Plantar fasciitis is a diagnostic term that is used to describe inflammation in the plantar fascia. The plantar fascia is connective tissue (similar to a tendon or ligament) that connects the heel and forefoot. The primary complaint is usually a sharp heel pain that radiates along the bottom of the foot. The pain is usually worse with walking or upright activities. It may even be noticed that the pain is the absolute worst with those first few steps in the morning. There are a few ways that plantar fasciitis may develop.
Causes of plantar fasciitis:
1) Flat feet, also known as hyperpronation. Over time this can cause repetitive tension or overload on the bottom of the foot. This overload will produce a constant stretching effect that can stress the plantar fascia.
2) High arch, or being overly supinated is another possible cause of plantar fasciitis. This sometimes causes the foot to be too rigid. In this case forces from walking are not transferred through the foot as they should be. Rather, the forces are all absorbed within the foot and primarily transferred to the plantar fascia.
3) Improper gait or biomechanics. Either of the first two conditions can be aggravated by having less than perfect biomechanics. A very common example is if the calf muscles are too tight. This leads to the heel lifting off of the ground too early with walking which causes a bouncy walk. There are several other areas of the body that sometimes need to be evaluated as well. Some of these areas are in the foot and some are up in the hip and pelvis. If this sounds bizarre just remember that the hip bone is connected to the knee bone. The knee bone is connected to the ankle bone, okay you get the point.
Although a heel spur is sometimes seen on x-ray (50% of the time), an x-ray is not necessary for the diagnosis of plantar fasciitis. We now know that the heel spur is not the cause of the plantar fasciitis but rather a reaction to the chronic tension that had developed. With proper treatment, pain can be managed and biomechanics can be restored, but the heel spur will still remain.
Treatment for plantar fasciitis may include ultrasound, electric stimulation, stretching, myofascial release, adjusting or realigning joints. Also, our office specializes in correcting biomechanical faults that contributed to the condition in the first place.
