Plantar Fasciitis

PF is noteworthy in that it is the only diagnosis that even acknowledges the existence of fascia.  Debate has persisted over what to name it:  plantar fasciosis, plantar heel pain, heel spur, and runner’s heel.  Call it what you like, those who have had it (me included) know that it can be pretty debilitating.  As with so many diagnoses, the literature states it is fairly common yet the cause is unknown.  The “idiopathic” nature of PF does not imply that there is no cause for it, as the body always has a reason for what it does.  Rather, it implies that the cause or source has yet to be identified.  Considering that fascial densifications stem from overload to the connective tissues, it’s good to consider sources of overload that may perpetuate the problem: non-supportive footwear, excessive walking / running, or even trauma such as an ankle sprain can contribute to PF.

 

PF has no clear diagnostic criteria like lab results or imaging that clearly implicate PF.  Instead, like so many other maladies, the diagnosis is based on the symptoms reported:  pain in the bottom of the foot/feet, usually worse upon rising in the morning or after a period of sitting which gradually improves with walking.  PF can eventually subside as mysteriously as it appears, making the “wait-it-out” approach seemingly appealing.  But I would suggest there are issues with this:  first, it’s tough to carry on in life while hobbling around on a painful foot – ask my friend.  Second, the “wait” approach does not address / resolve the root cause(s) behind the PF, leaving it like a dormant volcano creating compensations up the kinetic chain. While the foot pain may subside, the persistent densifications are still exerting their impact.  Bladder issues are a good example, and can accompany PF – often years later.  This is because of the continuity and connections of the fascia throughout the body, warranting a holistic perspective.

 

So what can be done for PF?  The literature does not show overwhelming support for the barrage of interventions typically thrown at the problem.  Some research supports the use of shock wave therapy, but units are expensive barring many practitioners from access to them.  In some cases people are desperate enough to resort to injections and surgery where the plantar fascia is cut.  I would suggest there is a better way, and as you might have guessed, my go-to for PF is Fascial Manipulation® Stecco.  Over the years I have found it to be far more successful at resolving not only plantar fasciitis, but a host of other diagnoses that often accompany PF.  It’s remarkable how often when I’m getting the history from someone seeking help for another problem that they relate a history of PF in their past.

 

Frustrated with stiffness and pain by any name, or looking for alternatives to medications, testing, and surgery?  Give me a call or send me an email to discuss your situation, or go to my website and schedule an in-person or virtual session. You have options – act on them!

References:

1. Cruz‐Montecinos, C., González Blanche, A., López Sánchez, D., Cerda, M., Sanzana‐Cuche, R., & Cuesta‐Vargas, A. (2015). In vivo relationship between pelvis motion and deep fascia displacement of the medial gastrocnemius: anatomical and functional implications. Journal of anatomy, 227(5), 665-672.

2.  Grim, C., Kramer, R., Engelhardt, M., John, S. M., Hotfiel, T., & Hoppe, M. W. (2019). Effectiveness of manual therapy, customised foot orthoses and combined therapy in the management of plantar fasciitis—a RCT. Sports, 7(6), 128.

3.  Pawlukiewicz, M., Kochan, M., Niewiadomy, P., Szuścik-Niewiadomy, K., Taradaj, J., Król, P., & Kuszewski, M. T. (2022). Fascial manipulation method is effective in the treatment of Myofascial Pain, but the treatment protocol matters: a Randomised Control Trial—Preliminary Report. Journal of Clinical Medicine, 11(15), 4546.

4.  Stecco, C., Corradin, M., Macchi, V., Morra, A., Porzionato, A., Biz, C., & De Caro, R. (2013). Plantar fascia anatomy and its relationship with Achilles tendon and paratenon. Journal of anatomy, 223(6), 665-676.

5.  Tognolo, L., Giordani, F., Bernini, A., Ruggerieri, P., Stecco, C., Frigo, A. C., & Masiero, S. (2022). Myofascial points treatment with focused extracorporeal shock wave therapy (f-ESWT) for plantar fasciitis: an open label randomized clinical trial. European journal of physical and rehabilitation medicine, 58(1), 85.