Are you suffering from foot or heel pain with your first steps in the morning ? Do you live in Oakville and have you been diagnosed with Plantar Fasciitis or Heal Spurs. Get the right treatment for your foot pain from our Oakville chiropractic team. We use a combination of shockwave, ART, Graston and stretching to help our patients heal.
Our Oakville therapy team, Dr. Steve and Dr. Jenn, is starting to see an overwhelming increase in patients with foot and or heel pain with their first steps in the morning or pain in the foot after a prolonged period of sitting. Like sitting at your computer for 4 hours and getting up to go to lunch only to collapse under the pain from your heel. Our Chiropractors find a large correlation between season change and the prevalence of plantar fasciitis. This is most likely do with footwear variables. Such as loosing your heavy winter go train boots and moving to a light non supportive casual dress flip flop or ballet flat. If your doing any walking to and from work or even basic errands we recommend you wear a quality pair of shoes and possibly get yourself fitted for custom orthotics.
What is Plantar Fasciitis
Plantar Fasciitis is characterized as heel or bottom-of-the-foot pain after a period of rest. The lower calf and Achilles can often be painful at the same time. It usually occurs with the first steps in the morning. Although some in the medical community feel heel spurs are the culprit of the pain, most patients with plantar fasciitis do not have heel spurs and the ones that do can be treated as if they didn’t have any heel spurs at all.
9/10 times Plantar Fasciitis is being caused by tight calves or Achilles tendons. The Calf muscles start above the back of the knee joint and turns into the Achilles tendon 2/3 of the way down the back of the leg. The Achilles tendon then wraps around the bottom of the heel and turns into the plantar fascia. When we sleep we point our toes down causing a mild contraction of the calf muscles. When we get up from bed, the first step forces you the calves into a stretched position and causes a sharp pulling on the Achilles tendon, usually at or very close to the heel. Additionally, the body has a chance to rest and repair overnight. The plantar fascia that has micro-tears and inflammation starts to heal overnight when the tissue is in a shortened position. Those first steps in the morning re-tear those tissues when you take your first steps in the morning, and that is why those first few steps after getting out of bed can be so agonizing!
Tight Calves and Plantar Fasciitis
Tight calves can be caused by numerous factors. They can include an imbalance of the pelvis, too much or too aggressive physical activity, not enough physical activity or just an overall lack of flexibility. In today’s desk driven society we have little time for physical activity let alone stretching. Some of our patients with plantar fasciitis limit their gym time to weekends and go 110% on Saturday and Sunday only to have ZERO physical activity during the week. This can lead to tightness in the legs from both over use (on weekends) and under use during the week.
The biggest influencer of Plantar Fasciitis we see at our Oakville Chiropractic Clinic is an imbalanced pelvis. The pelvic imbalance will usually shorten one leg or rotate on pelvis forward or back. This changes the biomechanics of the patients gait causes an imbalance of the muscles and possible tightness in the calves. How does one get an imbalance of their pelvis ? Many factors play a role how the lower half of your spine associates with your hips. Tight muscles around the hip and low back or restrictions in your spine or sacroiliac joint.
Psoas and Quadratus Lumborum and Their Effect on Plantar Fasciitis
Tight Muscles of your back could be caused by a improper posture and usually from sitting at the computer too much. Desk jockeys will inherently have tight psoas or hip flexor muscles causing an imbalance in their pelvis and spine and could ultimately causing their plantar fasciiitis. The quadratus lumborum muscle also plays a large role in the positioning of the pelvis. An imbalance of the QL can cause the patient to hike one side of their pelvis and change the tension of their hamstring muscles further affecting their walking gait and the structure of the calf muscles.
Over-pronation and Plantar Fasciitis
Pronation is a normal movement of the foot. Every time we take a step, our bodies need to absorb the shock and so the arches of our feet collapse a little bit. Pronation is the ‘rolling in’ that occurs with walking and it involves the arch softening in order to absorb the shock. Pronation is a natural and necessary aspect of walking.
What happens if our arches collapse too much? We lose the shock absorbing efficiency and that can lead to problems in the feet, ankles, knees and even the lower back! When the feet collapse, the ankles also roll inwards and this starts to put abnormal strains on tissues – from the feet all the way up to the lower back! When the arch collapses too much, the muscles and arches in the feet are lengthened more than they are accustomed to, and this causes a strain. Every time an over-pronator takes a step, excess strain is put on the plantar fascia and this can eventually lead to the development of plantar fasciitis.
So how do you know if you are an over-pronator? There are some really simple ways to tell if your arch is collapsing too much. Can you fit a few fingers under the inside arch of your foot when you’re standing? If that’s too awkward to try, then take a look at your wet footprint next time you get out of the pool or shower. If you can’t see a nice inner curve of the foot, and your footprint looks more like a rectangular blob, then you are an over-pronator! Another easy way to check is to look at the bottom of your shoes. If you notice the inside edges of the shoe are more worn down than the outer edges, then there is a good chance your feet over-pronate!
What can you do if you’re an over-pronator? Be sure to wear supportive shoes and/or orthotics. This is helpful to both prevent and treat plantar fasciitis. Over-pronators are more vulnerable to developing plantar fasciitis, so choosing supportive footwear is your best chance to avoid developing this condition!
Acupuncture Treatment For Plantar Fasciitis
As we mentioned above, tight calves are a big contributor to plantar fasciitis. Acupuncture is great at loosening up tight muscles and can really help get rid of plantar fasciitis pain. Dr. Jenn can insert needles into the calves and hook them up to a stimulator to make the muscle pulse/contract. This stimulation simultaneously helps fatigue the muscle (ie – makes it too tired to be too tight) and relieves pain by reducing the input to the nerves that transmit pain.
If your chiropractor has determined that a shifted pelvis is to blame for your plantar fasciitis pain, acupuncture can help with that too! The psoas muscle that we mentioned above is deep, and can be difficult to massage and stretch. Acupuncture needles can actually reach these muscles and stimulate them directly to help them release. There is a ‘fascial pecking’ technique that is quick, painless and effective to help soothe those tight muscles. Tight muscles in the back and glutes can also be alleviated via acupuncture.
Muscle imbalances can lead to pelvic shifts and problems further down the chain – all the way into the calves and feet. Another amazing benefit of acupuncture is that it can help ‘wake up’ inactive muscles. Traditional acupuncture, and electroacupuncture, are extremely effective at promoting muscle activation, and encouraging muscles to work at their full capability. Acupuncture can essentially flick a muscle’s ‘OFF/ON’ switch to ON, and make sure it activates effectively enough to keep the pelvis balanced. When all muscles activate the way they’re supposed to, no muscles have to pull extra weight, and there’s a lower chance of injury.
Acupuncture can also be inserted directly into the problematic area to help reduce inflammation and pain. Heel spurs and plantar fasciitis both benefit from inserting the needles into the foot and heel area. This helps increase blood flow to help the tissues heal, and flushes away inflammation that irritates the nerves that cause pain. The bottom line is acupuncture is a really effective, pain-free way to treat plantar fasciitis and the muscles conditions that can contribute to it.
Shockwave Treatment for Plantar Fasciitis in Oakville
Our Plantar Fasciitis team treats all types of plantar fasciitis and foot injuries. Some are acute, some are severely chronic. One of the best treatment tools we have at our Oakville clinic is shockwave therapy. The name is a little mis-informing as the shockwave machine does not shock nor wave.
It is essentially a pneumatic gun that releases energy into the tissue in an extremely fast and precise way. The shockwave works by sending a small “bullet” in a closed tube filled with compressed air back and forth. The bullet does not leave the tube but hits the application head and allows the therapist to work on and near tendon and muscle insertions with pinpoint accuracy that is not possible with other tools or their hands. The intensity of the shockwave modality depends on the injury and patient. Most treatment varies between 1.5 psi and 4 psi. The quantity of “shocks” or beats varies between 600 and 2000 depending on the body part. All of this takes less then 3 minutes and most patients will notice a difference when they get up from the table after their plantar fasciitits treatment.
Shockwave is a treatment modality that treats painful conditions in a few different ways. Shockwave is really good at breaking up scar tissue. The strong ‘shocks’ of energy delivered via the applicator can help loosen tougher tissue that is impeding proper movement and mechanics. Even if there is no scar tissue present, the tight muscles in the calves and hamstrings can be released very quickly with a short shockwave treatment. Shockwave therapy helps to increase blood flow, and has even been shown to create new blood vessels to help increase the tissue’s ability to heal.
ART, IFC and Graston for Plantar Fasciitis and Foot Pain
When patients visit our Oakville based chiropractic clinic they can expect more then just a single variable approach to treatment. Most of our plantar fasciitis patients receive a combination of Active Release Therapy, Graston , Interferential Current Therapy, shockwave and education advice and stretching/icing instructions. Dr. Steve usually demands a new choice of footwear that is frowned upon by some of our patients ;).
Active Release Therapy (ART)
At our Oakville clinic our doctors use a combination or Muscle release techniques including Active Release Therapy. ART for plantar fasciitis is usually performed with the patient face down. The Doctor presses their finger/thumb into tight and tender areas of the calf/achilles/hamstring/soleus and moves the patients injured leg or ankle in a full range of motion. Treatment usual lasts for 2 to 5 minutes depending on the severity of the condition. ART is used to help loosen the muscle and release areas of adhesion or scar tissue. Essentially the treatment our ART Doctors perform improve the range of motion of the ankle joint and allow for improved gait biomechanics.
Interferential Current Therapy
Interferential Current is applied to almost all of our Oakville plantar fasciitis patients. Our Chiropractic clinic uses a suction/vacuum applicator to apply 4 leads of IFC to the patients calf and/or heel. The stimulation (electrical current) is then turned on and increased to the patients pain tolerance levels. The IFC is used for pain control and help promote blood flow to the injured area. In most circumstances our Doctors combine a heat pack to further promote blood flow. We find this combination helps dramatically with the healing process and allows the shockwave therapy to be optimized after the heat and the IFC is removed. IFC is also very helpful at relieving pain, so you will leave the clinic feeling better!
Graston is a type of muscle release therapy that uses tools to loosen the muscles. The muscle is stretched and then a small plastic tool is used to dig deep into the tissue and release trigger points and the fascia that runs between our muscles. The scraping technique used in instrument-assisted soft tissue release, like Graston, creates microtrauma in the area which increases blood flow and optimizes the healing process.
There are different shaped tools to get into different tissues. Some tools have sharper corners to dig under tendons, others have more broad surfaces to release larger muscles. These tools often help our chiropractors dig deeper than just their thumbs would allow, and therefore reach the deeper layers of tissue in the problematic areas. The plantar fascia and Achilles tendon are very thick pieces of tissue that require a decent amount of pressure to loosen them up. The tools are a great way to dig into these areas with the necessary forces to make a positive impact.
Choose The Proper Shoes!
The alignment of the pelvis, the tightness of the hamstrings and calves and the biomechanics of your walking pattern can all influence plantar fasciitis. The shoes you choose to put on your feet are SO important. We already discussed that high heels are not an ideal shoe choice to promote perfect biomechanics. Flip flops are a horrible choice of footwear, especially when you’re dealing with foot pain. If Dr. Steve sees you come into the clinic wearing flats, and you’re complaining of foot pain, he might lose his mind.
If you have plantar fasciitis, the only responsible choice for footwear is a running shoe. We know they aren’t always the most fashionable choice, and they might not match your cute summer dresses, but we don’t care. Your feet need support! Running shoes are the best option. We are big believers in Asics running shoes, as they make the most comfortable, supportive shoes on the market!
Orthotics are another great option to help manage plantar fasciitis. As we discussed above, over-pronators are more at risk of developing this condition. When the inside arches of the feet collapse too much, it puts extra strain on the bottom of the feet. Our orthotics come in a variety of coverings to fit into dress shoes, running shoes and casual shoes! They can even be made in different lengths to accommodate narrow and pointy-toed shoes!
Orthotics are custom made to fit your feet. These inserts are built to match the contours of your feet perfectly, and help provide extra support in areas that are lacking. If you already have plantar fasciitis, wearing supportive shoes and orthotics is a must! Orthotics are made from a more rigid material than typically found in any running shoe. They help provide support, and more importantly they help wake up the muscles in the feet. Wearing orthotics help the muscles of the feet activate to their full potential, and the muscles help prevent the arches from over-collapsing. Orthotics are covered by most insurance companies and are a really effective way of helping manage plantar fasciitis!
Icing And Exercises For Plantar Fasciitis
The inflammation and repetitive strain that occurs with plantar fasciitis is the reason this condition can be so painful. One important treatment method that can be completed at home is ice therapy. Applying ice for 20 minutes can reduce inflammation and numb the pain. Plantar fasciitis is a difficult injury to rest because we are always on our feet and therefore always putting stress on the injured area. At the end of the day, sit with your feet up and ice your arches and heels to soothe the discomfort. We recommend a 20 minutes ON – 20 minutes OFF – 20 minutes ON approach to get the best results!
The last piece to the puzzle, when it comes to treating plantar fasciitis is stretches and exercises. Stretching the calves and plantar fascia help to heal the condition and reduce pain. Exercises to help strengthen the arches in the bottom of the feet will help reduce recovery time and strength the small, intrinsic muscles in the feet. When these small muscles get stronger, they provide better support to the arches of the feet, and there is less strain placed on the plantar fascia. These exercises are simple, quick and effective! Another great home-remedy for plantar fasciitis is self-massage. Our chiropractors recommend using a golf ball, therapy ball or frozen water bottle to roll the bottom of the foot. Digging the ball into the bottom of the foot helps to mobilize and loosen tight tissues. This technique is an extremely effective way to manage plantar fasciitis pain at home!
Straussberg Sock For Plantar Fasciitis
We told you earlier how the first steps in the morning can be really painful with plantar fasciitis. It’s one of the hallmark signs of the condition. One way to help avoid this pain, and speed up the recovery process, is to wear a Straussberg Sock overnight. This specialized sock helps keep your foot and toes in a flexed position, and doesn’t let the tissue tighten up overnight. Keeping the important tissues in the bottom of the foot lengthened while you sleep for 6-8 hours helps to limit the pain when you step out of bed in the morning. It’s a helpful home tool to help improve plantar fasciitis pain.
Plantar fasciitis can be painful, and it’s best to start treatment as quickly as possible. In the early stages, plantar fasciitis is a breeze to treat. The condition becomes much more stubborn once it gets into the chronic stage so do yourself a favour, and start treatment for this painful condition as soon as you start to feel the discomfort. With all the excellent treatment options our Oakville chiropractors have at their disposal plantar fasciitis pain doesn’t stand a chance. A combination of hands-on therapy, shockwave, acupuncture in the clinic will get you feeling better in no time. Add in the stretches, self massage and foot exercises at home and you will recover even more quickly! Don’t let your pain get into the chronic stages, start your treatment today!