Plantar Fasciitis consists of a sharp pain at the insertion of the plantar fascia at the medial tuberosity of the calcaneus and along the medial border of the plantar fascia (inside of the foot near the heel). Current evidence indicates that this condition is the result of microscopic degeneration of collagen with subsequent thickening of the plantar fascia caused by chronic overload. Atrophy of the abductor digiti minimi muscle of foot intrinsic muscles have been reported in people with plantar heel pain. Plantar heel pain affects 10% of the population at some point in their lifetime and is most commonly seen in athletes who engage in running and dancing which requires significant ankle plantar flexion and MTP joint extension. A classic symptom of plantar fasciitis is a pronounced increase in pain with the first step after a period of inactivity.
Risk Factors include but are not limited to:
- Increased body mass index
- Increased age
- Occupations requiring prolonged standing on hard surfaces
- Reduced ankle dorsiflexion and 1st MTP extension
- Prolonged standing
- Tightness of the calf and hamstring muscles
- Weakness or atrophy of the ankle plantar flexors and toe flexor muscles
Common Trigger Point Referral Patterns
Trigger points in musculature play a crucial role in the treatment and diagnosis of this condition. Below is a list of common muscles that may refer to pain in the plantar fascia.
- Soleus
- Quadratus Plantae
- Abductor Hallucis – A common muscle that refers pain to the medial aspect of the heel
- Flexor Digitorum Brevis
- Tibialis Posterior
- Flexor Digitorum Longus
- Gastrocnemius – Trigger points in the gastrocnemius mimics many classic signs and symptoms of plantar fasciitis.
It is important to also have a thorough examination of the hip and sacral nerve roots as well as the knee and ankle when determining the root cause of your plantar heel pain. Limited hip mobility or stability can lead to compensations in the lower extremities. For instance, if the hip doesn’t have adequate range of motion, it might result in compensatory overpronation or supination of the foot, both of which can stress the plantar fascia.
Chiropractic Sports Rehab Care (not limited to)
- Trigger point dry needling to detected lower extremity TrPs
- Manual soft tissue therapy to lower extremity musculature
- Strength, Stability, Flexibility, and Mobility training to correct dysfunctions in the hip, knee, and ankle structures
- Laser Therapy
- Shoe Modifications
At FRWD Sports Therapy, Dr. Cappelletti can perform a physical examination that includes observation of gait, motion testing of the knee, hip, and ankles, manual palpation of the lower extremity muscles, and any indicated orthopedic test for both injury prevention and evaluation of your plantar heel pain.