Hi, I'm Dr. Molly with Your Goals Physical Therapy and in passing I was talking with somebody who asked me if plantar fasciitis would just go away on its own. Apparently this poor woman has been suffering from having her feet hurt for several months going into some years. She, like many people with plantar fasciitis, has her ups and downs. Sometimes it's just like a mild ache every day. And then some days it feels so sharp she can't walk on her own feet. She has a lot of problems walking in the morning. Those first couple steps really feel like she's walking on eggshells but then she starts to get a rhythm going and she's okay after that for a few hours. When she sits for long periods at her desk, it feels like she has to start all over again, since those couple of steps are painful before she can get things moving again.
She has been to her doctor who sent her to a podiatrist, and they gave her cortisone injections that helped for a while. Then slowly over time that plantar fasciitis came back. So then she tried some really expensive orthotics and that was annoying because they only fit in sneakers. After doing some research, she found another place that has really nice inserts that fits in any shoe you choose. So she was a little bit happier, but she still has this pain that just keeps coming back over time. She was wondering how you get rid of it. She'd done physical therapy before where they had her do towel crunches and some ankle motion. But She said “I didn't really see a point, and so I didn't keep going.” She said “I do all the stretches they tell me. I’ve tried really hard to get rid of this, but it's just not going away. And I just want to know if eventually it will finally just work itself out.”
I replied with this…. Well that depends on what the problem is. What you're describing sounds like it’s more how you're walking. If stretching only mildly gets rid of the pain. Then that tells me that stretching sort of calms down the tissue for a temporary amount of time, but something is causing that fascia to be irritated.
She had a follow up question. “I don't really understand what the fascia is and why is it getting so irritated?”
Everybody has their own foot shape. Some people have higher arches and some people have flat feet, but all of us have this thick tissue, it's almost like a ligament that goes from the ball of your foot to your heel.
This thick fascia on the bottom of your foot is supposed to help keep the arch in your foot so that when you're absorbing impact, it just gives a little bit and then comes back so your arch doesn't completely drop to the ground. It's kind of like a little shock absorber. It's not meant to be stretched. So all those foot stretches you see people doing up against a wall with their toes pulled back trying to really get a good stretch on the bottom of their foot, could actually be irritating the bottom of their foot. Since it's not supposed to be stretched.
Disclaimer: If it feels good, I'm not going to tell anybody not to do something that feel good, but that's not going to stop you from having plantar fasciitis because the fascia is not supposed to be stretched, which is one reason it's irritated.
One thing that is common among every person that I've ever treated that has plantar fasciitis is when they walk, they pivot on the inside of that big toe. When they're walking towards somebody you can see them hitting their heel on the floor and then their foot collapses in, their arch drops, and they're pivoting on the outside of that big toe.
Even if it's a slight thing, that kind of the walking mechanism is what’s done every step that they're taking. Which is adding stress to that fascia, it's a little annoyance, a little annoyance, a little annoyance all day long, every step they take. And so what happens is over time, it creates inflammation, which then irritates more things and so on and so on.
So when people go get cortisone shots, they're amazing because they get rid of the inflammation, but they're not addressing what's happening at your foot to cause that inflammation.
That's what the question is. What is causing the inflammation in your foot? To find that out you need to see somebody who's going to watch you move to determine: Is it really just that you need extra arch support? Which seems to be the common thing people believe when they are trying to sell you inserts for your shoes. Is it something coming from your hip, that's not stabilizing your foot? Is it something coming from your core and it's not allowing your hip to stabilize, which is not allowing your foot to be stable? Is there a tight calf issue? Is there something else going on?
These questions are what I help people tease out. Plantar Fasciitis is not as simple as something has gotten annoyed and we just need to put ice on it, stretch it, do some simple seated exercises and then everything will be resolved. Normally with plantar fasciitis, you're talking about a dynamic problem.
There is more than one thing going on that needs to be addressed to really get rid of the problem.
But with this method, you can go back to running. You can run upstairs verses just walking up them. You can get up in the morning without foot pain and take those first couple of steps and not feel like you're on eggshells. You can sit at your desk at your office and stand up without even thinking about it. You could buy expensive inserts or not buy expensive inserts as you see fit, because you like them not because you need them.
And so that is what I help people do when they come and see me for plantar fasciitis. So if this is the type of service that you're looking for, feel free to send me a message. And let's talk about your specific needs.
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WE HELP ACTIVE ADULTS OVERCOME THEIR ACHES AND PAINS TO GET THEM BACK TO THEIR FAVORITE ACTIVITIES WITHOUT MEDICATION, INJECTIONS OR SURGERIES.
Dr. Molly McDonald