Chiropractic Approach to Plantar Fasciitis
One in 10 people will experience plantar fasciitis in their lifetime. It manifests as a stabbing heel pain that begins as you walk in the morning and worsens towards the end of the day usually after standing for long periods. Below, we discuss how chiropractic care has been proven to relieve symptoms of heel pain.
What is Plantar Fasciitis?
Plantar fasciitis is the inflammation of the ligament (plantar fascia) that runs across the soles of your feet, connecting your heel bone to your toes. It is the most common cause of heel pain, accounting for about 1 million patient visits every year.
It is frequently seen in runners but may also affect people who perform other sports or live a sedentary lifestyle. It affects more females than males, particularly ages 40 to 60. Risk factors include being overweight or obese, wearing shoes that do not give adequate support, long periods of standing, and limited ankle dorsiflexion.
Is Chiropractic Care Effective in Treating Plantar Fasciitis and Heel Pain?
People suffering from heel pain can benefit from several treatment approaches. These include medications, conservative treatments, injections, and surgery, amongst others. However, the chiropractic approach through recent studies has been proven to be an effective treatment approach for heel pain.
According to a 2012 study, chiropractic care improved the symptoms of a patient with plantar fasciitis. The chiropractic approaches used in that study included chiropractic manipulation, soft tissue therapy, exercise, and stretching therapies.
Another study reinforced that chiropractic care was effective in treating heel pain. The 2020 case report stated that a patient’s plantar fasciitis was successfully managed with extracorporeal shockwave therapy. The patient has suffered subtle foot pain for 3 months and had noticed it worsen and limit him in wearing shoes, running, and playing basketball.
Chiropractic approaches have been tested against each other to find out what technique successfully treats plantar fasciitis. According to a 2019 study, 45 patients with plantar fasciitis were divided into three groups. At the end of the study, cross friction massage of the plantar fascia, that is heel, and stretching of the muscles that span from the calf to the heel showed the most positive outcomes in reducing pain and disability. They also increased ankle dorsiflexion ROM (range of motion). The group that got managed using both techniques also showed an increase in plantar flexion. In other words, chiropractic care was effective in treating plantar fasciitis and relieving heel pain.
How Do Chiropractors Treat Plantar Fasciitis and Heal Pain?
According to the Illinois Chiropractic Society, treatment of plantar fasciitis includes the following chiropractic approaches:
- Manual therapy
- Stretching
- Myofascial release
- Exercise
- Orthotics
- Physical therapy modalities
- Night splints
The best results, however, are achieved when these therapies are combined, particularly exercise and mobilization.
Manual therapy includes ankle joint mobilization and manipulation. These techniques help to restore normal range of motion, especially ankle dorsiflexion. Other forms of manual therapy are trigger point massage therapy and soft tissue manipulation of the gastroc/soleus (muscles that span from the calf to the heel) and the plantar fascia. These therapies help to relieve pain and tension and enhance the range of motion of the joint.
Myofascial release procedures such as transverse friction massage and instrument-assisted soft tissue manipulation (IASTM) also help in treating heel pain. They stimulate proliferation and regeneration of cells which promote healing of the plantar fascia, hence reducing pain and inflammation.
Stretching exercises can significantly improve outcomes of treatment. These exercises target the gastroc, soleus, hamstring, and plantar fascia (they are all muscles and ligaments). Strengthening exercises are also included and are appropriate for the muscles of the calf, posterior lower leg, and foot. Examples are marble and towel gripping exercises. These exercises help heel support and promote healing.
Night splints benefit patients with chronic plantar fasciitis. This is because using a night splint prevents excessive passive plantar flexion and allows the plantar fascia to heal without being pronated or turned in.
Extracorporeal shockwave therapy is sometimes used by chiropractors to treat heel pain and promote healing.
How Can I Prevent Plantar Fasciitis and Heel Pain?
The following practices can help prevent plantar fasciitis. They include:
- Wear well-fitting shoes. If they do not fit so well, you may wear padded socks.
- Wear shoes that cushion the heel. If your shoes do not have that cushioning effect, you may get inserts from shoes and/or shoe accessories stores. These inserts support the arch of your heel and prevent your feet from turning in or pronating excessively. They also lessen the stress on your heel and promote proper posture and gait, thus preventing the risk of pain and inflammation.
- Lose extra weight and maintain a healthy weight.
- Stretch your plantar fascia and Achilles tendon regularly. This is particularly be done before you exercise.
- Avoid exercising on hard surfaces.
- See a doctor once you feel a burning sensation in your heel area. Early diagnosis and treatment are important.