You may have heard of the condition known as plantar fasciitis. If not, the word “plantar” refers to the sole (or plantar surface) of the foot, and “fasciitis” means inflammation of fascia. Therefore, plantar fasciitis refers to inflammation of the fascia that covers the sole of the foot. Fascia is simply soft connective tissue that exists throughout the body. It covers every muscle, bone, joint, organ, blood vessel, nerve, lymphatic vessel, etc.. Essentially, it helps support the structure of the body and provide some protection due its ability to act as a shock absorber.
The main symptom of plantar fasciitis is pain on the sole of the foot, especially on the heel. Additionally, it tends to hurt the most just after stepping out of bed in the morning, and may get better as the day goes on. However, it may also get worse with walking.
The primary cause of plantar fasciitis is overpronation of the foot; which is also referred to as “flat feet” or “fallen arches” in lay terms. If you think of the foot and its (plantar) fascia as a bow and arrow, the fascia would be the string and the bow would be the bones of the foot. In a biomechanically-sound foot, an arch is present which gives it the bow-like structure. Now, imagine if the arch (or bow) “dropped” (or straightened) as in overpronation; then picture what happens to the string on the bow (i.e.: the fascia). Essentially, it will have to stretch to accommodate the “flattening out” of the bones of the foot. It is this stretching and excessive tension of the fascia that can lead to the painful condition known as plantar fasciitis. Other factors that can contribute to plantar fasciitis are excessive pounding on the foot (as in jogging or jumping) and a tight achilles tendon or calf muscle.
Conventional treatment can include the use of orthotics, anti-inflammatory medication, and stretching exercises.
Chiropractic and applied kinesiology treatment consists of correcting the cause of the problem. If this relates to overpronation, the muscles and joints of the foot and lower leg need to be evaluated and treated appropriately. Certain muscles may need stretching and lengthening, while others need strengthening and shortening. Also, joint motion will most likely need to be restored in the foot and ankle with chiropractic adjustments. The integrity of the ligaments may need to be supported through specialized applied kinesiology treatment and possibly through nutritional supplementation. Also, supplements to assist with quelling inflammation and to speed healing may be warranted. If necessary, orthotics may be prescribed to assist in maintaining the structural integrity of the foot. Whether or not orthotics need to be used permanently depends on the severity of the problem. Most importantly, a treatment plan needs to be designed to fit each individual’s needs.
Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology
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Dr. Michael Horowitz, Vancouver Orthotics
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