You wake up, roll over and step out of bed- or at least try to. That first step feels like your foot is going to rip in half, making you want to avoid putting any weight on it.
Does this sound familiar? You may have plantar fasciitis.
This pain in the bottom of your foot with the first step in the morning or after sitting is one of the hallmark signs of plantar fasciitis. This pain tends to be close to the heel, but may progress towards the middle of the foot. It is at its worst just before your toe lifts off while walking. It tends to get better with activity, but will likely be worse at the end of the day.
It can be caused by new shoes, increased standing at work, or increased running/walking distance or intensity. If you are someone with “flat feet” or a previous achilles tendon problem, you may also be more likely to get plantar fasciitis.
But what actually is it? The plantar fascia is a thick band of tissue (see below) that helps to support the arch of the foot. This condition occurs when there is inflammation and microtrauma (repetitive strain) of the plantar fascia where it attaches to your heel (the calcaneus).
This condition is a little tricky- it is often very hard for people to eliminate the cause. If it is work related, you aren’t necessarily able to modify your duties. The good news is, there are a number of treatment options available for you.
- Soft tissue therapy
- Soft tissue therapy, especially instrument assisted of the foot and calf are extremely beneficial
- Mobilizations and Manipulation
- If there are biomechanic issues of the foot or ankle joints, mobilizations and chiropractic manipulation can be beneficial
- Custom foot orthotics
- More chronic biomechanical issues (including “flat feet”) may be addressed with orthotics. Your chiropractor will perform a full exam to determine if these may be helpful.
- Kinesiology taping
- Similar to how orthotics help to support the foot, kinesiology tape can add support and feedback to the foot and ankle to help decrease pain
- Acupuncture
- Although it may be a little painful if you have sensitive feet, acupuncture can also be very beneficial in both the plantar fascia itself as well as the achilles and calf.
- Ice and heat
- Ice should be used early on – first few days of pain. A frozen water bottle can be used to roll the bottom of the foot over to help stretch/massage at the same time
- After this initial period, heat should be used to encourage healing
- Home stretching
- Stretching should be done first thing in the morning and throughout the day
- A towel can be used to help pull the toes up towards the shin, to the point of a comfortable stretch in the bottom of the foot
- This same stretch can be done by putting the affected foot on your lap in the figure 4 position and using your hand to gently pull the toes up towards the shin
- You can use a tennis ball to roll the bottom of your foot while seated- go slow and gently apply more pressure
- Remember- you want to feel the stretch but there should not be pain!
- Intrinsic foot muscle exercises
- Place a towel on the floor and put your foot on top, scrunch your toes to pull the towel towards you, and then relax
- Weight can be added to the towel to increase the challenge
- Range of motion exercises of the ankle using a resistance band can help strengthen foot stabilizers
Each of the above options are a potential part of a comprehensive treatment plan. Your chiropractor will work with you to come up with a plan specific to your condition, as well as your preferences.
This is a condition where early diagnosis and intervention are key- if this is left, it can easily become chronic. Chronic plantar fasciitis is still treated in a similar way, it just extends how long it will take for you to start to feel better.
*The above are general treatment options for diagnosed plantar fasciitis, please consult with a healthcare provider to ensure proper diagnosis and treatment.
Dr. Brenna Byer D.C. 