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Plantar fasciitis is an inflammatory condition of the plantar fascia (a band of connective tissue that runs along the bottom of the foot from the heel to the toes). It typically causes foot pain at the bottom of the heel which is worse first thing in the morning.
What does chiropractic for plantar fasciitis involve?
Before treatment takes place the patient is taken through a thorough assessment.
This is especially important in cases of heel pain because other problems such as stress fractures or heel spur syndrome can mimic plantar fasciitis. The treatment approaches for these problems are very different so establishing a correct diagnosis is key.
In addition to finding the source of pain (for example, in plantar fasciitis the this would be the inflamed plantar fascia) it is also important to establish any underlying causes i.e. why the plantar fascia became inflamed in the first place? Is there a restricted ankle joint causing an early lifting of the heel? Is there weakness of the foot or hip stabilisers causing the arch to collapse with walking or running? Is footwear compressing the toes leading to weakness of the foot? All of these scenarios are potential underlying problems that also need to be addressed for long term relief and prevention.
How does chiropractic for plantar fasciitis work?
Restriction in the joints of foot or hip may limit movement and cause compensated movement in the foot which can lead to increased strain on the plantar fascia. Manipulation is a very effective technique to restore movement to restricted joints to help unload the foot and reduce pain.
Just as joint restriction (see above) can lead to compensated movement in the foot, muscular tightness can have a similar effect. A good example of this is tightness in the calf muscle. Tight calf muscles can lead to an early lifting of the heel when walking, which places increased strain on the plantar fascia. A variety of soft tissue approaches such as active release, trigger point therapy or ischaemic compression can be used to treat these muscles, helping to reduce the load on the foot.
Soft tissue techniques can also be used directly to the plantar fascia itself to aid healing and speed recovery.
Dry needling is a therapeutic technique using an acupuncture needle to penetrate the skin and stimulate the underlying tissue. Dry needling has long been successfully used in the treatment of plantar fasciitis. The beneficial effects of dry needling on plantar fasciitis have now also been confirmed in the literature with a recent study showing that after 4 weeks of dry needling patients with plantar fasciitis demonstrated a significant reduction pain and improvement foot function compared to controls .
With acute cases of plantar fasciitis gentle stretches and mobilisation exercises can be used to relieve pain and promote healing in the early stages of treatment. The great toe exercise for plantar fasciitis is a clever exercise designed by a group of researchers from America which has been shown to produce excellent outcomes.
Later, exercises must be targeted to address underlying causes such as weakness of the foot or hip. The supported reach is a fantastic exercise to develop strength and stability in both the hips and the feet.
A simple but effective method for strengthening the feet is selecting foot friendly shoes. Narrow shoes (most modern footwear) is problematic because the toes are compressed which can lead to inhibition (shutting off) of the important stabilisers of the feet. Therefore, if tolerable, opt for minimalist footwear (we recommend VIVOBAREFOOT) or go barefoot while performing daily activities. Minimalist shoes allow the toes to move through a greater range of motion and can effectively strengthen the muscles of the arch when worn routinely throughout the day. However, they are not recommended for long distance running in those with low arches due to the increased risk of plantar fasciitis.
Is chiropractic for plantar fasciitis safe?
Yes. Chiropractic is widely recognised as one of the safest, drug-free, non-invasive therapies available for the treatment of nerve, muscle and joint complaints. Most patients experience immediate relief following chiropractic treatment for plantar fasciitis however, some may experience mild soreness, stiffness or aching, just as they might after exercise. Current research shows that this discomfort typically fades within 24 hours.
Are you suffering with plantar fasciitis?
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Reproduced from Liebenson. C., Journal of Bodywork and Movement Therapies
- Eftekharsadat, B., Babaei-Ghazani, A., & Zeinolabedinzadeh, V. (2016). Dry needling in patients with chronic heel pain due to plantar fasciitis: A single-blinded randomized clinical trial. Medical journal of the Islamic Republic of Iran, 30, 401
‘Chiropractic for Plantar Fasciitis’ was written by Steffen Toates. Steffen is a chiropractor at Dynamic Health Chiropractic in Jersey, Channel Islands. For more information about Steffen click here.