Plantar Fasciitis

Plantar Fasciitis…..we hear the term thrown around quite often. According to the American Academy of Orthopedic Surgeons, 2 million people suffer from plantar fasciitis every year. According to the National Center for Complementary and Integrative Health, females are 2.5 times more likely to have it than males, and increase body mass index is strongly associated with it.

What is plantar fasciitis you say? How does one come by this diagnosis? How does one “heel” it?

What is it?

Plantar fasciitis is an inflammation of the fibrous tissue (plantar fascia) along the bottom of the foot that connects the heel bone to the toes. Often associated with the first steps out of bed in the morning or pain in the foot after sitting for long periods of time. Most patients describe the pain to be intense and located at the heel, however, it is not limited to the heel.

How do you get it?

The foot is made up of several small little bones, layers of muscle and soft tissue and three arches that help support the foot; the medial longitudinal arch (the arch most people are familiar with), the lateral longitudinal arch and the anterior transverse arch. Plantar fasciitis is usually a result of poor foot biomechanics and under or un-trained foot/arch musculature. The arch musculature is under a lot of inappropriate load with poor biomechanics causing microtrauma of the fascial tissues on the bottom of the foot.

In addition, poor biomechanics can also lead to knee, hip or low back pain.

How to “heel” plantar fasciitis.

As a practicing physician, I have performed numerous therapies designed to help decrease inflammation and pain; graston, adjusting, ART, trigger point therapy, massage, cupping, ice, heat, etc. And patients who arrive at my office have a wide array of therapies they too have tried. Sometimes they work and sometimes they don’t. What has been known to be the most important factor in decreasing pain is improving good mechanics. When the foot is held in the appropriate biomechanical position, the stress on the tendons, ligaments, muscles and bones is greatly reduced. The combination of the above mentioned therapies plus improving foot mechanics has proven time and time again to decrease pain levels and send patients on their merry way, enjoying life pain free.

Now, one would think that the rise in comfortable, shock absorbing shoes would decrease the likelihood of foot pain, however clinically, we see that these shoes don’t actually teach the foot to do its job but rely on external factors to support the foot.

In turn, we see a rise in foot pain as the flip flop seasons begins, and individuals go from a supportive shoe, to a flat, non supportive sandal, leaving the foot to support itself when it has not been trained to do so. It has lead me to conclude that most people rely on the steadiness of their foot wear, to create stability in the foot and ankle rather than the structures inside the foot to do so.

In closing, it is important to note that I am not deflating the importance of therapies as they have helped many people. Patients tend to see a huge improvement in their pain levels when they use these therapies IN CONJUNCTION with improving mechanics. And to reiterate, weak arches creates misalignment of the foot and ankle, leading to microtrauma of the plantar fascia leading to pain.

Stay tuned for my next blog post that will describe specifics on helping you “heel” your plantar fasciitis.

Dr. Heather Russell D.C., B.S, CCSP