Plantar fasciitis and foot pain; is it a foot problem or a body mechanics problem? Who should you see first and why?

Plantar fasciitis is a condition that involves pain on the bottom of the feet, involving a fibrous tissue called the plantar fascia. If you believe what you read on WebMD as well as other health sites, you are likely visiting a local podiatrist first and having things done to the bottom of the foot that may or may not relieve the pain.

They may send you to therapy to have you do things such as ultrasound to the bottom of your foot and to loosen the muscles in the calves, yet after weeks of this stuff, your problem may not resolve.

An injection may relieve the pain or it may not.

Most podiatrists recommend night splints that stretch the calf and plantar fascia at night which may or may not relieve the condition.

Most podiatrists will also recommend expensive custom foot orthotics  to correct foot problems that may be causing the problem.  Some patients find themselves paying over 600 dollars for a custom set of these devices that are merely a splint that goes under the foot that you wear.  Some patients report this help, many who do get relief stop wearing them when they feel better and others say they do not wear them due to comfort, fit or other reasons.  Most report that they were told to wear them in their sneakers or at the gym.

Do you need expensive foot orthotics to relieve your foot pain?  This depends on who you speak with. Most podiatrists have developed a profitable business of selling custom insoles which can be beneficial if you wear them all the time.   On the other hand, a properly selected off the shelf insert can be quite beneficial as well, and they are not subjected to casting errors which is common with custom insoles. Why custom vs. off the shelf;  If you are wearing out an off the shelf insert in under 6 months, consider custom instead which can last up to 5 years.  and ultimately, may be less expensive than constantly replacing off the shelf devices.  If you have very flat feet, a custom insert may be your only good option.   Devices prices in excess of $500 are simply, overpriced.

Foot orthotics should level of the hips and make the impact at the ground more symmetrical, which will improve the way your core and legs function. Spending more does not improve how this happens necessarily, but the quality of the casting technique determines whether the device is effective. A good off the shelf orthotic can often do the job quite well at a lower cost and there are many off the shelf inserts that are helpful. A knowledgeable healthcare professional can help you choose the best choice for you at the most affordable cost.

Traditional approaches like these are costly and are merely treating the tip of the iceberg, the foot.   Patients who have experienced plantar fasciitis are also likely to eventually have knee pain from meniscus tears, back pain, and even hip problems or should issues.

Most podiatrists will send you for therapy, again for the part meaning the foot and the calf, while ignoring the rest of the body which would require another prescription. If you have ever watched people walk in the park, do feet walk in the park or do people who have feet walk in the park.  Most healthcare providers treat us as if our feet and our bodies are not contiguous structures that affect each other.  Plantar fasciitis is a problem that requires a holistic evaluation and treatment to resolve the mechanism behind the condition.

The problem with medically-based management of the condition is that most podiatrists and medical providers fail to understand the condition while following standard medical methods that treat the symptom while ignoring the reason you are in pain; impact. The problem with the condition is that our current understanding and expectations for how to treat this problem and what you, the consumer should expect is exceedingly low.   If we resolve the problem, a number of other physical problems may resolve as well; if we use typical medical pathways of treatment; most people will develop other problems months or years later and may endure procedures, injections, and surgeries that were preventable.  The problem with plantar fasciitis is how we move against gravity, which is different from person to person and requires a personalized approach to care.

What you and your doctor do not understand about plantar fasciitis can hurt in ways you could only imagine years later.

If the idea that plantar fasciitis is not just a foot problem is new to you, you should consider reading the book Cheating Mother Nature, what you need to know to beat chronic pain.   Do your feet hurt because the pain comes and goes or are most healthcare professions failing to understand the mechanism behind why they hurt, instead of relying on an outdated understanding of the problem that is represented in Webmd.

Plantar fasciitis is a problem of impact, that can vary from person to person since we are all built differently.  People with flat feet or very high arches and who are built asymmetrically are most likely to suffer from the condition because their legs are very tight as a result of the distortion of the core muscles.   When the core muscles and the fascia surrounding them tightens over the years in someone who is asymmetrically built, the core distorts and restricts motion which loads the lower legs and the fascia surrounding them.  This fascia runs underneath the foot like a sock and when tight, reinforces the distortion in the core muscles.   A very inefficient body style will result in inflexibility, tight legs, and problems in the knees and feet from impact.  For those who run, they are likely to run more slowly as well as have more injuries from running that may include heel pain, foot pain, plantar fasciitis, and stress fractures.  In other words, their body mechanics increase the impact at the ground.

Secondary compensations in the upper body will affect the neck and shoulders as well.   This also reinforces the high level of impact at the ground and the distortions of the lower and upper body are behind most chronic pain people experience since the distortions of posture will strain the joints in the back, neck, and pelvis.

The latest literature seems to suggest that most medical approaches to back pain are inappropriate since they attempt to treat a body part, rather than understand the problem is one of movement and impact. Surgical approaches often fail miserably, resulting in millions of failed back surgeries. Recently, the British Medical Journal suggested that most meniscus knee surgeries done arthroscopically have little or no benefit over time. People have often turned to opioids and other medications for relief, often through pain management while other medical methods often fail because they are treating pain while ignoring the mechanical mechanisms that cause it.

Plantar fasciitis is a result of asymmetry and impact.  The typical piecemeal approach rarely solves the problem long term because it assumes that if we throw enough solutions at the problem, regardless of the cost, the patient will improve.  For those who have had the problem, they realize that the path to relief is not the path to resolution.

There are no simple solutions to the condition, however, and integrated approach that involves gait retraining, sensible inserts for your shoes, myofascial release and core retraining can often be found at your chiropractor’s office, your one-stop shop for properly managing the holistic needs of impact problems such as plantar fasciitis.  Stop suffering today by clicking here.