All About Plantar Fasciitis (Can Chiropractic Help?)

Are you one of almost 2 million Americans who will be treated for foot pain this year? Plantar fasciitis might be the cause. Here, we’ll go over what plantar fasciitis is, what causes the condition, symptoms and treatment options. 

What is plantar fasciitis?

Plantar fasciitis refers to inflammation of the fibrous tissue known as plantar fascia that connects the heel bone to the toes. This condition is sometimes referred to as policeman’s heel because police officers often develop plantar fasciitis after spending long hours on foot. 

The nickname holds true: plantar fasciitis is most common in people in professions that demand extended periods of time walking, such as nurses, factory workers, teachers and servers. Additionally, athletes who partake in activities such as long distance running and dancing possess an additional risk factor.

Other factors that contribute to increased risk of developing plantar fasciitis include:

Age

  • This condition is most common in people between the ages of 40 and 60.

Obesity

  • Plantar fasciitis is most common in obese people due to the added stress of excess weight on the plantar fascia. 

Foot shape

  • Unfortunately, the mechanics of the foot alone can lead to an increased risk of developing plantar fasciitis. High arches, particularly flat feet and abnormal walking patterns can create an uneven distribution of weight can affect the potential for plantar fasciitis. Pronation and supination of the foot can be big factors as well. Depending on how much your foot and ankle turn in or out, and especially if the asymmetry between the two is excessive. 

What kinds of solutions are there for Plantar Fasciitis?

First of all, The Right Shoe

  • If the shoe fits! All too often people get placed in a shoe that might not be ideal for their foot shape, weight or activity level. We can call it Cinderella syndrome. Not all shoes are created equal, and getting the help of a trained professional can be critical in injury prevention. 
  • As important as the right shoe is knowing when to move to a new pair. We recommend patients bring their shoes in for assessment and analysis. We can look at the wear patterns on the treads, the insole wear and impact points and complete our diagnostic picture. 
  • We recommend new shoes every 4-6 months if running or walking consistently for exercise. 
  • If running a considerable amount of weekly miles then replace the shoe after 300-400 miles. 
  • Chiropractic care can also help immensely.

What are symptoms of plantar fasciitis?

The number one symptom of plantar fasciitis is pain. The feeling associated with plantar fasciitis is described as a stabbing pain in the bottom of the foot, closest to the heel.  A burning or pulling sensation along the bottom of the foot is another common symptom. 

Those experiencing plantar fasciitis report the pain as becoming worse in the first few steps after waking up, then triggered by long bouts of standing or when initially standing up after long periods of sitting or laying. 

While exercise is a major factor in prompting pain associated with plantar fasciitis, the pain typically becomes worse after exercising rather than during.

Often patients will talk about a gradual soreness that goes away with exercise or movement; but all-of-a-sudden the pain becomes debilitating and they can no longer do what they want to or need to do because of the pain. 

Why is plantar fasciitis so painful?

Gravity! All the weight of your body goes on to the bottom of the feet. There is no escaping it. Your plantar fascia is a remarkable structure composed of connective tissue, muscle, ligament, tendon nerve and blood supplies. It can handle a tremendous load and never complain. If a runner weighs 200 lbs, with every walking step they are capable of putting 350-400 lbs of force into their plantar fascia. With jogging or running, now we are in excess of 500-600 lbs of force! No wonder plantar fasciitis hurts so badly. 

Complications of untreated plantar fasciitis

Fortunately, the vast majority of plantar fasciitis cases are considered to be a completely treatable condition that tends to resolve within months when properly cared for. However, ignoring or neglecting to treat plantar fasciitis can result in chronic heel pain that may limit one’s ability to partake in everyday or desired activities. Sometimes you can push the injury to a tear that may require a boot and treatment to help the condition. 

Oftentimes, those suffering from plantar fasciitis change their walking patterns or weight distribution as a way to alleviate the associated pain. This quick fix can have unfortunate long term effects, such as hip, knee, foot and back problems.

Diagnosing and treating plantar fasciitis

Diagnosis of plantar fasciitis typically involves a simple pain examination in which a trained professional will check for areas of discomfort or tenderness in the foot. Feeling the plantar fascia and calf for tears and inflammation.

In most cases, no tests or scans are needed. However, your doctor may suggest an X-ray in order to rule out other issues with similar symptoms such as stress fractures. 

And, in many cases, your chiropractor can help treat the symptoms with a combination of fascial soft tissue work and a series of adjustments, allowing better communication between the nervous system, more blood flow, unrestricted oxygen to the area and restoring proper biomechanical function to the injured site. 

Why is treatment of plantar fasciitis so difficult?

Part of the problem with treating plantar fasciitis is in the diagnosis itself. Unfortunately, a lot of practitioners attribute the majority of bottom of the foot pain as plantar fasciitis. When that happens, the practitioner forms a ‘protocol’ to address the condition. Herein lies the biggest mistake when it comes to the treatment approach. 

There are DOZENS of reasons why someone might have bottom of the foot pain. Giving it a vague diagnosis and treating the patient as if everyone who presents with bottom of the foot pain has the same issue is a massive treatment failure. 

Looking at the structures and biomechanics is critical to treating the condition successfully and efficiently. When a patient comes into one of our offices, we are able to look past just the pain in the bottom of the foot and abandon a standard ‘protocol’ approach which allows us to address the individual case in front of us. 

A typical treatment plan for plantar fasciitis includes:

Modification

  • Every case is different and although we recommend rest for some patients, they are indeed in the minority of people we see. Generally speaking, we must do what we can to stay active without aggravating the injury itself. 

Medication

  • Over-the-counter pain relievers such as NSAIDs can assist in relieving some of the pain associated with plantar fasciitis. However, if you have to use an NSAID on a daily basis then you can start to weaken the structures in your body and put yourself at risk for kidney and liver damage. You should never have to take “Vitamin I” daily. If anything, check with your doctor if you are doing so to make sure that you aren’t causing any serious damage to your body. 

Chiropractic Care & Therapies

  • A skilled and experienced chiropractor can perform a quick foot scan and provide a professional recommendation for specific shoes and insoles tailored to different arches in order to effectively alleviate the symptoms of plantar fasciitis. They can demonstrate the appropriate stretches and exercise to assist in the healing process in addition to providing a hands on approach to treatment.
  • Your doctor or physical therapist may recommend using a night splint, an apparatus designed to keep the ankle in a neutral position overnight allowing the fascia to heal.
  • Very few patients require surgery, but if needed, the procedure will detach the plantar fascia from the heel bone. This is generally only done in cases of severe pain or when traditional treatments have failed.

If you are experiencing plantar fasciitis, consider an appointment at one of our Colorado chiropractic offices in Denver and Boulder. Let’s get you feeling better. 

About Zandi Chiropractic | Denver & Boulder Chiropractors

Dr. Sepehr Zandi and Dr. Christina Zandi both specialize in full body chiropractic care and soft tissue manipulation. With chiropractic offices in Boulder and Denver, you’re not far away from getting the treatment you need to start feeling better today. Dr. Sepher Zandi is located at 1810 30th St., Suite D Boulder, CO 80301 and Dr. Christina Zandi is located at 2750 S Wadsworth Blvd Suite D-201. The Boulder office can be reached by telephone at (303) 499-0225 and the Denver office can be reached at (303) 653-3490

Resources and Further Reading:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6917457/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4853481/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951039/