4 Ways To Manage Plantar Fasciitis
Plantar fasciitis (PF) can be extremely painful and very difficult to manage. It is also an injury that is slow to heal and tends to reoccur for some. The plantar fascia is a very dense, fibrous tissue located in the sole of the foot. It is such a commonly used term that most people with foot pain refer to the term PF even when the fascia is not the tissue in question. A brief summary of the PF: it is a dense/thick band of fibrous tissue that begins just distal to the heel bone (calcaneus) and travels to the toes. The tibial nerve gives rise to 2 nerves, the medial and lateral plantar nerves. These nerves play a significant role in managing “PF” effectively.
At Chanhassen Chiropractic, we manage this condition effectively with a variety of different non invasive treatment options.
Active Release Techniques (ART)
ART is used to mobilize restrictions in the soft tissues (muscles, tendons, nerves, ligaments, fascia) to break down adhesions, or areas of congestion, where the tissue feels tight and it is not “sliding” well. One of the most common findings with PF is the lack of mobility in the ankle joint as well as the great/1st toe. Bunions are also a source of PF as the angulation of the great toe changes the tension/stretch on the medial side of the plantar fascia, thus leading to increased tension or inflammation at the tendinous attachment at the heel. Tightness in the calf musculature as well as a tibial nerve entrapment in the lower extremity can also mimic PF. Another site of tibial nerve entrapment that mimics PF is at the tarsal tunnel (medial/inner ankle area). This is commonly seen with people who have excessive pronation of their foot/arch as the pronated position of the foot increases nerve tension in the tarsal tunnel.
Dermal Traction Method (DTM)
DTM is a great method for fast acting relief from PF symptoms. The idea behind DTM is to create more space for the nerves within the skin and fascia using a pinching or rolling motion of the skin while simultaneously using a body motion to “floss” or pull the nerve back and forth through its space. The treatment can be done very quickly and the best part about DTM is the ease in which you can teach your patient to use DTM at home to manage their pain.
Needling the trigger points/adhesions upstream from the PF symptoms can provide significant relief in PF patients. As mentioned earlier, the root cause of the heel pain may be coming from the calf, the tarsal tunnel, a sciatic nerve issue in the hamstrings or an issue in the lumbar spine. All areas must be addressed when looking at PF pain, especially when the PF does not appear to be inflamed or palpate abnormally.
Shockwave Therapy uses precise pressure waves that stimulate metabolism, enhance blood circulation and accelerate the healing process in damaged tissue. This non invasive, highly effective treatment provides relief of tendon insertional pain, such as plantar fasciitis. If the PF itself is found to be very fibrotic during examination of the lower extremity, shockwave is an excellent choice to help the tissue start the healing process.
Dr. Gervais utilizes these methods of treatment and more at Chanhassen Chiropractic to help many patients overcome their PF and PF symptoms. Depending on the severity and how long you have had PF, this will play a role in which method is recommended for your recovery. Most patients experience a relief in their symptoms after 1-3 visits with full recovery sometimes taking 6 visits or more.
Stop living in pain and regain control of your health today! You deserve to feel well, move well and live a pain free life!
Thank you for stopping by to read!
Brian Gervais, DC, CCSP, L.Ac.