The Plantar Fascia

The Plantar Fascia

The plantar fascia of the foot is a thick band of connective tissue that supports the arch of the foot. It runs from the heel up towards the toes on the bottom of the foot. Excessive wear and tear on this structure can lead to inflammation and results in pain on the bottom of the foot or heel, which is often worse first thing in the morning or with too much walking. In certain cases, it can lead to the formation of a heel spur on the heel bone.

In my experience, this condition usually builds up slowly over long periods of time. Excess stress on the plantar fascia due to fallen arches (flat feet), improper footwear or excess time spent on the feet can lead to the development of plantar fasciitis. Treatment is aimed at reducing the inflammation and supporting the arch of the foot if it needs it.

In my office, anyone presenting with plantar fasciitis receives a low back, hip, knee, ankle and foot examination including gait (walking). Depending on the state of the arch, over the counter or custom made orthotics may be prescribed. Apart from restoring proper motion of the back, hip, knee and ankle, I tend to pay special attention to the movement of the foot bones that make up the arch (navicular and cuboid). I use active release therapy and/or muscle stripping with biofreeze to reduce the inflammation in the plantar fascia itself. Finally, I always end a session with application of Kinesiotape which often works wonders.

A thorough home stretch plan is very important in this case, as you are on your feet all day. I usually suggest stretching the plantar fascia (pull back on your toes), calf muscles and shins. I recommend icing at the end of the day, which is best done by freezing water in a 500 ml plastic water bottle and proceeding to roll your foot forward and backwards on it. Further self-massage can be done with some moisturizer and your thumbs. For severe or stubborn cases, I will recommend that my patient wear a good supportive pair of running shoes at all times when in the house. Finally, low intensity laser therapy is a great option to boost healing of the plantar fascia especially when recovery is slow.

I think that one thing all health professionals will agree upon is that you don’t want to let plantar fasciitis go. As with most problems, it is much easier to treat in the early stages. Listen to your body before it forces you to pay attention!

Dr Debbie Wright is a practicing Comox Valley Chiropractor.