Plantar Fasciitis
If you have foot pain, heel pain, pain with flat feet, foot pain when walking or just sore feet chances are that you’ve probably been diagnosed with Plantar Fasciitis by a physician or a podiatrist. After trying all the different massages, cortisone shots and orthotics/inserts available, you’ve learned that they don’t actually solve the problem. You may have even tried some exercises to help plantar fasciitis, and you still have feet pain. You wake up in the morning and can hardly walk and those boots you were at night, are not working!! (who wants to wear boots when sleeping?
What if you learn that your plantar fasciitis, the pain in your foot is actually not a foot problem? What if the solution is elsewhere and the wrong body part has been addressed all along?
Here is the story:
What is Plantar Fasciitis and what causes it?
The suffix -itis means inflammation. So plantar fasciitis is inflammation of the plantar fascia, the soft tissue at the bottom of your foot connecting the ball to the heel. This irritation can occur for a number of reasons all of which stem from failed posture. Let’s explore this a bit more.
Our lifestyle, injuries, and activities all play a role on our posture and how we carry ourselves. What happens if there is a slight shift to one side because let’s say, you play a one-sided sport like tennis? How about if you sit for an extended time and your hip flexors work more than the hip extensors? How about if you injured your knee skiing?
What happens if your car frame is off and you don’t notice that but find out that you need to change your front left tire more often than others? If you are in tune with your driving, you will, of course, learn that the stirring wheel pulls to one side more than the other and that is a subtle clue that should point you in the right direction if you are paying attention, right?
Have you ever pushed a shopping cart that had a mind of its own? You either abandon it or push and pull and fight till you are done shopping. By then, your upper shoulders, arms and lower back are hurt, right?
In all of these examples, which you can relate to, you see a slow degradation of ‘alignment’ and ‘posture’. This is your story of Plantar Fasciitis. This fascia is not meant to be walked on, it is not meant to work like a muscle, push and pull and move joints and bones but to provide support. When the structures above and around it don’t do their job right, ‘it’ has to do more than it was designed to do and after a while, you notice the pain. It typically starts on one side and if ignored or not addressed correctly, it is only a matter of time before it involves both sides.
Pain Relief treatment:
While many try pain relievers, injections, and physical therapy before they come to my office for treatment, my protocol for acute Plantar Fasciitis is
- Cold Laser Therapy over the Plantar Fascia
- Active Release Technique (ART)
One of the must do’s for all of my Plantar Fasciitis patients is a foot scan. I look at them as a gauge to see how the weight is distributed on both feet. This shed light on what postural imbalances are leading to the irritation of the Plantar Fascia. At times I order customized orthotics but this typically comes, if ever, AFTER a series of ‘action steps’ have been followed. Orthotics should never be looked at as a solution and in almost all instances, they are used temporarily while the ’cause’ is being worked on.
At times, I want to see an x-ray of the feet. For instance, if the Achilles tendon is too tight (which BTW is always a sign of tight hamstring and imbalance of the front of the back of the leg issues) you may end up with a bone spur. Shaving the spur is not going to make what created it to begin with go away!! In those instances, custom orthotics are built to accommodate the spur so you are not walking on them with each step. It is all about providing comfort with walking while the movement and posture are addressed.
Adjusting the ankle and feet joints are very important because if these joints are not properly aligned, even the simplest exercises are not being done symmetrically. Remember, the problem started when the symmetry was not there to begin with.
Now, when it comes to exercises, in my opinion, most exercises given when doing physical therapy sessions hardly work. Are they good? sure but they are not going to get your out of the mess you are in!
- Towel Exercise: This is done sitting first and then standing up! First, you get your towel and throw it out on the floor in front of you. Then, using your toes only, you will scrunch the towel closer and closer to you. Once it’s as close as you can go, you must pick up the towel with your toes, and bring it up to your hands. Then repeat.
- Arch Lift: This exercise requires a resistance band that can be easily ordered online. First, place the band around the center of one foot and around the ankle of the other. With the band on, stand wider than the shoulder width, placing tension on the band. The foot with the band around the ankle is the one working out! With your toes and heel remaining on the ground simply contract the muscle on the outside of your shin to lift your arch upward. The key in this exercise is to pay attention and make sure you are using the correct muscle, otherwise what’s the point right?
- Calf Raises: Now this isn’t your generic calf raises you see people doing in the gym to get bigger calf muscles. This is a very controlled movement using specific muscles. Before going up on the toes, you need to spread your toes out onto the floor in a splayed fashion. Keeping your toes in this position, push down on your toes, lifting your body upwards. Now, are not allowed to lead your entire body forward to accomplish coming onto the toes. You are rising upward not forward! This is an easy one to do wrong.
What gets to the actual root of the problem is to go to the CORE of the many postural imbalances that led to the failed posture the ended in the failed foot and ankle movement loss. Movement is a concert where everything comes together. We can’t go after individual musicians for a concert that does not sound good. While each musician has his/her role, it is all coming together, chiming in at the right time, playing their right part that makes a concert sound amazingly awesome or like a ‘tuning’ session. In this blog, I explain this simple fact that is the deal maker when addressed and deal breaker when ignored and Plantar Fasciitis is the ignored postural failure having gone chronic.
Posture Correction: The key solution to Plantar Fasciitis
As I mentioned before, Plantar fasciitis typically presents itself first in one foot, then in the other. So the question is, how does this issue over time, impact the brain sending a command to the muscles, bones and the whole body to move? After all, if we know for instance that not moving the biceps leads to the weakness of the biceps and that the brain sends the command to flex the biceps, then what happens if the command is not sent over a long period of time? If we know there is a map of the body parts in the brain that has to do with movement and sensation, then how is that map compromised when there is a lack of proper movement?
Those were the questions I always had for all of my patients in my practice, Plantar Fasciitis or not! And the answer lies in Brain-Based Neurology and Posture . Once having identified the brains’ weaknesses, we can focus on activating those portions of the brain to improve function and communication with the body.
With my patients who complain of plantar fasciitis what I find to be present every single time are hip flexor weakness and pelvic misalignment. This can be due to your lifestyle of prolonged sitting at work, physical activity like running or an injury that required favoring a side over the other. So does that mean we should go and strengthen the hip flexors? The answer is ABSOLUTELY NOT!! Why? Because isolating a muscle to strengthen it is never the answer, after all, the issue of weakness does the damage with movement. Remember, movement is a concert and not the individual musician. Movement, when done wrong, is like a concert that is more like a tuning session. Chiropractic adjustment of the spine and pelvis simply activates the nervous system so what comes next is ‘understood’ better. BTW, in addition to the pelvis and spinal adjustment, I always adjust the ankles for sure. Every misalignment in the body impacts the feet and ankles so if all the ‘fixings’ are taking place, they better be placed on top of an aligned set of ankles and feet.
Now that everything is aligned, how do we go about correcting poor posture? Bad posture over a period of time will result in some overly stretched muscles and some overly spastic or hyperactive muscles. Dynamic Neuromuscular Stabilization (DNS), takes us back as adults to how we all moved as babies, using the correct muscles for each and every movement. For instance, in a 6 week to 3-month pose on your stomach, the muscles in the back of the neck to stabilize it are developed, the triceps get activated and start communicating to the shoulder blades, the gluts start to work and the pathway from the brain to all of the involved muscles is established. This is how every single one of us first moved innately, no bands, no free weight, no kettle ball and no gyms. It was the natural reflex that took place and through persistence and repetition, we made the magic of movement happen. Why reinvent the wheel when all of us, regardless of race, gender, location, religion, etc. moved. We are PROGRAMMED to move that way. As you go through these poses your individual weaknesses show and through Dynamic Neuromuscular Stabilization and Brain-based Neurology and Posture, we address the issue. You’ll be fascinated by how quickly your brain recalls these movements and how your posture is affected.
Imagine that… all this for a “foot problem”!
Living Foot Pain Free
The bottom line is that every part of your body is connected. You can’t have a problem in one area without others being impacted. So if simply want pain relief at any cost go for really expensive bandaid orthotics and cortisone shots. To get rid of the pain by addressing the root cause of the problem correct your postural imbalances and live healthier.