The ‘barefoot’ northern beaches has many delights, but if you have experienced the pain of plantar fasciitis or the infamous joy of a heel spur you will truly value the health & wellness of your feet.
What is Plantar Fasciitis?
Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel) and extending along the foot towards the toes, creating the tension to create the arch of your foot similar to the road on Sydney Harbour Bridge. If excessive tension occurs along this sinew, micro tears occur or the plantar fascia leading to inflammation known as plantar fasciitis.
What Causes Plantar Fasciitis? Plantar fasciitis is most often associated with activties where there is high impact and running sports in particular. It is even worse still for those that involve toe running rather than heel running styles. Most often diagnosed in people with poor foot biomechanics that stress the plantar fascia. At Chirosports Northern Beaches Dr. Alfie Arcidiacono commonly sees that 'flat feet' or 'weak foot arch control muscles' are common causes of plantar fasciitis. We have found that a multi-faceted Chiropractic care approach helps during the inflammatory phase, provides gentle ankle/foot mobilisation and manipulation to assist poor biomechanics (eg overpronation) or a well designed exercise program to provide strengthening for weak muscles.
What are the Most Common Symptoms of Plantar Fasciitis?
Remember we said you'd have a hell of a pain in the ....................heel! You'll typically first notice early plantar fasciitis pain under your heel or in your foot arch in the morning or after waking. Your heel pain will be worse with the first steps and improves with activity as it warms up. Typically we see the 'plantar fascial dance' as you dance around trying to avoid loading your heel with pain, but just can't seem to escape.
How Does Plantar Fasciitis Progress?
As the plantar fasciitis deteriorates over the course of time, the pain may become more frequent. The following guidelines may be a valuable tool to see how you are tracking:
1. No Heel Pain - Normal! 2. Heel pain after exercise. 3. Heel pain before and after exercise. 4. Heel pain before, during and after exercise. 5. Heel pain all the time. Including at rest!
Ultimately, further trauma and delayed healing will result in the formation of calcium (bone) within the plantar fascia. When this occurs adjacent to the heel bone it is known as heel spurs, which have a longer rehabilitation period.
How is Plantar Fasciitis Diagnosed?
Plantar fasciitis is usually diagnosed by your sports chiropractor based on your symptoms, history and clinical examination. After confirming your plantar fasciitis they will investigate why you are likely to be predisposed to plantar fasciitis and develop a treatment plan to decrease your chance of future bouts.
On occasion radiologiocal investigation such as X-rays may show calcification within the plantar fascia or at its insertion into the calcaneus, commonly known as a calcaneal or heel spur. On rarer occasion, diagnostic ultrasound scans and MRI are used to identify any plantar fasciitis tears, inflammation or calcification and to exclude more serious forms of pathology that whilst rare, can cause foot pain. Pathology tests (including screening for HLA B27 antigen) may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.
Plantar Fasciitis Treatment
Fortunately, albeit sometimes much slower in healing than most would expect....plantar fasciitis is reversible and very successfully treated. About 90 percent of people with plantar fasciitis improve significantly within several months of initial treatment.
If your plantar fasciitis continues after several months of conservative treatment without satisfactory improvement, on some occasions you may be referred by Dr. Alfie Arcidiacono to a Sports Physician to inject your heel with steroidal anti-inflammatory medications (corticosteroid). This is not very pleasant, and whilst cortisone injections have been shown to have short-term benefits but they actually retard your progress in the medium to long-term, which usually means that you will suffer recurrent bouts for longer.
Fundementally, Dr. Alfie Arcidiacono is most interested in getting you back to movement, and if your poor foot biomechanics are the primary cause of your plantar fasciitis it is vital to thoroughly assess and correct your foot and leg biomechanics to prevent future plantar fasciitis episodes or the risk of development of a heel spur.
Your Chirosports Sports Chiropractor is an expert in foot assessment and its dynamic biomechanical correction. They may recommend that you consider an in-house foot and gait scan and analysis to consider the prescription of a passive foot device such as orthotics. This high tech equipment is very useful to assist us in the designing prescription orthotics specific to an individuals needs.