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A Chiropractors Perspective On Plantar Fasciitis Rehab

Jul

5

 

Introduction

 

We live in a world that has widely embraced the concept of rehabilitation and that is a beautiful thing indeed! A generation ago there was almost no rehab –  regardless of the severity of your injury.  All you did was get ‘healed up’ and resume normal activity, no chiropractor, no physio, no mobilisation, no strength training, no proprioceptive training. 

 

The legacy of major injuries left in an unrehabilitated state comes in the form of chronic pain, accelerated degeneration and early aging of body . As a chiropractor spend much of my time cleaning up these messes.  The world is a better place for our understanding of rehabilitation principles. 

 

Having broadly understood the value of ‘rehabilitation’ as a concept we are only left to decide which exercises we should use to assist with the recovery of any given injury or pain complaint. This is more of an issue than one might think. I frequently meet people who have worked hard but not on the right exercises, and who’s result reflect that fact. They have done the work but still need to see a chiropractor regualarly for pain.

 

The truth is that even with prefect willpower and a shiny halo if we aren’t doing ‘functional’ and ‘tissue specific’ exercises we might as well stick out toothbrush in our ear twice a day for 5 minutes in the hope of lasting pearly whites.

 

Rehabilitation for Plantar Fasciitis & Foot Pain

 

If you’ve been suffering from plantar fasciitis and you have had enough it’s treatment o’clock –  the first order of business is pain relief. People often seek out exercises to relieve their plantar fasciitis and foot pain, unfortunately for many of us exercises just don’t cut the mustard. Fortunately this is where treatments to manage the pain of plantar fasciitis come in and they have a very respectable hit rate! It isn’t the type of treatment most people associate with chiropractors but we do a lot of it. 

 

Plantar fasciitis is a condition that involves a build-up of microscopic scar tissue and collagen trauma in the sole of the foot. It’s understanding that this scar tissue is the primary pain mechanism that guides treatment choices. Breaking up the scar tissue and promoting blood flow is key to reducing the pain and without doing that we often struggle to get any traction with exercises for plantar fasciitis. Treatment options to precede exercises for plantar fasciitis include acupuncture, post isometric stretches, manual fascial release and vibration massage. 

 

Once you have at least a good degree of relief from your foot pain or plantar fasciitis the topic of rehab should be the first thing your practitioner raises with you. For many of us custom orthotics for plantar fasciitis and foot pain are essential for a good longer term outcome,  but there is also of course the topic of which exercises to do. 

 

It is VERY useful to be clear on the fact that there are 2 types of exercise for us to consider when rehabilitation plantar fasciitis and foot pain. These 2 types of exercise are extremely different in terms of their intent and what they can potentially do for you. 

 

Stretching Exercises for Plantar Fasciitis & Foot Pain

 

Stretching exercises are by FAR the most common exercise choice for managing plantar fasciitis and foot pain and there are some good reasons why. Soft tissues that are under constant strain have a tendency to  tighten up reactively and the plantar fascia is no exception.

 

It is hard to believe what the plantar fascia puts up with. You take somewhere in the region of 3-5 million steps per year on surfaces that are many times harder than nature intended. Your plantar fascia is a thin membrane of fibrous tissue that gets ferocious compressed by your body weight with each and every step. It is worth acknowledging that the heel comes down so hard with each step that when we walk at a normal pace on concrete the bone sustains a shockwave that has been measured at up to 200mph The real miracle is not only that we don’t all have plantar fasciitis and foot pain ( although in a sense we probably all do at subclinical levels ) but that it doesn’t just completely break down in a matter of weeks. The miracle is as it stands that all a plantar fascia does under this gigantic dose of repetitive strain is tighten up. 

 

The value of sretching exercises for plantar fasciitis and foot pain is obviously that they can loosen up the plantar fascia and connective tissue of the foot. Restoring some elasticity to the plantar fascia can bring relief but also assist with healing of the tissue due to increased blood flow. A good metaphore that illustates the nature of stretching exercises for plantar fasciitis and foot pain is scaling plaque off the teeth. When we clean plaque off the teeth we are tidying up some of the mess that sugar has made of them. When your stretch your plantar fascia you are tidying up some of the mess that concrete, modern shoes and life has made of your foot. 

 

Strength Exercises for Plantar Fasciitis & Foot Pain

 

If you want to be free of plantar fasciitis in the longer term it’s strength exercises that you will want to focus on – over and above stretching. Strength exercises for plantar fasciitis target the underlying misalignments and weakness that cause irritation of the plantar facia in the first place.

 

The muscles that support the foot are actually the hip and glute muscles. Ther foot and ankle have very little muscle of their own. This means that alignment of the foot and ankle is sustained during weight bearing by the big muscles in the hip.

 

We take million of steps on hard concrete and tarmac surfaces every year of our lives. The muscles in our legs are absolutely vital for preventing physical trauma from building up in our feet and ankles. This is why strength and balance exercises are more beneficial than stretching in the long term. Strength exercises make the changes necessary to prevent the tightness occurring in the first place.

 

It can be valuable to seek the perspective of a chiropractor on issues like plantar fasciitis. The traditional route of podiatry is also a valid one – but chiropractors are more inclined to look at the foot pain in its broader biomechanical context. The hip is the key to a happy foot when it comes to rehab in the longer term.