As I research around the internet including social media websites, forums and post there is an abundance of info about plantar fasciitis. Sadly much of it’s out-of-date and simply thrown up concepts, theory’s and treatment alternatives that just have been proven wrong or don’t work.
As a hand and foot chiropractic doctor in Melbourne, FL I have actually invested the past 15 years studying foot conditions, specifically plantar fasciitis. Exactly what was taught as factual in school has now been proven to be dated and ill sensible. What I am going to express are not just my views however, are all backed by clinical literature. I am continuously evolving in my mission of providing the best possible treatment choices for my clients and for that reason research study is necessary. The understanding I have gotten from this research has actually altered the treatment I now utilize today to deal with a patient with plantar fasciitis compared with what I used early in my practice. Find out more: https://mybowentherapy.com/plantar-fasciitis-treatment-massage/
So exactly what are these out-of-date concepts, theories and treatment options I continue to read about. Lets start with the name itself. Plantar Fasciitis. In medical terms this tells us that the plantar fascia (in fact it’s called the plantar aponeurosis) of the foot is inflamed. It prevails understanding on the internet that the plantar fascia is inflamed typically at the insertion on the heel. The current’s research recommend that inflammation has very little to do with plantar fasciitis. Initially there might be some inflammation although the condition becomes more of a degenerative disorder rather than an inflammatory condition. So what does it matter whether it is inflammatory versus degenerative? It is essential because it changes the kind treatment that should be administered. An example. If a patient has swelling they would be treated with nonprescription anti-inflammatory medication (NSAIDS) such as Advil, prescriptive anti-inflammatory or with an anti-inflammatory injection such as a steroid. These might be effective treatment options for reducing inflammation however, they won’t help much if there is little or no inflammation present such as in degenerative conditions.
So what does the scientific literature need to say? A 2003 evaluation of 50 cases performed by Lemont et al specified that plantar fasciitis is a “degenerative fasciosis without inflammation, not a fasciitis.” 1. In medical terms a suffix of -itis implies swelling where -osis indicates degenerative. Andres et al. wrote in the journal Scientific Orthopedics & Related Research “Recent basic science research suggests little or no inflammation is present in these conditions”. 2. A post titled Overuse tendinosis, not tendinitis, part1: a brand-new paradigm for a challenging medical problem published in Phys Sportsmed mentions “various detectives worldwide have actually revealed that the pathology underlying these conditions is tendonosis or collagen degeneration”. 3. I can go on pointing out many more although you can see that the professionals agree that the theory of inflammation present in plantar fasciitis not legitimate.
Another typical mis-conception is that Plantar Fasciitis is caused by bone spurs. When a patient provides to my office with Plantar Fasciitis and a heel spur is noted on an x-ray I say something which might sound extremely strange to the patient “A heel spur is your buddy”. I constantly get the look of “Did you simply say what I believe you stated?” I then continue with “Let me discuss … “. I then continue, “Plantar fasciitis is triggered by persistent irritation of the plantar fascia, generally at the insertion on the heel where the bone is present. With time the plantar fascia begins tearing away from the bone. The body reacts by calcifying (hardening) the tendon and keeping it intact avoiding it from tearing off the bone!”. Therefore, why it is refrenced as a “good friend”.
Despite the fact that stimulates prevail with plantar fasciitis the spur itself does not trigger pain but, the fascia or surrounding soft tissues in fact trigger the discomfort. 4. Surgery generally is not effective for alleviating the pain and the stimulates typically return given that the root of the problem has not been eliminated. 5
What about flat feet (pronation-often discovered with flat feet) or tight calves. I think these do location increased tension on the plantar fascia and add to plantar fascitis although I do not think they are a root problem of plantar fasciitis. There are lots of people with dropped arches, pronation and tight calves that do not have plantar fasciitis. There are also many individuals with plantar fascitis that do not have flat feet, pronation or tight calves. Early on in my career I treated clients with plantar fasciitis who were flat footed by fitting them with a custom-made orthotic to restore the arch. Although this did help in reducing the pain really frequently it did not remove it. If flat feet was the cause then the client need to have been cured. It’s been my own clinical experience that has reveal me that high arches and supination are just as problematic as being flat footed or having a foot with pronation.
So as a hand and foot chiropractic practitioner exactly what do I believe is the root cause of plantar fasciitis? Most of the times I believe it is a foot that is not effectively working. This might be from a bone out of place such as the Talus or Calcaneous (which I see all frequently) a traumatic injury or a congenital deformity. The human foot has 26 bones, 33 joints, 107 ligaments, 19 muscles and tendons and is extremely complex. When all these parts are not working correctly in sync it positions unnecessary stress on the foot and causes degeneration to occur.