Treating Plantar Fasciitis / Heel-Spur Syndrome
From an article by 'Michael Young', NCTMB:
I have heard numerous complaints from my clients, coming in for their
regular massage therapy treatments, about excruciating foot pain. Some
would complain the pain was in the bottom of the foot, while others
complained the pain was in or around the toes. Most would comment that
the pain was considerably worse in the morning, making it almost
impossible to walk when first getting out of bed. Many clients said
their doctor had diagnosed this problem as 'Plantar Fasciitis'. I
started investigating the best way to help my clients suffering from
this ailment. My investigation led to a treatment program that has given
my clients permanent relief.
What is Plantar Fasciitis?
The plantar fascia is a ligament-like band, running from the heel
ball of the foot. This band pulls on the calcaneus, raising the arch of
the foot as it pushes off the ground.
'Plantar Fasciitis' is also known as heel-spur syndrome. It is
problem among people who are active in sports, particularly runners. It
starts as a dull, intermittent pain in the heel. If not treated
correctly, it will progress to a sharp, persistent pain. Classic
symptoms include pain that is worse with the first few steps in the
morning, pain after sitting or standing for prolonged periods, and pain
at the beginning of a sporting activity. Problems may occur when part of
this inflexible fascia is repeatedly placed under tension. This can
occur in various situations, such as running or when people who sit at a
desk hold their heels off the floor for long periods of time. This
tension causes an overload that produces inflammation, usually at the
point where the fascia is attached to the calcaneus. The result is pain.
Plantar Fasciitis may also occur at mid-sole or near the toes. Since
it is difficult to rest the foot, the problem gradually grows worse. In
severe cases, the heel is visibly swollen. An inflammation process at
the calcaneus may produce heel spurs, yet heel spurs do not cause the
initial pain or problem. Rather, they are the result of the prolonged
muscle tension. If untreated, these heel spurs will cause sharp pain
Podiatrists and orthopedic surgeons claim that some contributing factors
to 'Plantar Fasciitis' and heel spurs include: poor shoe support, the
aging process, high arched feet, toe or hill running, family tendency,
flat feet and running on sand.
Conventional Medical Therapy
Doctors use ice, medication, physical therapy, orthosis (sometimes
as orthotics), taping and finally, surgery. Let's take a closer look at
each of these treatment protocols.
Most soft tissue injuries are caused by muscles and tendons
are shortened. When a person has short, tight muscles, the result is a
lack of circulation resulting in inflammation. Ice will numb the area,
giving temporary pain relief. However, ice does nothing to increase
circulation. In fact, it slows down circulation. Without circulation, no
healing can take place. Thus, ice is only treating the symptoms by
masking the pain for a short while.
Doctors prescribe strong, anti-inflammatory drugs
these drugs have many side effects. In most cases, drugs simply mask the
problem, making the injured soft tissue feel better temporarily. Then
the person tends to use the muscles even more, adding to the tension in
the muscles. Plantar Fasciitis is not caused by a drug deficiency.
Therefore, drugs are simply a quick fix to mask the pain.
The objective of physical therapy is to strengthen
muscles. If one strengthens a muscle, that muscle gets shorter and
tighter, resulting in less circulation, as well as causing more
adhesions and scar tissue. If strengthening was the answer to 'Plantar
Fasciitis', then runners would never have that affliction. A runner's
muscles are very strong. Runners develop 'Plantar Fasciitis' because
their strong muscles get shorter and tighter, through overuse.
Orthosis or Orthotics:
These are inserts a person wears inside
shoes to support the foot. These inserts range in cost from $150 to
$500. According to The Whartons' Stretch Book, by Jim and Phil Wharton,
"Myth #10: Flat feet and fallen arches are corrected by support devices
that are put inside the shoe, right? Wrong. If you put a support in your
shoe, you are guaranteeing that your 'spring' has nowhere to go and your
shock absorber can't absorb shock. It will feel good temporarily,
because it will relieve tension in your foot, but, long-term, it will
accomplish nothing." In other words, these devices only treat the
symptoms by allowing the already tight muscles to remain that way.
Taping will relieve the tension, in a manner similar to
orthotics. This is, however, only a temporary fix.
The surgeon goes in and cuts the fascia in the bottom
foot. At times, the tendons are even cut. This is an invasive and
unnecessary solution. The human body is an amazing creation. Each
tendon, muscle and organ was placed there for a particular purpose.
After all surgeries, scar tissue develops. These tissues form in
irregular patterns which are often stronger than the original fascia. As
the body heals from the invasive surgery, the problem redevelops since
the original cause was not addressed.
The Common Sense, Permanent Treatment:
Plantar Fasciitis is an injury derived from repetitive use, similar
Carpal Tunnel Syndrome. Like any repetitive use injury, the muscle is
stressed from overuse. The fibers in the muscle get tighter and tighter.
This, in turn, leads to the muscle losing its memory of a normal relaxed
state. Adhesions and scar tissue build up. As the muscle tightens, less
circulation is supplied to the damaged tissue.
This results in inflammation. The attachment sites of the muscle
to get sore from this constant pulling. Pain results from the oxygen
deprivation of the muscles, tendons and attachment sites.
The culprit is a short, tight muscle or a group of tight muscles.
sense does it make to strengthen an already tight muscle (conventional
physical therapy), or to take drugs to mask the problem? Orthotics and
taping also treat only the symptoms. Surgery is an extremely radical way
to treat the symptoms. Instead, all that is necessary to get a person
out of pain and on the road to complete recovery is to release the
powerful muscles that drive the foot. As the Whartons write, "to avoid
Plantar Fasciitis, concentrate your flexibility work on the lower leg,
ankles and feet."
Miracle treatment? No. Simple common sense. This is "the missing
that the health professionals and specialists are not focusing on. The
specialists seldom look at the muscles when searching to discover the
culprit for Plantar Fasciitis, Carpal Tunnel Syndrome, Thoracic Outlet
Syndrome, Tendinitis, Hammer Toes, Tennis Elbow, Piriformis Syndrome,
most sciatic problems and more.
What Complementary Therapies can help with Plantar Fascitis?
Massage and Reflexology is very helpful for stretching out the muscles and increasing flexibility. Combined with Acupuncture or Craniosacral Therapy, this can help increase circulation of blood to the muscles in the area and reduce the pain as treatment progresses. If posture is problematic or contributing to the problem in any way then Alexander Technique can be helpful to address this.