Plantar fasciitis (PF) affects approximately two million people in the United States, both sports and non-athletic groups. This condition can be debilitating and significantly affect the quality of life very negatively. There are several high-quality studies of this condition and the most successful treatments. Treatment varies from chiropractic, physical therapy, injections and operations. Fortunately, this condition can usually be solved with the help of conservative treatments and lifestyles that can prevent it from getting under the knife. Simply put, plantar fasciitis is a strain followed by inflammation of the thick tissue (plantar fascia) and muscles on the lower part of the foot, causing heel pain. Plantar fasciitis (PF) is characterized by biting pain in the heel / middle arch with the first bearing weight in the morning or after long periods of rest. The pain usually subsides within 5 minutes of walking or jogging, and then worsens with prolonged activity or weight. It is also associated with tired, aching legs at the end of the day and leg cramps. PF is observed in both active and inactive people and is rarely the result of an acute injury. PF can be the result of several different factors: recurring overuse injuries, poor fitment shoes, overtraining, structural abnormalities of the foot, and improper gait mechanics. PF often becomes a chronic and / or recurring problem if appropriate treatment and follow-up is not provided.
Some factors contributing to the development of plantar fasciitis:
Structural anomalies: Plantar fasciitis is very common with pes planus (on the left) or with flat feet. As you can see, this medial arch of this person is almost completely hidden from the ground. This can create stress on the plantar fascia. Severe injuries resulting in the need for surgical bending of the foot can also create tension on the plantar fascia. In these cases of severe structural abnormalities, orthopedics are usually indicated. Rehabilitation, including leg strengthening exercises, chiropractic manipulation and soft tissue techniques, can bind pain and help relieve tissue tension and resolve takeoffs. We use custom orthopedics from Foot Levelers in our office. Using a three-dimensional scanner, we can manufacture conventional orthopedics to maintain the full structure of your leg.
Bad shoe fit : Wearing unsuitable shoes over time can lead to PF. If the shoes do not fit your foot properly, your gait changes during any weight transfer activity. This affects the entire kinetic chain and may cause deformation on the plantar fascia. The strength and flexibility of your feet will determine your best type of shoe.
Overtraining : Could be a huge contribution to PF. The fact that many athletes, weekend warriors, etc. are prone to lose sight is the importance of recovery in training modes. If your tissues do not have optimal nutrition, rest and repair time, they begin to survive, rather than recover. Especially when it comes to long distance, or fast sprints, legs are in great demand.
Nerve impotence : Plantar fasciitis may be a symptom of a sciatic nerve. The serial nerve is the fattest nerve in your body. It comes from your lumbosacral plexus nerves, usually L4-S1 / S2 with some individual anatomical variations. Although this nerve is usually blamed for all rays of pain in the legs, it is only responsible for the pain along its trajectory in the posterior aspect of the leg and the foot. In some cases, the pain can completely miss the back of the leg and go straight to the foot. A lesion along any part of the nerve can lead to pain, but it should not be in the leg. If there is a sufficient lesion on this nerve, any added pressure, for example, forced squatting of the foot while standing or walking, can only be the right tension to create excellent pain in the legs. Our bodies are always trying to protect our nervous system; the reflexive muscles surrounding the nerve will tighten in an attempt to avoid further stretching or tension of the nerve. Ultimately, this leads to inflammation of the plantar fascia and surrounding muscles.
Other factors:
Systemic inflammation : Although general systemic inflammation is not usually the cause of plantar fasciitis, it will increase your symptoms. For this reason, we strongly recommend that our patients have an anti-inflammatory diet that meets their needs. We also understand that no one is perfect and does not eat perfectly all the time, so we encourage the 80/20 approach; eat a pure 80% of the time and use the other 20% to pamper themselves. Curcuminoids, like those found in turmeric, are great at smoothing out inflammation in acute cases of plantar fasciitis.
Alternatives to conservative care:
Cortisone or steroid injections are very often given for plantar fasciitis. In some really difficult cases, it is absolutely necessary to “let the fire out”, which is an inflammatory cascade, to get you out of pain initially. We never recommend treating this option as a cure. Cortisone is a very powerful anti-inflammatory agent that relieves pain without correcting the underlying problem, potentiating further trauma and repetitive episodes. Another option is surgery. In some cases, surgery is the best option for a particular case. We prefer to exhaust conservative treatment options before embarking on this path. In a study on overweight and obesity (43%), suffering from plantar fasciitis for an average of 34.8 months, decompression surgery was performed on the digdui abductor nerve with partial release of plantar fascia and tracked over a 4-year period. It was found that 75.6% of patients were painless or had only mild pain after surgery (pain was prescribed from 8.5 / 10 to 2.5 / 10). However, postoperative patient satisfaction was only 48%.
