Part 1 of 2

By Dr. Lisa Ortiz of Spring Ridge Chiropractic

The morning alarm sounds. You hit the button and get out of bed. As you start walking, OUCH! There goes that familiar pain again. You limp for a while and the pain lessens a little. Maybe you even tough it out to fit in your morning run.  Later you think to yourself, “What is this thing and is it ever going to go away?”

It could be plantar fasciitis. The plantar fascia is a strong band of tissue that supports the arch of the foot and is composed of three parts.  It connects the ball of your foot to your heel. Approximately 11% of the US population experiences bouts of this type of heel pain resulting in over 1 million visits per year to health professionals for treatment of plantar fasciitis. The peak incidence of plantar fasciitis occurs in persons aged between 45 and 64 years, and it is slightly more common among women. Some literature shows prevalence rates among runners to be as high as 22%. So the good news if you have it is, you’re not alone.  Someone with plantar fasciitis may also experience this pain with prolonged standing, after exercise, climbing stairs, walking after prolonged sitting or walking barefoot or in shoes with poor support (I see those old running shoes you love so much). This pain may be sudden, or it may be more gradual.

What is plantar fasciitis and what causes it?

While previous thinking was that this condition was largely an ongoing inflammatory process, it is notably characterized by an absence of inflammatory cells after the initial onset. That is why some professionals prefer the term plantar fasciosis instead of “itis” because the term “itis” means inflammation.  The research more recently demonstrates it is caused by micro-tears leading to degeneration of the plantar fascia although this too has been called in to question recently as research also shows this thickening can occur in asymptomatic individuals as well. Digging into this further, the degeneration may possibly occur via two mechanisms. First, a mechanically normal plantar fascia is placed under abnormal levels of stress. Another possibility is there is an inherent deficiency of the plantar fascia, ankle or foot which causes it to be unable to tolerate exposure to normal levels of stress. This deficiency when combined with an outside factor, such as activity one is not used to performing, prolonged standing or poor footwear, the strain threshold for good repair of the plantar fascia is exceeded. The plantar fascia accumulates micro-damage slowly and if this continues, degenerative change occurs. 

What this boils down to is when you combine a person with predispositions for plantar fascitis such as the right age, obesity, certain foot types, foot/ankle motion, and even possibly genetics and expose them to the outside factors listed above, you now have a person that is susceptible to developing plantar fasciitis.  A qualified health professional can perform an exam and differential diagnose plantar fasciitis.  In Part 2 of this blog, we’ll look at current treatments for this condition. Lastly, I would be happy to provide the resources from which this week’s blog was created. Feel free to email at doctor@springridgechiropractic.com.