Today I’ll discuss foot pain, specifically plantar fasciitis. We’ve been seeing a lot of it in our office so that calls for a video to explain what it is and how to determine if you have it.
Let’s start with the name. Plantar means the plantar surface of the foot which is a fancy way to say the bottom of the foot and -itis means inflammation. Combine those two together and it literally means inflammation of the plantar surface of the foot. People who have plantar fasciitis have pain in a couple of areas. It’s usually right at the bottom of the heel and it can also be down the arch of the foot. Symptoms of plantar fasciitis include pain with the first step in the morning or after sitting for long periods of time. We see this condition more often in our runners or those who stay on their feet for long periods of time. Now that we know what plantar fasciitis is, stay tuned to learn how we evaluate this condition in our office and how to treat this condition.
Evaluation Process for Plantar Fasciitis
Now that we know what plantar fasciitis is, how to determine if we have it then the next question is how do we as clinicians evaluate you to see if you do have plantar fasciitis?
The first thing we will do in our office is make sure to take a thorough history of your symptoms and your condition. Right away what I want to know is, where do you feel the pain? Remember we said that when plantar fasciitis occurs, it will show up right at the bottom of the heel or down into the arch. If you happen to have pain right along the Achilles then you could have more of a tendinopathy. If you have pain more in the base of the 2nd and 3rd toe then you could have Morton’s neuroma. We said before that plantar fasciitis is felt the most with the first step out of bed in the mornings or for being seated for long periods of time. To evaluate this condition further we want to palpate the area and see if there is any deep pain. What we’ll do is palpate the foot in the longest area to see if the patient has any pain in these regions. We will also palpate the lower calf, the gastrocnemius, and the soleus since they come down and form the Achilles tendon which can pull on the plantar fascia as well. We are palpating through these muscles and the surrounding tissues to determine if there are any adhesions in the area. The next thing we want to do is check on the biomechanics of the foot which we will do by going through all the different ranges of motion. This will help us see if the foot is moving well and able to go through all of its range of motion.
Chiropractic Treatment for Plantar Fasciitis with Dry-Needling
Once we have determined that this patient has plantar fasciitis, there are different ways we can treat it in our office.
Chiropractic Adjustment
To begin we want to make sure that the joints are moving well in the foot and that the talus and calcaneus are moving as they should. If we find that any area in the foot is not moving well then we will perform an adjustment to free up the joints.
Graston Technique
Next, we will look at the soft tissue that surrounds the foot and determine if there are any issues that need some extra work. We will do this by using the Graston technique on the muscles and soft tissues of the foot. We will also perform some soft tissue workup in the calf muscle. This technique helps to break up any adhesions and more blood flow to the area. This helps to promote healing in the muscles and tendons.
Dry Needling
Another technique we use is dry needling. We typically will dry needle the calf, the Achilles tendon, and the plantar fascia. Doing dry needling can be tender in some spots especially on the plantar surface of the foot due to the inflammation and irritation of the tissues. Dry needling can help to reduce muscle spasms by creating more blood flow to the area and promote the healing of the tissues. *Check out our video to hear more about each way we treat this condition in our office.
Home Treatment Options for Plantar Fasciitis
First, it’s beneficial to stretch your calf. Take a towel, wrap it around your forefoot, and pull the towel up towards you. While stretching the calf, we’re stretching the plantar fascia on the bottom of your foot. This will help to reduce the strain and tension you feel from the plantar fasciitis.
Next, we perform a form of self-massage. If you have a lacrosse ball at home, place it on the ground and massage the bottom of your foot and heel. A frozen water bottle will also be an excellent alternative to massage the bottom of your foot. Since the bottle is frozen, it cools the foot and reduces some of the pain and inflammation that you feel. Lastly, we want to strengthen the muscles of the lower leg and the foot and increase the motion of those joints. We do this by doing ‘heel lifts’. Go against the wall and gently lift your heel off the ground. You can stay close to the wall for your balance, but don’t rely on it. Do this and pause for a couple of seconds at the top of the movement, then come down and do it in sets of 10. If you feel that you want more of a challenge, you can do a single-leg variation by taking one leg off the ground, wrapping it behind the other, and performing the heel lifts with one foot at a time.
If you have plantar fasciitis pain, try these at home and see if they can help you.