As I study around the web consisting of social media sites, forums and post there is an abundance of information about plantar fasciitis. Sadly much of it’s outdated and just regurgitated concepts, theory’s and treatment choices that just have actually been proven wrong or don’t work.
As a hand and foot chiropractor in Melbourne, FL I have spent the past 15 years studying foot conditions, specifically plantar fasciitis. Exactly what was taught as accurate in school has now been shown to be outdated and ill logical. Exactly what I am going to reveal are not simply my views but, are all backed by clinical literature. I am continuously developing in my mission of using the very best possible treatment choices for my clients and therefore research study is essential. The understanding I have acquired from this research study has actually modified the treatment I now utilize today to deal with a patient with plantar fasciitis treatment massage compared with what I utilized at an early stage in my practice.
So what are these outdated concepts, theories and treatment alternatives I continue to read about. Lets start with the name itself. Plantar Fasciitis. In medical terms this informs us that the plantar fascia (in fact it’s called the plantar aponeurosis) of the foot is inflamed. It prevails knowledge on the internet that the plantar fascia is inflamed usually at the insertion on the heel. The latest’s research suggest that swelling has little to do with plantar fasciitis. At first there may be some inflammation although the condition becomes more of a degenerative disorder instead of an inflammatory condition. So what does it matter whether it is inflammatory versus degenerative? It is important because it changes the kind treatment that need to be administered. An example. If a patient has inflammation they would be treated with nonprescription anti-inflammatory medication (NSAIDS) such as Advil, prescriptive anti-inflammatory or with an anti-inflammatory injection such as a steroid. These may be effective treatment alternatives for reducing inflammation nevertheless, they will not help much if there is little or no inflammation present such as in degenerative conditions.
So exactly what does the clinical literature have to state? A 2003 review of 50 cases performed by Lemont et al mentioned that plantar fasciitis is a “degenerative fasciosis without inflammation, not a fasciitis.” 1. In medical terms a suffix of -itis implies inflammation where -osis implies degenerative. Andres et al. wrote in the journal Scientific Orthopedics & Related Research “Recent standard science research study recommends little or no swelling is present in these conditions”. 2. A post titled Overuse tendinosis, not tendinitis, part1: a brand-new paradigm for a difficult medical problem published in Phys Sportsmed mentions “numerous private investigators worldwide have shown that the pathology underlying these conditions is tendonosis or collagen degeneration”. 3. I can go on pointing out much more although you can see that the specialists concur that the theory of inflammation present in plantar fasciitis not legitimate.
Another common mis-conception is that Plantar Fasciitis is caused by bone stimulates. When a patient presents to my office with Plantar Fasciitis and a heel spur is kept in mind on an x-ray I state something which might sound extremely odd to the client “A heel spur is your buddy”. I constantly get the look of “Did you just say what I believe you said?” I then continue with “Let me discuss … “. I then continue, “Plantar fasciitis is triggered by chronic inflammation of the plantar fascia, typically at the insertion on the heel where the bone is present. Gradually the plantar fascia starts tearing away from the bone. The body reacts by calcifying (solidifying) the tendon and keeping it undamaged avoiding it from tearing off the bone!”. Thus, why it is refrenced as a “good friend”.
Although stimulates prevail with plantar fasciitis the spur itself does not cause discomfort however, the fascia or surrounding soft tissues in fact trigger the pain. 4. Surgical treatment generally is not effective for alleviating the pain and the stimulates typically return considering that the root of the problem has actually not been removed. 5
Exactly what about flat feet (pronation-often found with flat feet) or tight calves. I think these do place increased tension on the plantar fascia and contribute to plantar fascitis although I do not think they are a root issue of plantar fasciitis. There are many individuals with dropped arches, pronation and tight calves that do not have plantar fasciitis. There are likewise many people with plantar fascitis that do not have flat feet, pronation or tight calves. Early on in my profession I dealt with patients with plantar fasciitis who were flat footed by fitting them with a custom orthotic to restore the arch. Although this did help in reducing the pain really typically it did not remove it. If flat feet was the cause then the patient should have been treated. It’s been my own medical experience that has reveal me that high arches and supination are just as problematic as being flat footed or having a foot with pronation.
So as a hand and foot chiropractic specialist exactly what do I think is the source of plantar fasciitis? In most cases I think it is a foot that is not correctly functioning. This might be from a bone out of place such as the Talus or Calcaneous (which I see all too often) a distressing injury or a hereditary defect. The human foot has 26 bones, 33 joints, 107 ligaments, 19 muscles and tendons and is extremely complicated. When all these parts are not working appropriately in sync it puts unnecessary tension on the foot and triggers degeneration to occur. https://mybowentherapy.com/plantar-fasciitis-treatment-massage/