Dr. John W Phelts, D.C. - Mar 08th, 2011
You may have started training for a marathon, be in your second or third trimester of pregnancy, or recently experienced rapid weight gain. Any of these scenarios may cause you to feel pain on the bottom of your mid-foot or close to the heel. When you get out of bed you may be a little apprehensive about planting your feet on the ground, because that is when you experience your greatest pain. During the day when you are walking or standing, you purposely transfer most of your weight to the outer portion of your foot, because any pressure on your inner/medial foot generates so much pain that you begin to limp. These signs and symptoms are usually associated with a condition called plantar fascitis. Plantar fascitis is inflammation of the plantar fascia. The plantar fascia is a fibrous band of tissue that originates at the calcaneus (heel) bone, runs across the forefoot, and attaches to the toes of the foot. It helps to propel you forward when you toe-off while walking, running, or jumping. Hyper-pronation of your foot can predispose you to developing plantar fascitis. One way to tell if you may be hyper-pronating is to have a friend look at your feet while you are standing. If the arch of your foot flattens when you are standing then your foot may be pronating excessively. Treatment includes ultrasound, electric stimulation, cross friction massage of the plantar fascia, orthopedic Gua-Sha/SASTM, adjustments to restore alighnment and function of the feet, and exercises that strengthen the muscles that support the plantar fascia. If necessary your foot will be molded at the office for custom made foot orthotics. Custom made foot orthotics are placed in your shoes to support your foot arches and help to correct foot hyper-pronation. If symptoms do not improve after 3 weeks of care then we may order X-rays or MRIs. Other conditions that may be associated with plantar fascitis and cause some of the same symptoms include atrophy of the calcaneal fat pad and heel spurs. A common cause of fat pad atrophy is cortisone injection to the heel or foot. Most experts believe that heel spurs are caused by plantar fascitis and that it is actually the plantar fascitis that is causing the pain rather than the spur. They believe this because heel spurs are present in 10%-30% of people who do not have symptoms, also 65% of people with plantar fascitis have heel spurs in the non-painful foot. A heel cup is added to your custom made foot orthotic if you have fat pad atrophy and a spur correction is added if you have a heel spur. If you or someone you know are experiencing pain of this type, please call the office to schedule an evaluation.
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