Plantar Fasciitis

Have you been told you have plantar fasciitis? Are you still struggling with pain even after trying different treatments? Your plantar fascia is a thick band of tissue that runs along the bottom of your foot and connects your heel bone to your toes. Plantar fasciitis is a chronic degenerative condition caused by repetitive small traumas that cause a breakdown of the plantar fascia. Plantar fasciitis typically causes a stabbing pain in your heel and is often worse in the morning when you first get out of bed. It is a common condition and in the United States alone, more than a million people a year receive treatment for plantar fasciitis. Unfortunately, for many people their symptoms never completely resolve.

We are going to start with the bad news, but rest assured there is good news! Recent studies show that 44% of patients with plantar fasciitis will have pain 15 years after their original diagnosis. The most common treatments; such as orthotics, corticosteroids and short-term stretches have not been proven to help plantar fasciitis in the long-term. Let’s take a look at these traditional treatments and talk about why they don’t produce long term relief. You may have tried orthotics and even thought they were helping initially, but found the relief wasn’t permanent. Many patients are given orthotics to support their arch and stop their foot from turning in while walking. However, research has shown that people with high arches and flat feet both develop plantar fasciitis. The height of a person’s arch does not correlate with the probability of developing plantar fasciitis. So, orthotics alone are not likely the answer.

Another popular treatment is corticosteroid injections. Corticosteroid injections work by breaking a pain cycle caused by inflammation. However, research has consistently shown that plantar fasciitis is a chronic degenerative condition, not an inflammatory reaction. There are also risks with steroid injections, such as weakening of connective tissue. I know it seems frustrating, but corticosteroids probably aren’t the best treatment choice either.

The third traditional treatment given to patients is stretching. I am sure most of you have tried a stretching program for your plantar fasciitis. Yes, stretching is vital to recovery from plantar fasciitis. However, the stretches given to most people are not targeted to the specific portion of the tight muscle and they are not held long enough to make a permanent change to the length of the muscle. Therefore, stretching is great, but you most likely need more time doing very specific stretches!

I know, it sounds discouraging right? However, if you have been struggling with plantar fasciitis and the traditional approach hasn’t resolved your pain, don’t worry there is good news! Research shows a majority of people with plantar fasciitis demonstrate weakness of the peroneal muscle and intrinsic arch muscles of the feet. The peroneal muscle runs down the outside of the lower leg and attaches to the inside of your foot. Most people with plantar fasciitis also have tightness in the inner side of their calf muscle; also known as the gastrocnemius muscle. The good news is that if the cause of plantar fasciitis can be determined then we can work to correct the issues and resolve your heel pain. Exercises to increase the strength of the small muscles in your foot and a high-volume stretching routine performed for an extended length of time to stretch the inside of your calf muscle may be the answer to long term relief from plantar fasciitis! Also, using dry needling and myofascial release to effectively treat the injured areas can bring relief in weeks, instead of months.

Finally, it’s important to receive a correct diagnosis. There are multiple causes of heel and bottom of the foot pain. Heel fat pad syndrome and tarsal tunnel syndrome are 2 examples. And unfortunately you can have more than one cause of heel/foot pain at the same time!

Advanced Healthcare & Sports Injury can provide effective treatments and help you set up an individualized exercise program to put you on the road to recovery from chronic plantar fasciitis so you can return to your lifestyle. Click the link for to request an appointment.

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*photos and stats courtesy of Dr. Tom Michaud and