Plantar fasciitis is an inflammatory condition that affects the long supporting structures of the plantar (bottom) surface of the feet. The plantar fascia structure is designed to support the arch of the foot during weight bearing and redistribute forces during walking, running. It is also a connecting structure that links and helps chain together the fascia's of the lower leg, thigh, pelvis and lower back regions. Diagnosis is best achieved by clinical assessment and palpation (touch) of the arch and bottom of the heel region. Pain will usually present with weight bearing and is relieved with rest. Often symptoms are worse in the morning with pain being sharp and intense in nature and begin to ease as you start to walk. Symptom often return towards the end of the day as the body begins to become fatigued and energy levels decrease. The challenges with plantar fasciitis is that as we need to walk and bear weight on our feet, it takes longer for the feet to heal than if we had injured a arm or hand.
Injury to this area can have a major affect on muscle groups of the lower extremity and in particular the lower back and pelvis. When these structures become involved it is often difficult to diagnose which came first the injury to the plantar fascia itself or the lower back. Did a weakness develop in the fascia and core of the pelvis that produced a gradual weakness in the plantar fascial structures of your feet. An open looped question that could never be answered.
So where to from here?
It's imperative that proper diagnosis includes a full body postural assessment. Why for a foot problem you ask? Often successful treatment will involve different modalities that treat at different levels of the posture.
Assessment is concerned with how the alignment of the fore foot, rear foot, ankle and lower leg all interact with each other. Any abnormalities, muscle compartment dysfunction and structural mis-alignments must be noted and addressed if possible. Structural conditions such as tibial varum and valgum are often bone development problems and can only be and should be rectified via surgery (only in extreme cases). A physiotherapist and chiropractor or musculo-skeletal therapist will be concerned at pelvic posture, core stability and the functioning of the sacro-iliac joints. All practitioners should be acutely aware of changes in pelvic posture with respect to the anterior superior iliac spines (ASIS). Inferior tilting in the frontal plane (looking front on at the body) may indicate a leg length discrepancy or short leg.
Short leg can cause significant changes ion gait and muscle function. Leg length discrepancy can either be classified as Functional or Structural. Functional leg length problems arise due to changes in body posture and muscle adaption to these changes that pull either one leg shorter or cause the other leg to appear longer. Structural leg length discrepancy is due t bone deformity or actual shorter bones. These can be due to short tibia and fibula, short femur (thigh bone) or even changes and dysplasia of the hip joint and acetabulum. Correction and proper assessment of these postural and structural problems is essential to obtaining a quick and easy resolution to your plantar fasciitis.
Written by Ben Sibley
http://www.plantarfasciitissecrets.com
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