Plantar Fasciitis

They take you wherever you want to go, day after day, sometimes with little rest in between. I'm not talking about Uber or Lyft, but about your feet. Usually they don't complain, but when your feet have had enough, you may experience aching, tightness or even a sharp pain in the heel, often most noticeable with stepping down after sleeping or prolonged sitting. Commonly diagnosed as "plantar fasciitis or fasciosos" (PF), an estimated 1-2 million people per year are affected in the United States. You are not alone! The pain may occur for a variety of reason, including standing for long periods of time, inappropriate footwear, old injuries, limited motion of the ankle joint, weak leg muscles commonly called "calves and hamstrings", aging and increased Body Mass Index {1}. Some experience the pains and aches in one foot, while others feel it in both. 

I have experienced plantar fasciitis myself as a runner, and again as a mother with a newborn who liked to nurse frequently, often for hours in our favorite chair. In the running scenario, I had poor ankle motion and weak hip and leg muscles that led to my aches. In the second instance as a breastfeeding mother, sitting for long periods led to tightness in my hamstrings, which pulled on the connective tissues in my feet, commonly called the plantar fascia. How did I deal with it? I had the benefit of being both the patient and a doctor who knew how to treat plantar fasciitis with a combination of therapies. 

Success has been noted with joint mobilization (aka adjustments) of the foot and ankle joints in combination with soft tissue mobilization techniques, such as trigger point therapy, deep tissue massage or a form of myofascial release called IASTM, which stands for "instrument-assisted soft-tissue mobilization {2}." While that sounds like a mouthful, it is a simple technique involving application of smooth edged instruments on the skin surface to remove injured soft tissues, and facilitate the healing process by improving blood flow and stimulating cells that make collagen, the protein found in tendons, ligaments and fascia, to name a few. Treatment success also improves when patients perform appropriate stretching and strengthening exercises, depending on the identified  cause of plantar fasciitis. For me, gentle yoga moves like downward facing dog, monkey pose and chair pose were effective in both stretching and strengthening my leg and hip muscles. 

Painful feet can really limit our ability to function throughout the day. Give those tootsies some TLC and call our office if you have questions about how we may be able to help. 

[1] John j. Fraser, Revay Corbett, Chris Donner & Jay Hertel (2018) Does manual therapy improve pain and function in patients with plantar fasciitis? A systematic review, Journal of Manual & Manipulative Therapy, 26:2, 55-65, DOI: 10.1080/10669817.2017.1322736

[2] Kim J, et all (2017) Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury:mechanisms and practical application, Journal of Exercise Rehabilitation, 13(1): 12-22 

Thanks to Dr. Kugel for the article! 

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