foot and body, even small problems can cause discomfort, alter your walking, and affect the ankles, knees, hips, or lower back.

Arch pain may be influenced by one or more of the following factors:

  • Flat feet or high arches

  • Poor foot mechanics or alignment

  • Overuse or repetitive strain

  • Improper or unsupportive footwear

  • Sudden increases in activity

  • Aging or reduced tissue flexibility

Conditions Associated With Arch Pain

Flexor Hallucis Longus (FHL) & Flexor Hallucis Brevis (FHB) Tendonitis

  • Tendons that bend the big toe and support the arch become irritated or overloaded.

  • Symptoms: Pain along the inside of the arch or base of the big toe, pain during push-off when walking or running, arch discomfort that worsens with activity.

 

Posterior Tibial Tendon Dysfunction (PTTD)

  • Weakening of the tendon that supports the arch, often causing flatfoot and inner arch pain.

  • Symptoms: Pain along the inside of the foot, swelling, and gradual loss of the arch shape.

 

Plantar Fasciitis

  • Irritation of the plantar fascia, a thick band supporting the arch.

  • Symptoms: Arch pain, especially in the morning or after periods of rest, tenderness along the bottom of the foot.

Midfoot Ligament Sprains

  • Injuries to the ligaments that stabilize the arch.

  • Symptoms: Pain with twisting motions or activity, swelling, tenderness along the arch.

Tarsal Tunnel Syndrome

  • Compression of a nerve along the inside of the ankle and arch.

  • Symptoms: Tingling, burning, or sharp pain in the arch, sometimes radiating into the toes.

 

Structural or Bone-Related Conditions

  • Flat feet or high arches – can strain muscles, tendons, and ligaments.

  • Stress fractures – small cracks in midfoot bones from overuse.

  • Midfoot arthritis – degeneration of midfoot joints causing aching or stiffness.

When To Seek Our Care

If you have:

  • You have seen your physician and they recommend pedorhtic care

  • Pain along the inside or middle of the foot

  • Pain that worsens with walking, standing, or activity

  • Arch discomfort that does not improve with rest or footwear changes

  • Persistent discomfort remaining after physiotherapy treatment protocol

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