Plantar Fasciitis: What a Pain in the Foot!
January 22, 2019
In our office, we see patients for a variety of musculoskeletal issues, not just neck and low back pain, though we do treat a lot of people with those problems successfully. One of the more common complaints patients come in with is foot pain. This is often caused by plantar fasciitis, or inflammation of the soft tissue in the arch of the foot. Plantar fasciitis responds excellently to chiropractic adjustments and conservative treatments.
During walking and standing, the upward arching of our feet actually flattens a bit as our weight is distributed through them to the ground. (Envision the Tyrannosaurs Rex foot on Jurassic Park when he is hunting the kids in the Jeeps, and you will have an idea of how this looks in your own foot.) As the foot flattens, it causes stretching on the plantar fascia which is located on the bottom of the foot. This fascia is rather tough and fibrous compared to a lot of other soft tissues in our bodies, as it has to be strong enough to withstand the weight of our entire body when we are upright on our feet. The toughness of the tissue results in more inflexibility, which is where the problem begins.
The plantar fascia can become tighter than it should be due to wearing inflexible shoes, not walking around barefoot enough, over-exercising on hard surfaces, very tight calf muscles or even having your sheets tucked in too tightly around the feet at night. In general, this results in restricting the natural movement of the joints of the feet, which in turn causes the plantar fascia to shorten and tighten. When this tight, tough tissue is submitted to repetitive strain from walking and weightbearing, it becomes irritated and inflamed, resulting in pain in the arch of the foot and/or in the heel. The pain can be one-sided or in both feet, and can often be sharp or even burning, most notably in the morning getting out of bed or standing/walking for long periods.
It is important to begin preventing plantar fasciitis in the winter months before we transition into sandal season which requires a more flexible foot. Below is list of recommendations that I give to my patients to help combat their foot pain at home. Begin with one or two exercises, and start slowly and gently to avoid increased inflammation or pain due to overworking the area.
Plantar Fasciitis Home Care
- Heat/Golf Ball/Ice – 3 Times Per Day
- Apply moist heat for 5-10 minutes to the bottom of the foot.
- Using a golf ball, massage the bottom of the foot for 2-5 minutes. This may be a little uncomfortable, so only use enough pressure to get in there and get some tissues moving better, but not so much that it is painful.
- Apply ice to the bottom of the foot for 5-10 minutes.
- Ankle Alphabet – 2 Times Per Day (more if you like!)
- While laying down or seated, using your big toe as the “pen” write out the alphabet.
- You can do this one foot at a time, or at the same time.
- Calf Stretches – 3 Times Per Day
- Stand facing a couple of feet away from a wall. (If you’re not near a wall you can also just do this with your hands on your hips.)
- Place your hands on the wall for support and step one foot back into a mini lunge, bending your front leg and keeping your back leg straight.
- Lean into the wall and press your heel back down so that it’s flat on the ground. The greater the distance between your feet, the deeper the stretch will be.
- Hold for 5-10 seconds and repeat 3-5 times.
- Once you’ve held this stretch, change the angle of your back foot a few times and repeat to get the entire gastrocnemius and soleus muscles that make up your calves.
- Repeat on other side.
- At Night and in the Morning
- Avoid sleeping with your sheets pulled tight at the end of you bed as this can result in pointed toes.
- Be sure to massage your feet in the morning before standing up on the floor to loosen the plantar fascia that has stiffened overnight.
- Supportive Shoes
- When you are not barefoot, you should wear comfortable shoes.
- Avoid high heeled shoes, including work boots, with a heel 1” or higher as they shorten the calves and cause more tension in the Achilles tendon, as well as cause shortening of the plantar fascia.
- Consider orthotics or other supportive devices, such as heel cups, to support the feet as needed and recommended by your doctor.
- With adjustments and therapies in the office, as well as these at-home exercises, we are working to improve the mobility of the foot.
- By walking barefoot whenever possible you are helping to encourage the normal motion of the joints of the feet, as well as working the intrinsic muscles of the feet, and encouraging joint an uninhibited and more natural gait.
Oftentimes, patients that come in with foot pain will also have pain in other areas such as the lower back, knees and hips. By working the whole lower extremity as well as the pelvis and lumbar spine, we can address multiple areas of complaint. In addition to these at-home treatments for my patients, I will adjust the feet, toes, ankles, knees, hips and lower back to make sure that all joints of the lower half of the body are moving the way in which they were intended, as any issues with joint function can contribute to foot pain, and vice versa.
We also have therapies at the office that can be applied to aid in more soft tissue and muscle recovery such as electrical stimulation, percussion massage, manual stretching and cold laser. Adjustments, therapies and at-home care are very effective in relieving foot pain due to inflammation of the plantar fascia. If you or someone you know is suffering from these symptoms, feel free to call and set up an appointment to begin recovering from plantar fasciitis pains.