Plantar Fasciitis – Tips from a Chiropodist and Elite Distance Runner

What is Plantar Fasciits?

The plantar fascia is a deep connective tissue on the bottom of your foot. It helps you walk and aids to stabilize the foot. The cause of this stubborn condition is a combination of tightness and weakness due to overuse.  

Why Does it Happen?

The pain is caused by the plantar fascia band overworking in a compensatory manor, when it attempts to stabilize the foot.  This compensation of the band is due to compounding factors of a tight lower leg, combined with weak muscles specifically the glutes/ core and foot.  Weak glutes/core cause more collapsing down the chain and more pronatory force on the foot. Weak glutes / core can lead to very tight calf muscles and more load placed on the foot than it can handleWeak foot muscles cannot absorb impact properly, thus leading to the fascia band overworking to control the instability. The fascia is not designed to do this and pain occurs as a result. 

Me, being a runner who trains at a high level, has withstood many repetitive overuse injuries in my time. I was told that I should not run as I have a pathological foot type. This means that I am predisposed to a lot of foot injuries. I chose a field which I knew would educate me to help me stay healthy to do what I love to do. Not only do I love to run, but I also love to help people get back to health and continue doing what they love to do.

My entire philosophy has always been rehabilitative in nature as well as promoting adequate support to injured tissues. In fact, in practice I have found that to be the most successful for my patients. A combination of support to the injured tissues, while rehabilitating the imbalances. This is why it is important to have a thorough examination to determine where your individual weaknesses and flexibility errors may be. Not all the time is plantar fasciitis a problem of flexibility. Thus, if one is only given a program of stretches, they may not see the best improvement. Stretching is important but it is only part of the puzzle. I also have experience in plantar fasciiits orthotic prescription for people who wear flats, to those who partake in high impact activity, such as running.

Treatments

I am firm believer in strengthening the weaknesses and I do believe a strong foot is a healthy foot. When the foot is injured I do find orthotics helpful in pain alleviation as orthotics help to offload the injured area as well as adding support to injured tissues. Orthotics also help to provide stability to the foot to help prevent the fascia band from kicking in to stabilize the foot. Orthotics are of benefit while I train people to begin utilizing their lower chain muscles again. I attempt to promote this on a regular basis as well. When standing in line at the grocery store, brushing  teeth, to even waiting at a pedestrian stop light.

I do find shockwave therapy to be a very effective treatment for plantar fasciits. However, it is only effective if the mechanism of action causing the pain is managed properly and addressed. If the proper mechanics are not restored, the forces leading to strain on the plantar band will return, making the cycle a very frustrating experience. The shockwave is of benefit, it just need to be combined with the proper exercise regimen to yield most benefits. If one is doing the proper exercises and gets the treatment, they will see that shockwave therapy does help. Me, being a distance runner, I am no stranger to this injury. I know first hand the benefits of shockwave therapy when combined with the correct therapy protocols. I also may need to prescribe a strong anti inflammatory in more painful conditions. Clinically, I have found prescription grade to be far better than over the counter anti inflammatory medications in getting the inflammation to calm down. In the beginning , I also like to advice a regular daily icing protocol as well.

Footwear is an important topic. When the foot is injured, it is best to avoid flat shoes or shoes of little support. I usually tell people to avoid shoes which can easily bend . I typically like a wider toe box, so one can activate their foot muscles better. A narrow shoe immobilizes the foot muscles,  leading to further strain on the fascia band. I also like soles with a bit more of a medial flare such as the New Balance 840 or 860. I am a big fan of New Balance. They started off as an insole company and they are pretty bang on with most of their footwear engineering.

If you are suffering from plantar fasciitis, I am thrilled to help you! That is my passion and I understand how miserable that condition can be. I have had continuing education training from Harvard Medical School focusing on foot and ankle conditions. I look forward to providing a well rounded approach to help those with plantar fasciitis.

Wishing you the best in your foot health!