By Dr. JIM FORBES
There are many people suffering from foot pain. One of the most common complaints that I see in patient’s feet are problems with the plantar fascia. The plantar fascia is a very tight fibrous tissue that is at the bottom of your foot. It has connections from your heal to your toes. The job of the plantar fascia is to maintain a solid arch in your foot. An arch in your foot allows you to absorb impact during walking and running activities to decrease the stress on the rest of your body.
How do plantar fascia problems begin?
Many factors (to be discussed later) result in the arch of the foot “flattening” and eventually lengthening the plantar fascia. Unfortunately, the plantar fascia (along with the neighbouring muscles) that acts to maintain the arch do not give up without a fight. The constant traction of the falling arch on these structures causes pulling on the inside of the heel and this causes extreme pain, especially with the first few steps in the morning.
What causes plantar fasciosis?
1) Weak / injured muscles in the foot, ankle, knee, and hip.
– Muscles that weak and / or injured are not doing their job at creating optimal mechanics in the hip, knee, ankle, and foot are
– When we look at the arch of the foot, many muscles are responsible for maintaining that arch.
– If these muscles do not work then the arch of the foot will collapse and put stress on the plantar fascia
2) Excess weight gain
– Those who are overweight have more stress on their joints and the arch of their feet.
– This means that there will be more stress on the arch of the foot and thus easier flattening of the arch causing stress on the plantar fascia
What can my Chiropractor do to help my plantar fascia problem?
1) Direct Treatment of the Plantar Fascia and Surrounding Muscles
When the plantar fascia is damaged it has gone through many cycles of being inflamed and many cycles of trying to heal itself. When this happens the tissue of the plantar fascia and the neighbouring muscles may not be of the best quality. This means that they may benefit from various muscle treatments in order to get that tissue ready for some active exercise. There are many muscle treatments that chiropractors use and they are specific to each location.
– The muscles of the hip, knee, ankle, and foot to ensure that you are able to maintain better mechanics throughout your work day or recreational demands.
– This is especially important for recreational runners as they put a high frequency of stress through their feet and legs.
– We want to focus specifically on the muscles that control early and excessive pronation.
– Everyone pronates! Pronation is a natural motion of the foot to absorb the impact forces of walking and running. It is the speed and duration of pronation in certain phases of the running / walking cycle that need to be controlled.
3) Stretching Program
It may seem counter-productive to stretch a tissue that is already being stretched and causing pain, however, when we put a controlled stretch through a tissue it is therapeutic. Stretching will decrease the pain in a tissue and make you more comfortable in new ranges of motion. Stretching before getting out of bed in the morning has been shown to be the most effective at controlling the pain with the first few steps in the morning. This can be done with the use of a towel rolled up and wrapped around your toes.
You can perform these three stretches roughly five times each while holding each stretch for 10 – 15 seconds.
4) Custom Orthotics
If exercise and stretching does not do the trick then I often prescribe some custom orthotics which can mildly correct feet problems. I do not rely solely on orthotics (no pun intended) because I see them more as a seatbelt for foot problems. A seatbelt is not going to prevent a car accident, however, it will make it easier to handle. Therefore, orthotics are just there to make the problem you have easier to handle. For this reason, I always encourage exercise to correct the dysfunction causing a flattened arch.
5) Weight loss
Aside from the obvious cardiovascular effects of weight loss, the effects of weight loss on the joints of your body are vast. Thus, you should stay within your target body weight. This can be done with diet and exercise which is another article write up on its own.
Dr. Jim Forbes is a chiropractor with Hare Chiropractic Centre on Colborne Rd. near Cathcart in Sarnia.