Dr. Zach Daniels PT, DPT, Cert. DN
It is likely that most of us will experience some form of foot pain over the course of our lives simply due to the sheer impact and mobility they experience every day. The goal of this article is to discuss a common foot injury often onset without any true "injury" at all. Plantar fasciitis is the inflammation and irritation of the taught band of tissue that stretches from the heel to the base of the toes. Small micro-tears in the tissue can arise over time due to stress and excess loads added to the fascia. This tissue has limited blood supply, unlike that of a muscle, making healing significantly slower when damaged.
The classic signs of plantar fasciitis are pain in the bottom of the heel and pain that is worse with the first few steps in the morning when getting out of bed. Like that of a muscle, when the fascia is tight and is elongated with a step a sharp pain may occur. So then, why might there be sudden pain making it difficult to walk, if you have not altered anything?
In many cases, the true cause or incident that caused you plantar fasciitis will never be known. Major factors that have been associated with the inflammation of this tissue involve poor foot mechanics, poor footwear, excess weight and an increase in running distance. Additionally, running or walking on the beach barefoot may predispose a poorly aligned foot to injury. The terms "flat feet" or "high arches" are often associated with plantar fasciitis. The bones, ligaments, fascia, and muscles of the foot/ ankle act as a shock absorber upon each step, so if part of the system is failing, likely others will.
Treatment involves the precise restoration of blood flow and tissue alignment in the most affected areas of the tissue. The fascia is larger than most think, so many times more than one targeted area is inflamed. The tissues are restored through treatment techniques including soft tissue mobilization, Active Release Therapy (ART), dry needling and phonophoresis. Occasional joint mobilizations of the heel bone/ talocrural joints are required to reduce the tension placed on the fascia by simply adjusting/ re-aligning bones or increasing joint capsule mobility.
In conjunction, strengthening and flexibility exercises are prescribed to target the small muscles of the foot and ankle often overlooked with normal exercise. A simple orthotic insert designed to contour to your foot is often necessary to prevent the return of the tissue inflammation. If the fascia remains severely irritated and the treatments listed above do not work then your doctor may prescribe a steroid injection to reduce the inflammation or place your foot in a boot to allow for more productive physical therapy treatment.
Plantar fasciitis is a common injury and often times a relatively easy fix but if not addressed early, the length of recovery time will likely increase. If your doctor or you determine the need for physical therapy, we are very familiar with this condition and will deliver the hands-on manual therapy care needed to get it better.
For further information on this or other related topics you can contact Zachary Daniels, PT, DPT Cert DN, at Professional Rehabilitation Services (Market Commons) (843) 213-6338, Richard DeFalco, DPT, OCS, CSCS, CWcHP (Myrtle Beach) (843) 839-1300, Brian P. Kinmartin PT, DPT, MTC, STC, OCS, CWcHP (Pawleys Island) (843) 235-0200, Richard A. Owens, MPT, OCS, Cert. SMT, CWcHP (Surfside) (843) 831-0163, Jill P. Phelan, PT, DPT, Cert. DN (Conway) (843) 773-3031, Lisa O'Brien, PT, DPT, Cert. DN (Murrells Inlet) (843) 314-3224, Karl Ehlers, PT, DPT, Cert. DN (Little River) (843) 281- 4222, Samantha Crisafulli, PT, DPT, Cert. DN (Carolina Forest) (843) 282-0440, or visit our website at www.prsrehabservices.com where you can learn more about the company and even download a referral form for your physician to fill out. You can also call and schedule a free 15-minute consultation!