What Is It?
Plantar fasciitis is a condition marked by inflammation of the plantar fascia, a thick band of tissue in the bottom of the foot extending from the heel bone (calcaneus) all the way to the toes. Sharp foot pain can be noticed in the middle of the foot (arch pain) or at the heel. Pain is often characterized as sharp, stabbing, or shooting pain, typically noticed first thing in the morning or immediately upon weight-bearing after any long period of rest. Often, the pain is a result of plantar fasciitis or a heel spur. Less commonly, it results from fat pad atrophy, nerve entrapment, or even a stress fracture. If the pain is felt at the back of the heel, it can also be Achilles tendinosis or a result of Haglund's deformity.
While it is widely used, and the condition is prevalent, there has been some discussion within the medical community about the accuracy of the term and whether it is overused. Some experts argue that the term "plantar fasciitis" may be a misnomer in some cases because inflammation may not always be the primary issue. In some instances, the condition may involve degeneration of the plantar fascia tissue or other factors contributing to heel pain. As a result, the term "plantar fasciopathy" has been suggested as a more inclusive and accurate description.
Additionally, not all cases of heel pain are related to the plantar fascia. Other conditions, such as heel bursitis or nerve-related issues, can cause similar symptoms. Therefore, a comprehensive diagnosis that considers various factors, including medical history, physical examination, and sometimes imaging studies, is essential for accurate treatment.
It is important to get a proper diagnosis from a foot health professional so that Plantar Fasciitis can be treated effectively. Seeing a foot specialist such as a Pedorthist, Podiatrist, or Chiropodist can save a considerable amount of time and money in providing an appropriate and comprehensive treatment plan. Seeing an Align Clinician will evaluate this as well as provide diagnosis and treatment from a whole-body alignment perspective.
Plantar Fasciitis Symptoms
The most common symptom is shooting pain down the bottom of the foot, often most painful first thing in the morning or after rest periods when getting out of bed. If the pain gets better initially with activity but then worsens later in the day, this is a common symptom of plantar fasciitis. The symptoms often occur with long periods of standing and start off mild and progressively get worse.
Plantar Fasciitis Causes
Plantar fasciitis is an inflammation of the plantar fascia that runs along the bottom of the foot, from the heel to the toes. The inflammation occurs as a result of many micro-tears in the plantar fascia tissue. The microtears can cause pain and swelling and significantly impede your lifestyle. A heel spur can develop when the plantar fascia chronically pulls on the calcaneus (heel bone), causing a bone spur to develop. A bone spur is a bony projection that develops at the end of a bone. It can dig into adjacent soft tissue and be quite painful; however, many people have bone spurs that are asymptomatic.
Often, plantar fasciopathy is treated without understanding what caused the inflammation in the first place, which results in chasing symptoms instead of addressing the root cause of the problem. Inflammation occurs for a reason. Tendonitis or fasciitis is most commonly a result of overuse or excessive loading to a tissue that is not properly conditioned to handle that load. External factors (such as improper footwear or specific activities) can be major contributing factors. Additionally, if other tissue (muscles, tendons, ligaments, etc.) in the body are not functioning optimally, then the plantar fascia can increase loading to assist, but this often will occur for only so long before the fascia incurs damage (microtears) and inflammation occurs, left untreated long enough, it can become chronic and very difficult to treat, so early detection and accurate diagnosis to the root cause is instrumental in treating it effectively. Hip function, pelvic alignment, and lower extremity muscle activation are all important factors in human movement, so if there is a dysfunction up the kinetic chain, it can influence the mechanical loading to the plantar fascia.
Plantar Fasciitis Treatment
Stretching and proper warmup before and after activity can help, as can rest, ice, compression, and elevation (R.I.C.E.). Specific eccentric exercises for building tissue resilience can be effective as a long-term solution. Taping can help to support the arch, and medication can help manage pain. Align Orthotics™, carefully crafted after your Body Align Assessment, can help relieve plantar fasciitis by promoting strength, flexibility, and proprioception in the feet. They can effectively support the arch and improve foot function as an immediate and longer-term solution, respectively. During times of pain, avoid going barefoot unless instructed to do so by a foot health professional, and wear well-structured footwear.
When considering treatment for Plantar Fasciitis Mississauga patients who visit Align can experience the benefits of their specialized approach.
Everyone's body is unique, and understanding what are the contributing factors in your case is key to developing a comprehensive treatment plan.
Training both with and without your Align Custom Fit Footwear, under the guidance of your Align Clinician, may help promote better foot function. This can contribute to a healthier foot position and potentially alleviate some of the stress on the plantar fascia. Arch support can be helpful, but this is not always the case. Understanding how your foot should function is important so that improving foot function can be the focus. Sometimes the arch is too rigid, sometimes too flexible – the treatment plan should be specific to you.
Align Orthotics™ allow your feet to move more naturally and help improve overall foot mechanics. It encourages a more even distribution of weight and may reduce excessive stress on certain areas of the foot, including the plantar fascia. Align Orthotics™ can also be used to address dysfunctions in the ankle, knee, hip, pelvis, and back that can be major contributing factors to the onset and development of Plantar Fasciitis. For example, one may have a leg length discrepancy where one leg is longer than the other. The shorter leg may lift off the ground earlier to maintain pelvic alignment and try to achieve symmetry during walking. This results in increased loading to the Achilles and plantar fasciitis. One-sided plantar fasciitis is often indicative of dysfunction in our body alignment, resulting in uneven stress to certain tissues in our body, such as the plantar fascia. Hence why our foot specialists (Pedorthists & Chiropodists) are trained in the Align Clinician method to understand full body biomechanics and not simply look at just the foot.
Once your plantar fasciitis is in a safe stage of recovery, strengthening the intrinsic muscles of the foot, including those responsible for maintaining the arch, can be very effective at building resilience to the tissue and preventing it from recurring. Eccentric loading of the Achilles and plantar fascia is often prescribed in conjunction with other therapies to help with Plantar Fasciitis recovery.
Simply wearing your Align Orthotics™ increases proprioception and weight distribution in your entire kinetic chain, which is the body's ability to sense its position in space. This heightened awareness can improve balance and coordination, reducing the likelihood of awkward foot movements that could aggravate plantar fasciitis.
Exercises provided to you in your treatment plan, both on and off your Align Orthotics™, often involve a greater range of motion in the foot, ankle, and calf muscles. At Align in Mississauga Plantar Fasciitis treatments focus on enhancing flexibility, which contributes to a more natural and efficient gait, potentially reducing strain on the plantar fascia. They can also help address muscle imbalances, which may be major contributing factors.
Your Align Orthotics™ allow your feet to absorb shock better. This can be beneficial for individuals with plantar fasciitis, as it reduces the impact on the feet during activities. The Align Orthotics™ can also be designed to improve shock absorption if the feet are unable to do so.
Hands-on manual therapy can be very effective at providing immediate relief. You can have our Align Clinicians perform it for you, or we can teach you how to do it and you can practice at home.
In severe cases, it is sometimes necessary to temporarily immobilize the foot. Often, a plantar fasciitis night splint may be recommended to help you achieve this. This medical product helps prevent movement, puts the fascia on stretch, and prevents excessive loading on the plantar fascia. It is typically worn at night but can also be worn during extended periods of sitting, such as at a desk or while watching TV.
Use a small massage ball to increase blood flow, reduce tension in the tissue, and alleviate pain. However, it is important the ball is small enough to fit the contours of the foot (typically the size of a golf ball).
Using the sensory massage ball in conjunction with our Toe aligners (aka toe spacers) is extremely effective in the recovery process. The Toe Aligners separate the metatarsals and thereby splay the plantar fascia band, making the massage ball rolling more effective in reducing adhesions and scar tissue, improving blood flow, and overall helping with the recovery of the tissue.
Specific braces such as the OST sock can effectively provide compression and immediate relief to symptoms. This brace works extremely well at rapidly alleviating pain. It can be worn daily. With targeted zones of compression, it is specifically designed to alleviate pain caused by plantar fasciitis.
It's important to approach plantar fasciitis treatment with caution. Before starting any new treatment plan, it's advisable to consult with a foot health professional (such as a Chiropodist, Pedorthist, or Podiatrist) who can provide guidance based on your specific condition. We can help you determine the appropriate exercises and monitor your progress to ensure that your treatment plan is safe and effective for you and guide you into gradually introducing your Align Orthotics™ and barefoot activities to allow your feet to adapt and avoid overloading them.
For a quick rehab program on plantar fasciitis Mississauga patients can check out this video.
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