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Stupid Medicine, Part 3: Plantar Fasciitis

Truth be told, plantar fasciitis, the latest entry into stupid medicine, isn’t as mind-numbingly stupid as some other conditions that we have covered and will cover in the stupid medicine annals. But it’s still pretty stupid.

Plantar Fasciitis

For instance, here’s a look at WebMd.com’s list of the most common causes of plantar fasciitis:

• Common if you pronate (have flat feet)
• Common if your arch is too high (the opposite of flat feet)
• Worse for some people first thing in the morning
• Worse for some people as the day goes on
• Common in young people who run a lot
• Common in older people who are inactive and have arthritis

Essentially, according to WebMd.com, plantar fasciitis is common in almost everybody who wakes up each day.

Instances of plantar fascial flare-up can be accelerated by a variety of factors, such as tight calf muscles, poor shoes, and prolonged periods of standing. But the single biggest factor — and the most overlooked cause of plantar fasciitis — is loss of proper joint movement in the foot.

Here’s a quick test for you: how many bones, joints, and muscles are in the foot? Take a second to look down at one of your feet to do a candy jar estimate. Remove your shoes and socks, touch your foot with your hands, and feel around. You will notice numerous bones, joints, and muscles that make up the foot and ankle.

More than 100 muscles, tendons, and ligaments, as well as 26 bones and 33 joints exist in your foot and ankle.

Each of the joints in your foot and ankle is supposed to move smoothly and fluidly, but with poor footwear, tight muscles, and excessive use, it is common for joints to move out of place by just a little bit. When a joint is stuck out of place, it tends to lack movement, which then affects the soft tissues around the foot, especially along the sole of the foot from the heel to the underside of the toes.

And herein lies the stupidity of most traditional plantar fasciitis treatment: the pain will persist and the patient will struggle if the treatment calls for fitting for orthotics, calf stretches, or worse still, surgery, without first correcting the dysfunctional joints.

The joint dysfunction has to be corrected first, before the soft-tissue work can be effective.

Don’t get me wrong. Exercises and yoga movements specifically for plantar fasciitis have been effective, and the correct exercises will help to facilitate normal or at least, better joint movement in the foot, thus promoting healing.

If you have been struggling with plantar fasciitis here is your prescription:

1. If the pain is severe, see your doctor to rule out more serious pathology, such as a heel spur. They will have to take an X-ray of the foot to do this.
2. In most cases, the pain is soft tissue and joint in nature. Schedule an appointment with your chiropractor or physical therapist and be sure to ask, “Do you mobilize the joints of the foot?” Remember that all practitioners aren’t the same and don’t practice the same, so you must be assured that they are proficient in mobilizing foot joints before you schedule an appointment.
3. Treat the soft tissue. Active Release Technique, Graston Technique and dry needling have all been shown to mobilize the soft tissues of the foot.
4. Do your home exercises and stretches.
5. In some cases, nutritional support to reduce inflammation and promote healing should be considered.

If you have struggled with plantar fasciitis, don’t hesitate to contact our office to see if we may assist you with your questions.

Read more posts on Stupid Medicine.

 

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