Experiencing a sharp pain or aching pain in your heel throughout the day as you walk or first thing in the morning is something you shouldn't ignore. You may think that the pain is just from standing too long or you slept on it wrong. While those reasons may be true in some cases, in others, you could be suffering from plantar fasciitis. Most people begin to feel foot pain and then ignore it for months. Eventually the pain increases to sharp severe pain that has progressively gotten worse over months. Soft tissue and plantar fasciitis pain is much easier and quicker to treat when the symptoms are mild and in the early stages.
On average, you take between 5,000 and 10,000 steps in a single day. During all these steps, your bones, muscles and ligaments in your feet and legs bear the brunt from the impact of the steps. In a healthy foot, the ligaments are flexible in order to support standing, walking, and running. One of the most important ligaments within the foot is the plantar fascia and when this ligament gets damaged or becomes inflamed, it is called plantar fasciitis.
The plantar fascia is a ligament located on the sole of your foot and runs from your heel, across your arch, through the ball of your foot and toward your toes. The plantar fascia ligament is meant to support the bounce in your foot as you walk or run. When you have plantar fasciitis, the plantar fascia ligament is stretching and moving more than it should. This excess movement results in small tears in the tissue of the ligament and these tears cause inflammation. Along with plantar fasciitis, calcium build-ups, or bone spurs, can be deposited in your heel bone and every time you walk, these protrusions are pushed into the fatty pad of your heel which causes further pain with every step.
"Plantar fasciitis" is literally translated to "foot inflammation." As a progressive condition, if it is left untreated, the combination of excessive movement, ligament tears, and possibly bone spurs, can become unbearable. However, there are several conservative treatments available to resolve the pain.
There are many different reasons and causes for foot pain. If you are experiencing these symptoms, it's time to consult your local chiropractor about plantar fasciitis:
As one of the leading causes of foot pain, plantar fasciitis affects both children and adults. Children will usually outgrow plantar fasciitis, but adults who suffer from it can experience recurring symptoms over the course of years. Plantar fasciitis affects both heavily active people and those who are less active, as well. Plantar fasciitis can result from a combination of reasons including:
Treatment for plantar fasciitis is directed at decreasing the chronic inflammation of the plantar fascia, stretching tight muscles, and encouraging proper healing of the fascia. Initially you will want to start with home treatments which includes lots of rest and ice therapy. By decreasing the activity and pounding forces to the soft tissue muscles, tendons, and ligaments, the tissue is given a chance to heal and recover. Many people think plantar fasciitis should heal within a few days, but they often wait too long before seeking treatment or reducing their activity, which results in severe damage to the plantar fasciitis that requires weeks to heal.
Changing footwear is very beneficial to anybody experiencing foot pain. Wearing more supportive shoes that absorb the forces while walking, standing, and running remove those forces from the plantar fascia, which means the tissue is not exposed to as much trauma and has a better chance to heal and recover. You can also use night splints and orthotics to decrease stress and support the arch and fascia. Over the counter nonsteroidal anti inflammatory drugs (NSAIDs), as recommended by your doctor, can help reduce pain and inflammation, as well.
Common home self treatment products we recommend include roller balls, golf balls, prostretch, ice packs, and the strassburg sock. Patients with severe plantar fasciitis should definitely use these products at home to decrease pain and enhance healing.
Additional products, recommendations, and self treatment recommendations are available at plantar fasciitis self treatments.
If home treatments don't work in reducing your pain, the next step is active treatment which involves physiotherapy to decrease inflammation of the plantar fascia through electrical stimulation and ultrasound. Stretching of the calves and hamstrings will also reduce stress and improve your walking mechanics: another key component of therapy. Proper proprioceptive and foot strengthening exercises prescribed by your healthcare provider will further strengthen your foot and decrease stress on the plantar fascia.
Specific balance exercises can be given to increase foot strength and endurance. Often times patients have weakness in their ability to stand on one foot with their eyes closed while maintaining their balance. This lack of proprioceptive ability results in excessive strain on the lower leg and foot during running. Properly strengthening these muscles helps relieve stress on the tissues and ultimately allows the fascia to heal. Exercises can be performed on the ground, unstable surface such as a BOSU ball, foam, or vibration plate. The more difficult and challenging the surface the more the body is challenged and will improve.
However, it can be difficult to successfully treat plantar fasciitis because the cycles of inflammation and healing need to be taken into account. Cycles of stress, rest, stress, and rest often produces improper scar tissue formation on the fascia. Scar tissue is essentially a temporary patch until the injured area can heal correctly. In many cases, however, the foot often ends up with patches of scar tissue that become injured daily with standing and therefore the foot never heals correctly. A very successful treatment that aims to break up the scar tissue and allows the plantar fascia to heal correctly is the Graston Technique.
Graston technique is one of most effective treatments at improving plantar fasciitis. It can be used on all of the lower leg muscles and the bottom of the foot, along the plantar fascia. Graston technique utilizes stainless steel instruments specifically designed to break up scar tissue by sheer force. When the tools slide along the skin they help pull one layer of tissue past another. The scar tissue that has developed from the micro tearing of the fascia is pulled apart, which triggers the body's healing mechanisms to come in and repair the fibers. Oftentimes scar tissue has developed along the plantar fascia from years of standing, walking, and running. Graston technique helps break up the scar tissue throughout the fascia. Treatment from the Graston Technique increases the speed of healing and quickly reduces the sharp pain.
Class IV cold laser or low level laser therapy is an excellent treatment modality for decreasing pain and inflammation. Specific wavelengths and frequencies help shut off inflammatory cells. By stopping the production of these inflammatory markers there is less pain and inflammation around the tissue. Excessive inflammation slows down healing and makes the area more sensitive to the touch. Different wavelengths and frequencies help turn on the repair and healing processes inside cells. These wavelengths trigger the increased ATP or mitochondrial production of energy within the cells. The repairing cells then use this energy to lay down more fibers at a faster time frame. Laser is speeding up the healing and repair processes in addition to decreasing the inflammation.
Plantar fasciitis is a common condition in runners, jumpers, weekend athletes, and people who stand on their feet. Multiple treatments are often required to help with the pain and inflammation. Over-the-counter NSAIDs, icing, rest, and improved footwear provide a significant benefit for many people. Others require in office treatments to help with moderate or severe cases of plantar fasciitis. Cortisone injections, orthotics, foot inserts, massage therapy, Graston technique, active release technique, and cold laser are excellent treatments for anybody affected with moderate or severe plantar fasciitis.
Many people with plantar fasciitis have weakness in the foot and ankle stabilizer muscles. Muscle weakness and fatigue leads to foot over pronation which strains and stretches the plantar fascia. Likewise, foot and ankle weakness changes your walking gait and leads to increased pounding with each step.
Stretching and strengthening exercises progress from basic standing on one foot to dynamic and explosive exercises. More information and examples can be found at foot strengthening exercises.
Prior to Graston Technique, manual therapy, and proprioceptive exercises extracorporeal shockwave therapy was a popular treatment; which involves using waves of energy to break up scar tissue on the bottom of the foot.
Newer medical treatments involve plasma rich prolotherapy or prp to stimulate healing . By increasing platelets around a soft tissue injury, the body's healing mechanisms are stimulated. Blood is withdrawn from the patient, and the blood is separated into parts. The healing platelets are injected into the bottom of the foot.
Stem cell treatments are continuing to evolve over time. Stem cells help with soft tissue healing by enhancing healing and repair. These treatments are significantly more expensive but have not shown to be more effective than prp or conservative treatments. As therapy and treatments evolve, we might begin seeing stem cell therapy for severe cases of plantar fasciitis. Stem cell treatments are more effective in other areas of the body and with different injuries.
If you are experiencing symptoms of plantar fasciitis, seek treatment early on, before the condition is allowed to become chronic and more difficult to treat. An experienced provider can prevent plantar fasciitis from becoming an injury that lasts for months or years. A combination of conservative treatments, habit modifications, and home treatments can help plantar fasciitis heal quickly. Call Alpha Chiropractic today to resolve your plantar fasciitis at (480) 812-1800.
Our Chandler Chiropractic & Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Ahwatukee, Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.