Plantar Fasciitis: What a pain in the ……heel!
Have you ever overdone it pounding the pavement, or been on your feet all day and noticed the bottoms of your feet are aching? Then in the morning instead of feeling better after resting, the first step of the day is excruciating heel or foot pain. Once you get moving the pain subsides a little but never really leaves you. These are all telltale signs of plantar fasciitis (PF).
What is PF?
PF is a chronic inflammatory condition of the plantar. The plantar is a thick, fibrous ligament that covers the heel and bottom of the foot. It acts as a stabilising wrap holding all the bones and muscles at the bottom of the foot together.
Why does PF occur?
PF usually occurs due to an over use injury or a rapid increase in exercise too quickly. You know, kind of like when you realise it’s three weeks until that big wedding and to get into shape you decide to walk 25km in a day, then you wake up and can’t walk!
The problem with PF is that ligaments and fascia-like tissue are very strong fibrous structures and have minimal blood flow. So once they become inflamed and obtain micro tears, it’s very difficult to turn that reaction off and get on with healing (excuse the pun). So before you know it the debilitating heel pain is chronic and really impacting your life.
What can be done?
There are a number of treatment options for PF that are usually carried out by sports physicians, physios and podiatrists. Examples include:
- Stretching and strengthening
- Strapping or splinting
- Cortisone injection
- Platelet rich plasma injection
These are all reasonable options and evidence has shown them to improve PF. However, positive results often take time. It’s not unusual for PF to take up to 18 months to improve. That’s a really long time to be hobbling around the place.
A little voodoo acupuncture can go a long way
Another option to consider is acupuncture. In particular, the Balance Method or ‘distal acupuncture’. When the heel or plantar is inflamed and sore, poking around the painful area and using local needles tends to stir the pot and create greater discomfort.
The balancing method applies mirror imaging when treating the body, meaning it can treat one body part by inserting needles into another part. For example, if the pain is the right heel we might choose to needle the left wrist or palm. As there are no acupuncture needles in the foot in question, this allows us to test the area of pain whilst performing the treatment to make sure the pain has reduced and to ensure we are on the right track. Whilst performing the treatment we hope to eliminate the pain altogether or reduce to a low grade. It’s common for the pain to return after the treatment, particularly if the problem is chronic. However, if we perform a few treatments in quick succession the intensity and frequency of the pain will likely be much less or gone, and treatment takes not weeks or months but only a matter of days.
In conjunction with acupuncture I always recommend a thorough stretching program not just for the foot but the leg as a whole. Recent research has also provided evidence that a slow and steady strengthening program can help prevent PF from recurring.
Some tips to get you started!
If you feel heel pain, don’t ignore it. Here are some things to do initially that may help, though if the pain persists you should get some help!
- Calf stretching: Very important to reduce the pressure being relayed to the foot. Try to hold the stretches for at least a minute to allow the deep fibres in the muscle to release pressure in the foot.
- Pressure point work: Use a massage ball or homemade tape ball to roll the calf and foot on. Hold until you feel the area release.
- Plantar stretch: Do first thing in the morning and with calf stretches throughout the day.
- Check shoes: Make sure the shoes you are wearing are supporting your feet well. Preferably lace-up and not too old.
Chinese Medicine Practitioner
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Schwartz, Emily N., and John Su. “Plantar fasciitis: a concise review.” Perm J 18.1 (2014): e105-7.
Thiagarajah, Anandan Gerard. “How effective is acupuncture for reducing pain due to plantar fasciitis?.” Singapore medical journal (2016).
Cotchett, Matthew P., Shannon E. Munteanu, and Karl B. Landorf. “Effectiveness of trigger point dry needling for plantar heel pain: a randomized controlled trial.” Physical therapy 94.8 (2014): 1083.