Few things in life are as painful as that first step in the morning when you have plantar fasciitis. It’s a condition that affects your quality of life with reckless abandon. It makes you think about taking that long walk with your partner after dinner. Those heels that you’ve been dying to wear? Impossible.
It’s important to get one matter out of the way. If you’ve had plantar fasciitis for more than 4-6 weeks, it’s not plantar fasciitis. It is plantar fasciosis. An “itis” is an acute inflammation. An “osis” is a chronic inflammation with associated degeneration. No tissue remains acutely inflamed for 4-6 weeks without transitioning into chronicity and degeneration.
Plantar fasciitis, or fasciosis, more commonly, causes pain in the bottom of your foot. In some cases, you may also experience pain in the back and front of your ankle. In rare cases, you may feel an intense burning sensation on your instep.
Plantar fasciosis is a degeneration of the plantar fascia, a thick band of tissue that lies on the underside of your foot. It is most commonly caused by improper shoe use, heavy body weight, excessive running, and a lack of flexibility in the ankle joint. It’s because of this complex etiology that a diagnosis is needed.
Your first order of business must be to perform a range of motion test for both plantarflexion and dorsiflexion. 95% of people with plantar fasciosis have limited range in either or both of those ranges. Because of that, we cannot just direct treatment towards the bottom of the foot. Restoring proper range to the ankle is imperative to long term success with plantar fasciosis. Because the calf muscles control toe movement and shin muscles help to stabilize the arch, treatment is needed in those affected tissues.
Two exercises that you can try at home are eccentric ankle dorsiflexion and eccentric heel to butt. However, these will be relatively ineffective when compared to in-office treatment. 10% improvements over the course of 6 weeks happens in only a select few individuals.
With shockwave therapy, we can make quick work of any adhesion in the calf and shin, enabling us to get right to the actual plantar fascia. The sound waves will break up senescent cells and with full range in your ankle, you can begin to expect regeneration of the plantar fascia to happen within a few weeks.
It’s also imperative to measure strength. Using the lift-off test, you can determine if your calf and ankle lack strength. This should only be done AFTER range has been restored, as a decrease in range can disguise itself as a weakness. If you find a weakness, the eccentric ankle dorsiflexors will do the trick.
If you’re an individual that still has pain after following the advice of this article or you’re looking for a more comprehensive, efficient approach, please reach out for an in-person consultation and exam!
At Wildcard Spine and Sport, we specialize in fixing pain that’s lasted longer than six months, even if you’ve seen two or more providers. We are the only practitioners in the five boroughs certified to diagnose and remove adhesion. Click the button below or call the office today at 917-908-0055.