Plantar Fasciitis
- Pain on the plantar surface of the heel.
- Heel pain that radiates to the toes.
- Stiffness of the plantar aspect of the foot.
- Pain early in the morning with initial steps or pain with walking after prolonged sitting.
- Pain is alleviated with activity but quickly returns.
When one thinks of this condition, it sounds like only one group of tissues is involved. In actuality, plantar fasciitis can have a number of possible etiologies. There are three specific structures in the plantar aspect of the foot that are most commonly diagnosed as plantar fasciitis: the muscles of flexor digitorum brevis, and the quadratus plantae along with the plantar aponeurosis. This grouping of tissues lies more centrally in the foot, whereas the plantar fascia actually lies medial and lateral. Occasionally, the muscle abductor digiti minimi can be indicated due to it’s calcaneal origin and the fact that the quadratus plantae lie just beneath it. Similarly, the abductor hallucis lies ontop of the medial plantar fascia and any adhesion of these two muscles can create symptoms like plantar fasciitis. Less frequently, the hallicus brevis is involved. This deep, strong muscle can be differentiated by testing gait mechanics and looking for hyperpronation during push off.
Plantar Fasciitis is also closely related to the working order of the lower leg, more specifically, gastrocnemius, soleus, flexor hallicus longus, and the achillies tendon. Trauma in this are can easily refer to the foot. The best way I have found to ensure that there are no fascia adhesions or nerve entrapments ( medial plantar nerve) in this area is through combined treatments of Active Release Technique® (ART) and acupuncture. Through ART the muscle condition and gate mechanics of the injury area can be assessed for tissue texture, tension, movement, and function. There are easily two dozen specific protocols for treating the foot alone. This should be done by someone that is ART® certified. Some massage therapists or PT’s may claim to ‘know some’ ART® but do not actually know the protocols and techniques.
So what can be done through acupuncture and to alleviate the symptoms of plantar fasciitis? Usually the standard measures of acute care are applied such as: RICE protocol, anti-inflammatories, and stretching. Acupuncture treatments should be twice a week for at least three weeks. Treatments should focus on Kidney and Bladder meridian pathologies due to the location of the pain. Systemically there is likely qi and blood stagnation with the possibility of heat. Work to nourish blood, move qi and clear any local heat.
Whitfield Reaves has spent a lifetime applying classical acupuncture theory along with western pathology and kinesiology to create applicable protocols for injuries like plantar fasciitis. I have found that in combination with ART® and acupuncture, plantar fasciitis can be resolved with a high amount of success and longevity. Here are some classical protocols from Mr. Reaves that I have found useful in practice.
The plantar fascia is the long muscle that runs along the sole of the foot. Plantar fasciitis is an inflammation of this muscle that can make walking painful. Treatment plans include physical therapy, stretching, using shoe inserts, acupuncture and also lifestyle changes. One study published in 2006 in “Medical Acupuncture” showed an improvement in pain reduction in 9 of 11 people who had painful plantar fasciitis.