Plantar Fascia Issues Explained.

Ouch!  Even the term Plantar Fascitis will bring a cringe to anyone that has ever suffered from this issue.  This injury has been known to sideline runners for months and can affect anyone.  

Rest assured, this issue is treatable.  

There is no simple fix however.   Sorry.  This one will take some work.

Even more importantly just doing more isn’t the answer.  You need to be doing the CORRECT work and this varies and changes with your condition even week by week.    That’s why simple answers like “Wear these. Do This stretch or Roll on this.” Don’t work well.

You need to put in some time and you need to pay attention to what is and what is not working!

That’s why you have this handout.    Without a little basic understanding, you are going to fail.   Putting your time into some basic “at-home rehab exercises” can speed the healing considerably but relying on your chiropractors, PTs, and doctors to fix this for you set up a long road to failure.

You really need to appreciate the rules of treatment and understand what you are trying to accomplish and what you should be working towards.   

 Plantar Fasciitis, as much as any other condition we see in the clinic is  SLAMMED WITH MISINFORMATION.   Everyone has an opinion of how to fix this and one treatment probably contradicts the next.    There are braces, sleeping apparatus, stretches, orthotics and tens of million dollars spent on treatments annually.   You are at our clinic now, so here’s our WHY and HOW of the way we treat this injury…

At the heart of the problem is the name itself – collectively, Fascitis (as well as any –itis) has multiple, different issues that are all called the same thing.

There are at least that 20 separate/different issues all called the same thing!

20 different injuries need different treatments if they are going to be successful. 

 See the picture above and how large of a tendon, fascia and muscle we’re dealing with?  26 bones and close to 70 muscles, facia and nerves…  There’s a lot going on and technically, almost any issue to this area will cause inflammation of some sort (itis) and now you’ve got a diagnosis –

That’s why I ALWAYS tend to dive deeper than just the diagnosis of Plantar Fascitis.

 We want to know what is happening that is screwing up the function of the foot… IE: “what is causing the –itis?”

It’s not that your friends, magazines, therapists, doctors, and YouTube is wrong– it’s just not specific – it’s giving you general information and you may not have the exact same condition, it’s just called the same thing!

So if you’re looking for, “Doc, what exactly do I have to do to fix this?”  I can’t help you with this article – it’s going to take a little trial treatment and a lot of homework to get us to the right protocol for you. 

I know it’s not what you want to hear.  I wish it was simple too, but you need the truth.

We will however give you some basic ideas that seem to really help out the healing procedure and speed up recovery time– at ASC we want you BACK IN THE GAME or ON THE ROAD OR TRAIL QUICKLY!

You need to learn about your foot.  It’s probably the most important area of your body to have working right.

In fact, I almost always tell my clients to just pay the $80 and take the online seminar from the company called The Foot Collective (TFC).  

Without understanding, we all just tend to get stuck doing the wrong things and there is no way any doctor or therapist can give you ALL the information you need to have to in the clinical setting.  We can do our best –

 But, it’s not the 30 minutes you are in our clinic that fixes your foot.  It’s the 16 hours you’re awake and doing the wrong stuff that’s the problem.  

This is what you need to know to fix PF.

OK, so let’s dive in.  In almost all cases of PF it’s not so much the pain, but the lack of proper function of the foot that is a major obstacle in the recovery of the issue.   Get the Function back to the foot and you tend to get faster results.  That’s why you won’t hear us push orthotics, braces, and long-term rest as part of our treatment protocol. 

Mobility is the key component to recovery.

  Let’s face it, function and mobility need to be present before proper stability and healing can occur.

Let me repeat that, Function and Mobility need to be present before proper stability and healing can occur.  Read it again and memorize it…that’s what my in-clinic and at-home rehab focuses on.

The 6 rules of at-home treatment

Ice – I prefer a frozen water bottle so you can strip out the fascia at the same time.   This needs to be done DAILY.  And keep working it until numb, usually 8-10 minutes.  Work the fascia out with the ridges and contours of the bottle.

Don’t use flip-flops while there is pain. Look I can’t stand flip-flops anyway, but we live on the coast, they are practical and a common part of our days.  They also force the foot to bend as one piece at the push of phase and limits the rotation you should have off the big toe.  This keeps the function of the foot… less than optimal.  Keep the flip flops if you must but save them for when your foot is fixed.

Limit your orthotics – this is where I get the most resistance in my office – these things are expensive, were ordered from a pro and you like them – I get it. But, the build-up of some arches is built to support and sometimes limit full ROM.  This really helps with pain initially but keeps perfect and proper motion while trying to fix the issue. Same reason I’m not a huge fan of the slings and braces – I want motion!

There are a few main arches in the foot and we want them mobile and functional, not limited!

Blocking these arches stops the natural movement of the foot.

If you guys are in love with these things, keep them with you but try hours on and off and see what works better.  Remember these are general rules of rehab, not laws and absolutes, everyone is different, but this seems to work in our clinic much faster than staying in them 24/7.

Force foot motion – Really exaggerate your step and the roll from the heel to the toes.  I tell clients, start on the outside of your foot.  Roll your foot and force a push off with your big toe, not all the toes at the same time – this will take practice – if you’re in pain, I will bet you can’t do this correctly.  Usually ten steps in a row a few times a day and you’ll notice a ‘release’ and freedom of motion in the arch.

ABC’s with your foot

Maybe the ONE thing that seems to help the MOST people.

Especially first thing in the morning, when the first two to 100 steps hurt. Get back into bed and put your foot through a full large letter alphabet of movement. Seriously, A, B, C….This isn’t a fix but at least you put the foot through all kinds of great ROM and it helps move the tendons, bones and fascia.   This usually at least gives notable relief on the first agonizing steps out of bed and over 7-10 days makes a HUGE difference!

The BIG 3

Play with your toes.

Foot Fist.

Wide Spread

It’s been since you were 2 years old since you played with your feet and toes!

Get this back.  It is a HUGE part of the issue.

Usually, there are other issues such as the low back, hip rotation issues, calf and anterior tibia strength ratio issues, and others.    You may run incorrectly or land incorrectly.    Like I’ve said over and over.  This issue is HUGE and complex.   Dig deeper.

The heel bone (the calcaneus) is the attachment for both the plantar fascia as well as the Achilles. It’s almost impossible to just have one single issue with this condition.  Just like everywhere in the body, one thing leads to the next. There is a systematic and bigger approach to fixing this condition than just attacking where it hurts. 

We say in the office all the time, “The victims scream, but the Culprits hide!” We want to go a little larger in our search for the culprit and correct any factors that affect the area of pain. Better stated, If you’re not moving correctly, you’re not going to be able to walk or run this condition away!

This condition takes homework.  I strongly recommend patients with this condition take the online education seminar from TFC ( The Foot Collective.) This condition is just something you need an education and understanding with.   You need to become your own best doctor and have the ability to treat yourself.

Remember that 20 different issues are all called the same thing. They are all PF in their own way. But, these 20 different injuries need different treatments if they are going to be successful.

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