Stride Strong PT’s Formula
• Delineate offending structure and determine whether pain is truly plantar fasciitis, or neurodynamic dysfunction originating from the spine.
• Manual therapy, stretching and ASTYM to improve soft tissue pliability and decrease pain.
• Strengthen gluteal muscles for better loading mechanics during weight-bearing to offset pressure into the foot.
• Taping, orthotics guidance with concurrent modalities to decrease further strain on the foot.
Plantar Fasciits is the inflammation of a band of fibrous tissue at the bottom of your foot. Aching or sharp pain usually occurs in the inside arches of your foot, and/or sometimes is focused around the bottom aspect of the heel bone. Stretching pain is usually most prominent upon the first step in morning, and usually feels worse the day after bouts of increased walking, running or standing.
What causes it?
Excessive loading of the foot usually is the main cause of plantar fascia pain. This can be a result of an increase in walking or running mileage, increased jumping activities, or even weight gain.
Folks with both low and high arches can experience this, and is also usually associated with tight calves, and tight achilles tendons. Walking and running in unsupportive shoes may also be a contributing factor.
What you can do about it:
1) The easiest first-measure solution is to move into more supportive shoes. Look for shoes with inner arch support, or look for over-the-counter arch inserts like Superfeet. Be sure to try them out first in the store as there is sometimes an adjustment period before you feel completely comfortable with them. Some shoes have too much support so make sure you go to a reputable athletic shoe store like FitRight, or a family shoe store like Shoe Mill, so their associates can fit the best supportive shoe for you.
2) Manual therapy by our physical therapist can help with softening up fibrotic tissue and reduce inflammation of the fascia. ASTYM is a very popular approach with excellent results. It may be uncomfortable at first, but effects and relief are felt immediately. Stretches of calf structures, and self-massage exercises are usually prescribed to make sure the tightening pain is kept at bay. Gluteal/hip strengthening also helps tremendously in treating faulty biomechanics related to the strain of foot arches. Over-pronation is sometimes a culprit, which can be corrected by changing the landing angles of the foot and knee in walking and running. Physical Therapy for plantar fasciitis need not be a long stint of rehab – 4 weeks is the usual timeframe of PT needed for your feet to feel ay-OK again.
3) We can also help arm you with accessories and tools to help in your recovery – e.g. some patients report really good results from using night splints or boots. My personal favorite is The Strassburg Sock (sold online and at FitRight).
4) In some serious cases, a podiatrist’s intervention may be what you need. They will prescribe PT as the first conservative approach and may move into cortisone injections when warranted, or suggest surgery options.
Our Physical Therapy Portland Clinics are both well verse in treating Plantar Fasciitis patients.
By Alice Holland, DPT.
Alice’s Google + page.
Doctor of Physical Therapy, Director at Stride Strong Physical Therapy