Plantar fasciitis is an overuse pathology of the plantar fascia, a flat band of tissue that connects from your heel to your toes and is vital in supporting the arch of your foot. It is the most common source of heel pain, affecting one out of ten people in the United States. At CIMT, we see many individuals with plantar fasciitis. In many cases, they have had symptoms for several months, even years.
There are several reasons why this condition can linger in individuals...
- Joint/soft tissue mobility issues in the foot/ankle- An old ankle sprain, fracture or surgical procedure alters tissues in the foot/ankle and may have never been restored properly. These tissue changes alter foot and ankle function, leading to increased strain on the plantar fascia. The foot/ankle anatomy is fairly complicated. Oftentimes, very specific mobilizations are needed to take tension off the plantar fascia.
- Prior injury to the body (usually in the legs or back)- The pain caused by any lower extremity/spinal injury changes the way we move. Once the pain subsides, we don't automatically go back to moving how we did before the injury. This new way of moving may be changing the way we load our feet, causing increased strain on the plantar fascia. You can treat the foot every day, but unless you correct the altered movement patterns, the pain will not subside.
- Referral from spine or tight nerve tissue (sciatica)- The pain that you are feeling in the heel might not be from the plantar fascia or coming from the foot at all! The S1 nerve root in the low back commonly refers pain to the heel. A more commonly missed diagnosis is referral to the heel from your tibial nerve. The tibial nerve is a branch of your sciatic nerve that runs deep within the calf musculature. Sometimes the tibial nerve can get pinched within fascia and/or muscle, causing pain in the heel. This is likely the culprit if stretching the calf actually makes your symptoms worse.
At CIMT, we not only resolve your symptoms, we look at the whole body as an integrated unit so that we can find the CAUSE. Our manual therapy training allows us to treat all tissues (joints, muscles, fascia, nerves, viscera, etc.) in very specific ways that will restore your optimal mobility, not only in the foot/ankle, but throughout your entire body. In addition to restoring that mobility, we work on your movement patterns to ensure that you are loading your plantar fascia correctly. This is the only way to prevent the pain from coming back.
There is no cookie cutter approach to treating plantar fasciitis. Every individual's case is unique, which means his/her treatment should be unique as well. This is not something that you need to "tolerate" or "put up with." If your heel pain is not resolving, consider making an appointment at CIMT.