Healing Plantar Fasciitis
Nov 30, 2016 07:52PM
by Eric Winder, DC
Plantar fasciitis is a foot condition which can cramp your entire lifestyle, making it difficult to exercise, take long walks, shop for groceries or even simple check the mailbox. Getting relief from this annoyance might seem out of reach, but with the right diagnostic approach and treatment, a sufferer can experience “happy feet” again in a short amount time. The key to relief is understanding what plantar fasciitis is and what causes the pain.
The name “plantar fasciitis” has an “-itis” suffix which means “inflammation.” However, research shows that inflammation is not usually a major part of this problem. Instead, the plantar fascia, a strong band of connective tissue supporting the foot, suffers multiple micro-tears where the fascia attaches to the heel bone. These tears result from excess stress where it pulls on the bony attachment. What creates this stress? The human body is a complex mechanism, so in the case of plantar fasciitis, there is more than one cause––too much stiffness in the foot, weak ankle muscles, and unstable joints in the foot or ankle.
Stiff, Weak or Loose
The least common cause of plantar fasciitis is foot stiffness. Sometimes people with high arches get stiff joints in their feet because their arches don’t spring enough. Without the springiness of a flexible arch, stress occurs on the plantar fascia. For people with high arches, proper arch supports or orthotics are the most important treatment. In addition, therapies to mobilize and stretch the tight tissues of the foot are often helpful.
Muscle weakness and joint instability are the most common causes of plantar fasciitis. Unstable joints (i.e. joints that move too much) are usually due to muscle imbalance that involves weakness of certain muscles, so these two problems are related. The question in both cases is, what makes the muscles weak? The most common cause is restriction in the fascia, or connective tissue, in the body. Improper shoes and a sedentary lifestyle are also factors for some people.
The plantar fascia is just one small portion of the body’s fascia network. Fascia is fibrous connective tissue that covers every muscle, bone and joint. Restrictions in muscle and joint fascia result from prior muscle strains, impact injuries, postural weakness, repetitive stress, local inflammation and other causes. Fascia holds the nerve endings that tell your brain where each body part is located, as well as how tight the muscles are.
This information guides posture, joint alignment and proper walking gait. Restrictions in fascia can confuse the signals from these nerve endings, resulting in uneven joint alignment, muscle imbalance and weakening of particular muscles. This can result in weak or collapsing arches which is common in plantar fasciitis.
Where in the body can fascial restrictions affect the plantar fascia? Well, “the foot bone’s connected to the knee bone,” and so forth, so there are many points where fascial restriction can affect the ankle and foot. Restricted fascia in the low back, hip, thigh, knee, calf, ankle or foot can cause problems in the posture and motion of the ankle and foot.
For example, fascia restriction from an old hamstring injury might trigger weakness in the gluteal muscles on one side, causing the pelvis to torque and the knee to twist slightly, stressing the ankle joint and weakening the ankle muscles which support the arch. This stress could be mild and not painful for years, but over time, can build to the point where the plantar fascia becomes so overstressed that pain is imminent.
Fixing the Fascia
In my experience treating plantar fasciitis, each case is different. One patient might experience problems with fascial restriction in the lower back and weakness from an old ankle sprain. Another might be deconditioned from a sedentary lifestyle and have fascial restrictions in the hip muscles from sitting too frequently. And yet another might have scar tissue at the knee, causing ankle weakness made worse by wearing flip-flops all the time. However, although each patient is different, there is a pattern for successful relief:
Release restricted fascia wherever it might be affecting ankle and foot muscular strength and alignment.
Strengthen weak muscles that are needed for postural support.
Stretch overly tight tissues.
Wear properly supportive shoes and possibly arch supports or custom orthotics.
In stubborn cases, low-level therapeutic laser treatment can usually offer relief.
Numbers three and four are often the main treatment most people receive for plantar fasciitis, but without the first two, treatment often falls short. Fascial restrictions are common, usually overlooked, and straightforward to treat by a properly trained practitioner. The muscles that need strengthened are different from person to person, but when properly exercised, make a significant difference. Put all the above parts of treatment together correctly, and you can typically achieve rapid, lasting relief for plantar fasciitis pain.
Dr. Eric Winder has been practicing chiropractic for 19 years, with a focus on fascial treatment and soft tissue therapies for the past 16 years. Dr. Winder’s practice Gentlebay Chiropractic focuses on relieving pain and restoring alignment and motion through soft tissue therapies without forceful manipulation. For more information, call 941-957-8390 or visit Gentlebay.com.