Plantar Fasciitis and Custom Orthotics

Foot and heel pain are common complaints that we see in our office. Unless it is injury related, one of the most common reasons for foot pain is a condition called plantar fasciitis. It is characterized by pain and tenderness around the heel and bottom of the foot. This condition describes inflammation of the band of connective tissue called the plantar fascia that connects the heel to the base of the toes at the bottom of the foot. From years of prolonged standing, walking, or running on hard surfaces this band can be stretched, allowing the arches to drop. The tension from that prolonged stretching can irritate the spots on the foot and ankle where the plantar fascia inserts. It can even cause the shape of the bone to change leading to heel spurs. While it appears unlikely that heel spurs are the direct cause of heel pain, the bony changes reflect the amount of tensile force that the plantar fascia exerts on its attachments as the arches drop.

Custom orthotics are designed to restore the structural integrity of the bridge that the plantar fascia stretches across. When indicated, they can increase the arches and correct poor foot posture.  When the arches are built up and foot posture is improved, tension on the plantar fascia may be lessened and symptoms hopefully reduced. There is an inherent dependency that is created with custom orthotics; however, if conservative therapy, stretches or exercises fail to improve symptoms, they can provide a potential solution for not only the pain, but the structural problem.

The first step for individuals with this type of foot pain is to visit their appropriate health care provider for an assessment to determine if plantar fasciitis is the proper diagnosis and to determine what proper course of care should be. The foot is not a static, immovable structure. Your feet move through a complicated pattern with each and every step you take, all day long. The function of the feet, ankles, knees, hips, and spine should be taken into consideration when coming up with a treatment program. Often, stretches and exercises can be prescribed to improve movement, flexibility strength, stability and coordination. While common treatments may consist of various forms soft-tissue therapy, laser (FAQs: ClassIV Laser), acupuncture, ultrasound, joint mobilization or manipulation to assist with the functional improvements and to decrease pain. Custom orthotics are not usually used as a stand-alone treatment for plantar fasciitis.

Here are examples of some very basic stretches and exercises that are commonly used:

Sitting with one leg extended out in front, place towel under the ball of your foot. Gently pull foot back towards your shin. Hold each stretch for 30 seconds. This stretches the bottom of the foot and the calf muscles that tend to be tight with patients who have plantar fasciitis.

 

 

 

While seated, place marbles, pennies, or a towel on the floor. Use the toes to pick up the various objects. Two sets of 12 repetitions daily are normally recommended. This exercise is used to slowly build up strength and coordination.

 

 

 

Place a water bottle with either cold or frozen water under the arch of the foot. Roll foot back and forth over the bottle. Daily for approximately five minutes each time and up to 4 or 5 times per day.  Other suggestions I have come across include using golf balls, tennis balls, or dryer balls. While this is done mainly to improve symptoms, it can be very helpful when done daily.

 

Depending on each individual, we will provide exercises according to each patient’s needs. Occasional follow up appointments are needed to progress the patient’s exercise program, provide treatment, or to modify the orthotic supports if needed.

For more information about custom orthotics or plantar fasciitis, please don’t hesitate to contact our office or comment below. Please visit: http://www.solesupports.com/PUBLICHOME.aspx or see thisvideo to learn more about the type of orthotics we offer.

Examples of exercises provided are courtesy of Phases Rehab exercise prescription software.

Dr. Chris Enns, B.Sc., D.C. has been a Winnipeg chiropractor since 2005.  He is the owner of Balance Chiropractic and Wellness Centre, located at 121 St. Anne’s Rd in Winnipeg, Manitoba.  Services include: chiropractic, massage therapy, athletic therapy, orthotics, spinal decompression therapy, laser therapy, x-ray services, and health and fitness consulting.

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