What You Should Know About Plantar Fasciitis
In the last couple of months, more and more people are coming in with plantar fasciitis. I attribute it to the change in weather. As the temperatures rise throughout the spring (and then fall, and then rise again, and then fall…I digress), so do the activity levels of a lot of people.
Some of the people I’m seeing have had plantar fasciitis for years and others are having their first bought with the condition. For some people the symptoms get worse with rest; for others it gets better. Some people have pain in their heel; others have pain closer to their toes. This is what makes plantar fasciitis so tricky to treat.
Textbook plantar fasciitis presents as pin point heel pain that occasionally radiates through the medial arch of the foot and sometimes as far out as the toes. Typically, it is worse in the morning. People usually describe intense heel pain with the first few steps in the morning that gets better throughout the day, but for some people the pain never gets better and sometimes worsens. People experiencing this pain have very colorful descriptions of it. Burning, sharp, stabbing and knife-like are just a few of the descriptions I’ve heard.
What Is Plantar Fasciitis?
Plantar fasciitis is an irritation of the plantar fascia, a dense strap of connective tissue on the bottom of the foot. The purpose of the plantar fascia is to maintain proper foot mechanics and arch support. It originates at the front portion of the calcaneus, or heel bone, and inserts into the bottom side of the toes.
When the plantar fascia is stretched or repeatedly overused, it causes inflammation and pain. The added stress or tension on the plantar fascia causes inflammation in the tissue. As always, with inflammation comes scar tissue formation. The formation of adhesions inhibits it from releasing tension on the tissue and changes the mechanics of the tissue causing further pain and discomfort.
Overpronation or a collapsed medial longitudinal arch each put extra tension on the plantar fascia causing irritation. The plantar fascia also aids in toe off during the gait cycle. If the ankle has any restricted motion, it puts added stress on the plantar fascia to maintain a strong toe off.
Muscular imbalances in the lower extremity can also place more stress on the plantar fascia. These imbalances can changes the biomechanics of the ankle and foot. Improper footwear can also be a factor. More support is usually necessary to take tension off of the area.
The best treatment for any condition is prevention. Stretching the calves is extremely important in preventing plantar fasciitis. Proper foot strengthening is also imperative. I recommend the towel scrunch exercise and barefoot walking on soft surfaces for my patients. Custom orthotics are a great way to support your feet while allowing full mobility. The support from the orthotics will release tension on the fascia by limiting any overpronation or supination. Chiropractic adjustments of the ankles and feet will allow for full range of motion and less stress on the fascia.
Therapeutic ultrasound can be helpful in decreasing inflammation and breakdown of adhesions in the area. I’ve found ultrasound to be a slower option as far as treatment and recovery are concerned. Active Release Technique® and Graston Technique® are both excellent options but I give the nod to Graston Technique in terms of effectiveness and success rate.
Since treating plantar fasciitis can be tricky, a combination of the above is your best bet to recovery. People suffering from acute or chronic plantar fasciitis hear and read a lot of doom and gloom about this condition. But keep your head up, help is out there!