PLANTAR FASCIITIS - WHAT IT IS AND HOW TO GET RID OF IT

Plantar fasciitis is a very common and very frustrating problem. I used to dread when patients would be on my schedule with this diagnosis because it was hard to completely resolve. But that was when my approach was very passive…stretch, ice, tape, rest.

Over the last 5 years or so, I have learned more about our feet and mechanics to learn that we need to be active in our approach to heal the very painful plantar fasciitis. The plantar fascia that runs along the bottom of the foot from the forefoot to the heel is a tissue that is elastic but does not like to over stretch. If a foot is weak, over fatigued or not supported enough, then the arches will collapse to the point of over stretching the fascia tissue. This repeated overstretching at the insertion point on the inner heal causes inflammation and significant pain with every step.

The goal is to calm down the inflamed tissue by reducing the stress. This can be done by temporary providing arch support (footbed, tape) and strengthening the foot and lower legs muscles to support the arch. We don’t have inherently strong feet due to use of shoes and little foot focused work so making sure the foot mechanics are ideal is important too.

Dry needling is a tool that works very well to reduce the symptoms quickly. It will often reduce or completely remove symptoms temporarily.

I get a lot of patients who finally come see me when they have ‘tried everything’ that they can find online with no real change. So if you have been passively trying to heal this and not seeing major improvement then it is because the approach is old school.

Foot strengthening, assessing and changing foot mechanics, dry needling and managing volume all work really well. AND if this is a new symptom with pain on the inner heal then get on top of it as quickly as you can. Last week, I had a patient come in who had symptoms for 10 days - I did an assessment, dry needled the heel and gave him a strength program. He is heading out on a hiking trip this week and is feeling confident and encouraged with the significant reduction in symptoms after one visit. We will probably meet up when he is back. It is not always this quick but runners, hikers and movers all get back to pain free eventually!