The dreaded Plantar Fasciitis!
We have utmost sympathy for anyone who is suffering from this painful and debilitating injury. It classically makes itself known with the first few steps out of bed in the morning and affects a staggering 10% of us at some point during our lifetime – our chiropractor Ben included.
The physical pain is just the beginning. Many people find that its impact on quality of life is worse than the pain itself – being able to exercise, walk any distance, climb the stairs and dance are things we can sometimes take for granted.
What is plantar fasciitis?
The plantar fascia is a band of connective tissue that connects the base of the heel, the calcaneal bone, to the bones in the front of the foot, the metatarsals.
It works to support the arch of the foot, very much in the same way that the string of an archer's bow works to keep its curvature. By connecting to both ends of the bow, the string ensures that the curvature remains, even if we attempt to flatten it. The plantar fascia helps maintain the arch of the foot in a similar manner, allowing the foot to work as a shock absorber and function optimally.
As with any tissue of the body, the plantar fascia can only cope with so much stress; if it’s constantly overworked its fibres begin to disorganise and tear – this is called PLANTAR FASCIITIS.
The severe pain of plantar fasciitis is usually felt at the base of the heel and can be incredibly sharp, commonly likened to standing on a pin.
Who is at risk from the injury?
There are a number of risk factors which can contribute to injuring the plantar fascia, these include:
· Prolonged standing
· Poor alignment of the bones in the foot
· Excessive exercise
· Being flat footed / having high arches
· Over-pronation of the ankle (the ankle rolling inwards)
· Wearing poor fitting, unsupportive footwear
· Tightness in the calf muscle and achilles tendon / weakness in muscles of the lower leg
Can we self treat Plantar Fasciitis?
For some sufferers, specific home stretches can be enough to ease the pain. However, we advise that you should approach a healthcare professional first to ensure that your symptoms are that of plantar fasciitis.
The exercises below are commonly prescribed as the ‘first phase’ of rehabilitation for the injury.
Unfortunately, for many sufferers, the injury is too far progressed for home rehabilitation as a cure, this is where we can help.
How can chiropractors help?
Put simply, chiropractic care improves physical function. Initially, we must improve the mechanics of an injured area, rather than focusing purely upon the region of pain.
When you think about it, this actually makes a lot of sense.
Poor mechanics lead to injury - injury leads to pain. If we solely focus on the area of discomfort, in this case the bottom of the heel, we may be ignoring its root cause. If there was a fire in your house would you focus on removing the smoke, or would it not make more sense to put the fire out?
As chiropractors we are not limited to treating spinal injuries but have the training to help treat many other conditions, plantar fasciitis included.
Adjustments of the foot and ankle joints.
If the bones of the foot and ankle are poorly aligned, the arch of the foot is going to be affected, and therefore the plantar fascia also (remember our archers bow metaphor).
Specific chiropractic adjustments of the bones of the foot / ankle, if required, will help improve the function of the arch and reduce the stress placed on the plantar fascia, with particular focus upon the navicular and medial cuneiform bones.
Medical acupuncture / Massage.
Both of these techniques help to reduce muscular tension. Working to loosen the gastrocnemius, soleus, hamstrings and other muscles around the foot will reduce the pressures it’s placed under and improves the movement of the foot and ankle.
Supportive taping of the ankle.
A number of specific taping techniques can be used to help to support the foot, its arch and the injured plantar fascia. We use both zinc oxide tape and kinesio-tape depending upon the stage of recovery. These two types of tape work in slightly different ways but are extremely helpful in speeding up the healing process.
A number of muscles in the lower leg work to support the arch of the foot, and take pressure off the plantar fascia - in particular the tibialis posterior muscle. If these muscles are weak the arch of the foot drops and over-stretches the plantar fascia. Providing the correct strengthening exercises will not only help in recovery but also in preventing a recurrence of the injury.
Advice regarding orthotics.
Depending on whether an individual is flat footed or has high arches, we can advise accordingly as to what actions must be taken. Everyone is different, therefore a 'one-size fits all' approach doesn't work for plantar fasciitis, but an assessment by a chiropractor will allow us to give you the correct advice.
So there we have it, plantar fasciitis and the techniques that can be used for a speedy recovery. It goes without saying that if we look after our feet, through daily stretching techniques and minimising the number of risk factors mentioned above, plantar fasciitis can be avoided, but for those suffering does not have to be the long term, disabling condition that it so often becomes.