Plantar fasciitis is a common cause of heel pain, and can be incredibly painful. Our patients typically present with pain under the heel which radiates along the underside of the foot. Quite often, the pain is worst when getting out of bed in the morning. You may also have pain when trying to stretch up. The pain is caused by tiny microtears, scarring and a breakdown of collagen where the plantar fascia attaches on to the heel bone.
What does the plantar fascia do?
The foot has 26 bones and over 33 joint-surface contacts or articulations. Each joint has to be moving properly in order for the foot to function
properly without causing pain. The bones and joints in the foot are uniquely designed to help with shock absorption. They keep the foot aligned by softening with pronation (rolling in) and tights with supination (rolling out). The plantar fascia plays a vital role in the tension-compression structure of the arch of our foot. It runs from the underside of our toes to the base of our heel, and helps to maintain the arch of our foot, prevnting it from falling flat. It also “hooks” on to the toes that helps create tension and springing through the foot as we walk or run.
The arch of the foot can misbehave in two ways. Firstly, by overstretching and not returning to its usual length. Secondly, the joints in the foot (and the way they function in relation to each other) can change, which impacts on the normal movement of the foot and arch of the foot.
These can occur alone, or together, and either way can result in pain. Neither will heal properly until the foot moves normally again.
What causes plantar fasciitis?
Faulty foot position is a common cause- either rolling on to the outside of the foot, or having an arch through the foot that collapses. these put repetitive strain through the underside of the foot. Normally, the foot and ankle would move to absorb forces as we walk or run, but instead these forces are transmitted to the plantar fascia and lower leg. As a result, plantar fasciitis can also cause pain into the lower leg.
Plantar fasciitis is more common in women, and people who are overweight or spend a long time standing each day. It is also a very common complaint in runners who may have faulty foot movement which can lead to plantar fascia pain developing. Your risk of developing plantar fasciitis also increases if you:
- Wear worn-out shoes with thin soles
- Frequntly wear high-heeled shoes
- Have very tight Achilles tendons
- If you do not do much physical activity
How can chiropractic care help plantar fasciitis?
As seen in our accompanying video, there are a range of treatment modalities chiropractors can use to help plantar fasciitis. The type of treatment you could receive will depend on the severity of the pain, your personal preferences, and if there are other issues contributing to the plantar fascia pain. Treatment may involve adjustments of the foot, dry needling, soft tissue work, stretches and exercises and kinesiology taping. Around 95% of patients respond to this type of conservative care.*
There are a number of self-help techniques you can use at home. As a number of other issues can mimic or contribute to plantar fasciitis, it is important to get an accurate diagnosis from your chiropractor before self-treating. Your chiropractor will be able to give you advice, support and appropriate rehabilitation strategies for you as part of your treatment plan.
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* Source: Baxter DE. The Heel in Sport. Clin Sports Med. (1994) 13: 685-693
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