Plantar Fascitis Explained by Dr. Mueller
Being a Doctor of Chiropractic, back pain is the presenting chief complaint patients want help with on their initial encounter. If they are referred by an existing patient, they may think to tell me straight up about their history of plantar fasciitis, otherwise, I have to explore any history of problems in the foot, ankle or leg when investigating the origin of pain and dysfunction in the knee hip pelvis and spine.
The foot is an extremely complex collection of joints made up of bones held together by ligaments, the joints allow movement by tendons connecting the muscles to the bones and everything is wrapped individually and as a whole, in fascia. Fascia is a specialized connective tissue of various densities containing collagen and elastin that provides “play” or “give” to anatomy at rest and under load.
The fascia across the bottom of the foot is shown below from an image obtained from Wikipedia. The image on the lower left shows the most common site for inflammation to occur. I think the inflammation occurs here because all the tangents of force converge at that site and the fascia is stretched beyond normal ranges of motion when the load above becomes too great, occurs too often or lasts too long. Actually, to develop plantar fasciitis, many other “connective tissues” have to have yielded to divert load or mechanical responsibility to a layer of tissue that is not supposed to withstand that load over time. Therefore, it is critical to examine the anatomy and biomechanics of the foot in every case of foot pain and lower back pain.
Dysfunction in the foot can set the stage for altered tension adaptation up the leg into the thigh and hip, across the pelvis and into the spine. In fact, it has to! So, the foot has an immediate and direct impact on the spine and pain syndromes located there, period.
Obviously, activities known to stress or exacerbate plantar fasciitis should be curtailed to allow healing to occur. Recovery in my office can be multifaceted beginning with examining and addressing muscle spasms or weakness in the legs and, if necessary, introducing an Aetrex orthotic to prevent the ankle from rolling in, straining the collapsing the arch and elongating the bottom of the foot. There are home-exercises which can add an essential dimension of support to the leg, arch and ankle. In some people, predominately women, with hypermobile joints, we recommend a nutritional formula Chondro Plus from Biotics Research to make the ligaments stronger. To combat inflammation, I recommend Bio-Allay from Biotics Research and may apply the K-Laser Cube to extinguish pain locally, and some cases require Kinesio Tape to assist in load absorption to allow a person to maintain as normal a life as possible during recovery.
As a Doctor of Chiropractic my primary training was in locating and eliminating a condition called a Vertebral Subluxation. This is a misaligned vertebra in the spine, placing pressure on a nerve and compromising health. I have found dysfunction in the foot to be one of many reasons vertebral subluxations occur and I believe it is more important to get to the cause whenever possible than to treat the effect!