Plantar Fasciitis? Probably Not.

Foot pain is one of the more commonly mismanaged areas of the body. A quick trip to your family doctor, podiatrist or even to the Internet and you will be labeled with plantar fasciitis. After that you are quickly icing, stretching, taking anti-inflammatories, rolling your foot with a ball, or may have even been convinced that it was a good idea to get a cortisone injection. You can continue this routine for months or years with minimal results. The symptoms may reduce or resolve with time but that only occurred because your body compensated and put extra stress on another area of your body to take pressure off of your foot. This compensation can lead to pain in your other foot, knee pain, hip pain, low back pain, or reoccurring pain in your injured foot over time.

So where did you go wrong?

It all starts with an inaccurate diagnosis (plantar fasciitis) that can lead to wrong and ineffective treatment methods. It is crucial to receive a correct diagnosis so that you can receive the right treatment to stay pain free and continue to do everything you love.

To get an accurate diagnosis regarding your foot, it is best to start with a soft tissue specialist. Click here to contact Phipps Soft Tissue and Spine so you can receive the correct diagnosis and treatment and begin your road to recovery.

Below you can find some additional information to better inform you of your foot pain, foot anatomy, and why treatments such as injections, stretching, rolling and ice can be a waste of time.

The plantar fascia is a thickened area of connective tissue on the bottom of your foot, and most often gets blamed when you have pain on the bottom of the foot. The diagnosis of plantar fasciitis implies that the attachment point of the plantar fascia onto your heel (circled in red below) is inflamed and causing your pain.

The plantar fascia just like all the structures in the foot is capable of generating pain; however, plantar fasciitis is rarely the main diagnosis as the foot is much more complicated than just the plantar fascia. Pictured below are some of the muscles and tendons in your feet that are deep to the plantar fascia. The pictures below show multiple layers of muscle that are deep to the plantar fascia.

In addition, muscles originating in your calf will travel behind your ankle and attach onto your foot as well. Pictured below highlighted in blue, green, and yellow are muscles that originate deep in your calf, and travel and attach onto the bottom of your foot (depicted as the red shaded areas)

After looking at these pictures it becomes pretty clear that there are many structures in your foot and calf that can contribute to pain. All of the structures in your foot (not just the plantar fascia) and calf play a role in stabilizing and keeping your foot pain free. They are also all capable of developing pathology and generating pain.

The most common pathologies that develop in the foot are:

  • Adhesion
  • Tendon degeneration

Adhesion

Adhesion can form in any muscle in your foot and calf and form from overuse (standing, walking, running). It acts like glue in your muscles causing them to become weak and less flexible. This will generate pain and cause the tendons in your heel to become overloaded and degenerated (more on this below). A soft tissue specialist will break down adhesion with Manual Adhesion Release™ or Instrument Adhesion Release™(Method will be determined by which muscle is involved). Below are 2 brief video clips of Dr. Phipps utilizing both techniques on muscles that will contribute to your foot pain.

Injections, rolling your foot on a ball, stretching, ice, and anti-inflammatories will not break down adhesion. Adhesion needs to be properly treated so that it can be quickly reduced with expert treatment and will improve the function of your foot immediately.

2. Degenerated Tendons.

A tendon is a soft tissue structure that attaches a muscle to a bone.  Below shaded in orange, green, and blue are 3 muscles that have their tendons attach onto the heel. These tendons are capable of degenerating and causing heel pain, which is commonly misdiagnosed as plantar fasciitis.

If you have had heel pain that hurts when you take the first few steps getting out of bed or a chair, this is most likely one of your diagnoses. The tendons in your feet can degenerate for months or even years without you knowing it, causing it to one day cross a threshold, resulting in pain that doesn’t go away. This degeneration can occur when the load placed on the tendons is too high and the tendon can’t recover properly, causing it to break down and degenerate.  Muscle Adhesion and prolonged standing/walking/running are a few sources that create high loads on your tendons. The first step for treatment of degenerated tendons is to have the adhesion treated to decrease the load on the tendon immediately. Load management advice, orthotics and rehab exercise will depend on your personal case. Properly managing your case and receiving the correct treatment will allow the tendon to regenerate and become healthy again- meaning your foot will be pain free and stay that way.

Contact Phipps Soft Tissue and Spine today to receive the correct diagnosis for your foot pain. Ignoring your foot pain or relying on ineffective treatment methods will only make your condition worse and harder to resolve.

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