By Karl Ehlers, PT, DPT
You wake up in the morning and attempt to get out of bed to go make breakfast. Then, out of nowhere during your very first step of the day, you experience a sharp shooting pain in the bottom of your foot This may be followed by a tightness or cramping feeling that follows you throughout the day If you're saying to yourself, "that sounds really familiar!" Then you may have Plantar Fasciitis.
The plantar fascia plays a very important role in the plantar aspect of our foot that supports the arch necessary for carrying the weight of our body during standing and walking activities The plantar fascia itself is a thick band of tissue that connects at the front of our heel bone (Calcaneus) and runs the length of our foot connecting distally at the toes (phalanges) When this tissue becomes irritated and inflamed it leads to a sharp pain in the bottom of the foot, most commonly near the heel bone where the tendon attaches. Our body is essentially a continuous chain of bones, muscle, tendons, ligaments, and other soft tissues, therefore, if one link in the chain is disrupted, it can lead to other dysfunctions of the foot and ankle, Achilles tendon, knee joint, and structures of the hip.
There are a variety of causes for Plantar Fasciitis that range from increased activity to bone spur formation. Often times, when new activities are introduced to our bodies such as prolonged walking, jogging, running, stair climbing, or even work-related tasks, our body does not always react so kindly to this sudden change. This may cause the muscles and tendons to begin a state of protection or "guarding" leading to the inflammatory process and potentially painful symptoms. Bone spur formations at the heel can contact the plantar fascia and cause trauma or tears in the muscle or tendon also leading to muscle guarding and inflammation, as well as an abnormal walking pattern. A tight Achilles tendon that is not addressed with the correct intervention may also cause similar symptoms as the attachment site of this tendon is on the back of the heel and can cause a mal-alignment of the joints within the foot and ankle This change of position will cause the plantar fascia to become taut and lead to further pain and discomfort. Imagine squeezing your hand in a first position as hard as you can for the entire length of the day? Can you envision how tired your hand and forearm muscles would be? Imagine that same process occurring at the bottom of your foot, then add the entire weight of your body on top of it That is what's happening with plantar fascia in the bottom of your foot.
Treatment options may vary depending on when your symptoms began and what caused them to occur. Conservative treatment has been researched and proven effective including a course of physical therapy to address your painful symptoms and functional deficits The goal of physical therapy would be one that focuses on identifying the causative factors of the condition and alleviating the painful symptoms in the plantar fascia. During your examination by one of our board-certified orthopedic physical therapists, we will identify areas of dysfunction These areas may be muscle weakness, soft tissue tightness, and poor movement patterns. A plan of care would be established to address these areas through prescriptive exercise, manual (hands-on) therapy, and modalities (ultrasound, electrical stimulation) The goal with any physical therapy regiment is to eliminate the problem and educate an individual on strategies to keep it that way.
One of the newest and most effective procedures that we have incorporated in our offices with great success is dry needling. The name sounds worse than the actual procedure! Dry needling is a process by which fine gauge solid filament needles are inserted into the symptomatic dysfunctional area to create tiny lesions (microtrauma) in the underlying soft tissue. These lesions stimulate the body's natural response of healing by way of secretion of proteins and the blood factors responsible for tissue remodeling to the affected areas, as well as stimulation of the central and peripheral nervous system to create a decrease in pain In other words, the microtrauma that is caused in the tissue creates an environment that allows the tissue to remodel and repair itself. Because the needles are of an extremely fine gauge, the procedure has minimal pain associated with it.
A thorough history and physical examination by a board certified orthopedic physical therapist can determine if you would be a candidate for physical therapy to address your foot pain At Professional Rehabilitation Services we pride ourselves in distinction and providing a higher level of care. So if you or someone you know is having foot pain or another musculoskeletal problem and would like to know more about dry needling or other physical therapy options, seek the consultation of a physical therapist at one of our six locations or see your physician for a referral to one of our facilities. Physical therapy is a regularly covered service by most health insurance plans. Free 15-minute consultations are a great way to identify if you are a candidate for treatment!
For further information on this or other related topics you can contact Karl Ehlers, PT, DPT, Cert. DN at Professional Rehabilitation Services (Little River) (843) 281- 4222, 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, Samantha Crisafulli PT, DPT (Carolina Forest) (843) 282-0440, Zach Daniels PT, DPT (Market Commons) (843) 213-6338 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.