– Plantar fasciitis(PF) is the burning, sharp or sore pain that someone may experience at the heel of their foot or the mid arch region.
Common pain patterns include: experiencing pain in the morning on the first few steps or pain that increases during long walks, standing or running throughout the day.
– PF is caused by the stretching of ligaments resulting in micro-tears. This can be attributed to a number of causes but more commonly it is from either having flat feet, faulty foot mechanics, improper footwear, increased foot workload (eg. starting an exercise regimen) or any combination of those along with a number of other causes.
– Treatment of PF has a number of methods with no one being the guaranteed cure all. Usually recovery starts with a combination of changes and treatment.
1)Footwear– the easiest and quickest method is to begin by changing footwear. Generally, you want to make sure your shoes have good arch support and heel cushion. Try to avoid flat soled shoes.
2) Orthotics– A quick, easy and longer term solution is getting custom made insoles. While shoes only last 6 months to a year before their quality breaks down, orthotics last for years. Also, orthotics correct faults in foot mechanics which shoes can not.
3) Rest or decrease activity– I usually avoid telling patients to outright stop physical activity but decreasing work load and gradually working back to preinjury levels is sometimes a necessary option. Full out rest may be required if the pain continues to increase even with treatment and changes.
4)Ball stretching– this is the first method I recommend for treatment of the foot. Patients will use a ball (eg. tennis ball) on the ground and roll their foot back and forth to help stretch out the fascia.
– alternatives to a ball or in combination with is to either use a frozen plastic water bottle, foam roller or a variety of wooden foot rollers
5) Calf stretching– Stretching is important for decreasing the tension placed on the Plantar Fascia and improving flexibility of the feet.
A couple of methods to calf stretching includes A) While standing facing a wall; lean towards the wall with hands outstretched to brace oneself; have the feet staggered with one in front of the other, the back leg is the one being stretched. It is important to remember to keep the back heel on the floor and not raised off the ground.
– B) the patient can instead sit on the ground with one leg stretched out in front; using a towel wrapped around the ball of the foot, pull the toes toward the body to apply a slight stretch on the calf. It is important to keep the leg straight and not bend the knee.
Hold stretches longer than 30 seconds. Make sure to stretch both sides.
6) Short foot exercises– To strengthen and build up the arch of the foot, place a towel on the ground; while standing step on the towel with one foot; from there pull the big toe back towards the center of the foot while grasping the towel. Repeat 10 times each foot a couple times a day. It is important to not claw the toes to help pull the towel in.
7) Adjustments– Sometimes the bones in the feet are out of place or not moving properly so an adjustment is important to regain full function and alignment.
8) A.R.T.– a manual soft tissue stretching technique, A.R.T. involves the thumb pinning the plantar fascia and stretching it out. This breaks up adhesions and lengthens the fascia to improve flexibility.
9) Graston Technique– Another method using a stainless steel tool, Graston involves stripping away built up scar tissue. This method is most effective when the patient has had the PF for a long period of time.
By Dr. Alex Murray
Point Grey Chiropractic
Vancouver, BC, Canada