Plantar fasciitis is a common ailment for active people. We'd like to help you figure out if you've got it and help you treat it.
1. What exactly is plantar fasciitis? (Mechanics, how many people are affected, demographics, etc.)
Plantar Fasciitis involves pain and inflammation of a thick band of tissue, called the Plantar Fascia, which runs across the bottom of your foot — connecting your heel bone to your toes.
Plantar Fasciitis causes stabbing pain that usually occurs with your very first steps in the morning. Once your foot limbers up, the pain of plantar fasciitis normally decreases, but it may return after long periods of standing, getting up from a seated position, or running/walking.
2. What are the causes and symptoms (Not sure where to start? Book with us now.)
The causes and symptoms are varied, but below is a list of causes we find to be the main root causes of Plantar Fasciitis.
- Tight calves will increase tension on the Plantar Fascia.
- Altered foot function: Excessively flat or high arches.
- Lack of big toe extension- Upward movement of the big toe.
- Tight hip flexors will reduce the ability to use Gluteals in ‘push off.'
the phase of the stride, hence increasing the workload on the Plantar
Fascia and calves. - Reduced glute and hamstring strength will again increase the demand on the calves and Plantar Fascia, predisposing to an overload of these structures.
- Walking barefoot on hard surfaces
- Improper running/walking technique
- Worn-out/Improper shoes
- Increased distances of walking or running too soon.
3. When should you seek medical help and How will a doctor evaluate the problem (tests, x-rays, etc.)
Seek a chiropractor’s help if the pain has been present for longer than a week because regular soreness should start to dissipate after a few days.
At Align To Health, we will start with a general assessment of the spine, a detailed assessment the low back to ensure there is no involvement (a true sciatic nerve can be reproducing similar symptoms). We then check and make sure the hip, knee, ankle and foot are moving well. Focusing in on the foot, we check each joint and muscle to screen for major injury. This allows us to come to a definitive conclusion and diagnosis for the pain you are experiencing.
If there was a traumatic incident (a major fall, pain was sudden during activity, or a “pop” was heard) consult a physician sooner rather than later. X-rays or further imaging may be necessary which can rule out a bone issue (heel spurs) or a soft tissue problem (muscle strain/tear).
4. What is the normal course of treatment from the most conservative to surgery perhaps? (Ask us about treatment options)
Plantar Fascia is a muscle/tendon. Muscles and tendons can have varying levels of injury, a basic strain all the way to full tear. Which means that treatment expectations can vary depending on the severity of the situation.
General rule of thumb though: It should first be treated conservatively for 4-6 weeks via adjustments to ensure proper movement of the joints, soft tissue therapy to reduce muscle tightness, and exercise to strengthen the joints muscles involved. If after this trial of care, you are still experiencing pain, you should be referred out for further examination to determine if the cause of pain is of another nature.
Stretching for the Gastrocnemius (outer calf), Soleus (inner calf), hip flexors (front of the hip) and the Plantar Fascia. Secondly, you need to be evaluated to determine if you have excessively flat or excessively high arches. If you have flat feet, an orthotic may be beneficial. Manual therapy such as massage, Active Release Techniques, Graston Technique to the calves, Achilles, and Plantar Fascia are instrumental in achieving resolution of pain. Lastly, strengthening of the glutes and hamstrings (along with hamstring flexibility) are vital to the proper biomechanics of the lower body.
5. How can we avoid this condition while performing our important activities?
From a physical standpoint, the best way to prevent Plantar Fasciitis is to obviously correct the causes by performing exercises to correct any of the above listed dysfunctions. Sports that involve running tend to get this condition the most, though I have seen a number of non-athletes with the same condition. Proper technique, footwear, mileage increases, and surfaces should be addressed and improved as much as possible. If you are an athlete, reducing how much activity you do is an easy place to start to reduce the amount of load the fascia is taking. Seeing us for soft tissue treatment, proper stretches, and a thorough rehab program is going to streamline the healing process. Leaving you with more time to be happy and pain-free during your activities.
