Kimbrell’s Health Korner

Plantar Fasciitis— A pain in the heel

BY GRAY KIMBRELL

If when you get out of bed in the morning your foot is stiff and painful near your heel, you may be suffering from, a relatively common affliction called Plantar fasciitis. This is an inflammation of the strong connective tissue that spans the plantar surface (the bottom of the foot) from the front of the heel to the base of the toes. It may also be called a heel spur, which is bone the body lays down on the front of the heel bone in response to a long term shortening of the tissue along the bottom of the foot.

This is a chronic overuse injury characterized by significant heel pain. It is usually worst upon arising in the morning, or after activity. It is a problem that may worsen over time if left unattended.

There is a reason that the pain is at the heel. Imagine this connective tissue (fascia) in the shape of a triangle, with the point of the triangle attached to the heel, and the base of the triangle connected to the joint area at the base of the toes. The stress point is at the heel, or the point of the triangle. As the tissue contracts it pulls on this bony attachment,causing irritation and pain.

Some of the potential causes of plantar fasciitis may include standing for long periods of time on hard floors in hard-soled shoes (This was a common problem for factory workers on their feet all day on concrete floors). Tight calf muscles/ Achilles tendons, flat or high arches, running in worn out running shoes or a sudden increase in the level of activity may also be contributing factors.
What we can do to help promote the healing process? The culprit is shortened fascia, or connective tissue; so we lengthen it.

Some of the ways we do this, in addition to what you are doing for yourself would be to:
•Employ chiropractic manipulation to the joints at the base of the toes, and heel.
•Active myofascial release work to affected areas and to calf muscles to induce lengthening of the fascial network. This is an important aspect because on a cellular level adhesions may develop within the tissue that make it difficult to lengthen by self-stretching. (You can’t stretch a rope.)

•Demonstrate appropriate stretches, after the hands on work is done.
Treatment that you can do for yourself:
•Rest it
•Ice after activity to reduce inflammation (in the form of ice massage 5-7 minutes is the most efficacious)
•Regular stretching of the calf and the Achilles tendons.
•Standing on a tennis ball and rolling it lengthwise front to back 3-4x with as much weight as possible on the ball. The focus here is on lengthening the shortened fascia.
•Wearing well cushioned shoes with good support.
•Orthotics or shoe inserts to support the arch of the foot.

This can be a long term aggravating problem that can often times be alleviated if it is attended to as soon as you notice it coming on. As with many other musculo-skeletal issues, the older it is, the longer it takes to get resolved.