Plantar fasciitis causes heel pain that is especially concerning and frustrating to deal
with the classic sign is that it hurts that first step when you get out of bed in the
morning.
In this video I'm going to explain everything you need to know about plantar fasciitis heel
pain.
Im going to answer the question, what is plantar fasciitis?
I got my friend here Kay Sanders, though and she's been on our channel for some other videos.
If you're interested in New Age, metaphysical topics, go check out her channel on YouTube,
you can just look up Kay Sanders on YouTube and you'll learn more.
Now the plantar fascia, that's the name of the tissue fasciitis means that it's inflamed
or swollen or irritated.
That's what itis means.
But it's a big, kind of like a ligament structure that runs from the bottom of the heel bone
right here and it fans out and it spreads out and sends part of it into different toes
into each of the different toes here.
So it's like a kind of like a triangle with the point being down here at the heel and
then it goes upwards towards the toes.
Its purpose is to help maintain an arch in the foot.
So if that plantar fascia becomes irritated and you develop plantar fasciitis, then you
have irritated it by over stretching that arch and putting too much pressure on the
plantar fascia.
And it just tends to become irritated at the heel.
It gets overstretched usually because it's compensating for a lack of muscle strength
in the rest of the foot.
And it's typically the toe flexors.
We'll talk about that more, that's usually the root problem that goes and curl your toes,
the muscles that make your toes do that, that curl your toes you can relax if those aren't
strong enough, and they don't give support to that arch because all these different struggles,
the muscles, the tendons, ligaments, everything has to contribute to supporting the arch.
If you don't get enough support from everything else, then that plantar fascia can begin to
become injured.
That plantar fascia gets consistently overstretched every time you take a step.
And if you don't have that muscle strength, it's just a matter of time before you've been
on your feet long enough or taking enough steps or been jogging or hiking been on your
feet too much to where it becomes irritated then you develop plantar fasciitis.
I've said on this channel many times that plantar fasciitis is often misdiagnosed and
it's actually a sciatica problem.
Now I have k in this position here, because I want to show you this idea about the set
of the sciatic nerve being a problem for plantar fasciitis symptoms vary, it looks like the
same thing.
The sciatic nerve comes off the hip right or the backside like in the butt area.
And that nerve runs on the back of the thigh between the hamstring muscles, it goes to
the back of the knee.
And then there's some branches that go different directions down into the lower leg.
There's one specific branch called the tibial nerve that runs right in the middle of the
back of the calf.
And then it goes through around the heel on the inside of the ankle.
And it ends up right at the same point where the plantar fascia attaches to the heel bone
on the bottom of the foot where people get the classic heel pain when they get their
first when they take their first steps in the morning.
And they get up the problem in healthcare is that anytime anyone goes into a doctor's
office, or most medical facilities, and you know a podiatrist office, even physical therapy
clinics, and you come in saying I heard it my heel, and my first steps in the morning
are especially painful.
And if I'd been sitting for a while, if I'd been in a long car ride, if I sit down and
watch a show or movie or have a meal, when I get up and take those first few steps, my
heel really hurts and then it kind of frees up and improves as I move on.
But it consistently hurts when I take those first few steps.
If you come in saying those symptoms to your medical professional, they reflexively almost
always reflexively say Oh, you have plantar fasciitis.
And they don't take a good look at what's happening in the sciatic nerve.
And they're not aware of those branches of the sciatic nerve that reach all the way down
to the foot and go right over the attachment point of the plantar fascia.
And it's important to distinguish which problem you actually have.
And it's possible even have both problems happening at the same time, I see that occasionally,
the treatments for an irritated nerve in the foot from the sciatic nerve are different
because we have to focus more so on what's going on at the hip.
What's going on at the knee, we have to look at the whole leg and even though the lower
back a lot more closely, versus the plantar fasciitis treatment tends to focus more just
on the foot.
So this is why people often don't get better from a typical plantar fasciitis treatment
because they actually have nerve irritation in the it should have been treated differently.
Let's talk about how to diagnose plantar fasciitis.
The number one thing like I said is heel pain, but it could still be sciatica.
So you got to go another step beyond that.
The test that we use here in this clinic is called a modified when last tests now windlasses
some guy that developed this test and he did it off a step stool and you're pulling the
toes, but I've modified that test largely to bed or tease out the nerve versus the actual
plantar fascia.
And let me show you how to do it here to put your foot right here.
So the theory here is that plantar fascia, which is like a ligament type structure is
made of the same kinds of cells and tissue.
When you tighten it up, just like if you sprained your knee like you like you had an ACL or
MCL tear, or a stretch and a sprain to it.
If you tension a ligament, it hurts because it's supposed to hold the joint together.
And if it's injured, it's not going to do its job.
And it's going to let you know.
So if you pull the toes and the ankle, let me bend your knee, because it can be a little
aggressive all the way up like that, then it should aggravate or cause pain in the plantar
fascia at the insertion point right here.
So if I do this to a patient, and they're telling me, it hurts, then I'm starting to
think we might actually have legitimate plantar fasciitis here, but I'll take it an extra
step.
Because if you poke an irritated tendon, or plush plantar fascia, as we're talking about
in this video, it's going to hurt even more.
So before I even move the toes up, I'll get in there and poke the spots, I know exactly
where it attaches, you have to find that right spot.
And it might be a little bit tender, but the nerve is going to be there too.
So you have to think about both.
So once I find the spot, and then I do the test again, it's going to be hurt painful
at that point if it's legitimate plantar fasciitis, but then if I poke it, and it doesn't hurt
anymore, now that's a different story.
Because what's happened here is when I pull the toes back and the foot up like that, the
plantar fascia tightens up and it stretches out and lifts off the bones, which gives the
nerve space, so you're no longer compressing the nerve.
So if I do this right here, and I poke in, it hurts less than I have taken pressure off
the nerve there.
And we can diagnose it as a nerve problem.
And the alternative if I do this, and it hurts more than it's obviously a plantar fasciitis
problem.
And so that's how I can clearly tell with patients have a nerve issue versus a plantar
fasciitis issue.
And then there's other things to look at within her, we can look at what's going on in the
lower back and the pelvis, we have to basically look up the pathway that the sciatic nerve
travels and find other signs or other symptoms that could be related to a sciatica type problem.
Now, both of plantar fasciitis problem and a nerve irritation problem at the heel will
get worse, the more time you stand up and you're on your feet, they'll also both get
better, the more time you take off your feet.
So if you sit down and relax or if you if you if you take it easy, you'll tend to recover
a bit more and feel better.
And both of these problems absolutely hurt.
If you've been sitting around for a while not doing anything or sleeping at night, and
then you get up and take those first steps.
That is a classic sign.
That's why it can mask the nerve problem can mask as plantar fasciitis.
Now, age wise, this affects people of all ages, I had this as a teenager myself.
And I've seen young kids have this problem.
The youngest I've seen has been about 1415 years old.
And then I've seen this problem in elderly people and people in their 90s even so it
doesn't seem to be related to age as much as it is the weakness in the toe muscles.
Another factor that comes along with plantar fasciitis, especially if you've had it off
and on for years is a development of a bone spur on the heel.
Now if you can see the skeleton here, there's here's the heel bone and there's this little
hook right on the edge of the bone.
That's where the plantar fascia attaches.
And it's a the bone is thicker right there.
Because the plantar fascia is such an important structure in the area that it's got its own
dedicated hook if you're getting consistent overpressure on that plantar fascia because
it's having to compensate for your weak foot muscles.
Then that hook on the bone that this bones called the calcaneus.
It begins to lengthen and grow in order to protect itself.
It's trying to not fracture it's trying to not break there.
So it thickens very much like you get callus on your skin.
Whenever you do something that rubs your skin like exercising or yard work or house chores.
You'll get calluses on your hands while you get kind of like a bone callus.
That's essentially what a bone spur is.
And the solution from our medical field is often to remove the bone spur but then that
doesn't solve the root problem.
It just mitigates it.
It's a pain relief.
It's really a short term concept.
We've got to look at the toe strength in order to take the pressure off the plantar fascia
and off the bone spur area.
Let me tell you the common treatments for plantar fasciitis.
If you see your general doctor or even a podiatrist, one of the first things they're going to they're
going to recommend is taking pain medications, they're also going to likely recommend you
go get an x ray, possibly a CT scan or an MRI because they want to make sure that nothing's
broken in your foot to try to rule out the bigger problems.
They're absolutely going to tell you to rest from any exercise in case you've been running
for instance, or doing some sort of sport activity, some gym exercise that keeps aggravating
this problem.
They're going to tell you to stop that and they'll often recommend it So one of the common
ways that they'll recommend you ice your foot your heel is to get a water bottle like a
plastic water bottle and freeze it.
And then once that water bottle is frozen solid, you can roll your foot over the water
bottle and kind of massage your heel at the same time.
This can provide some short term pain relief.
Of course pain medications are going to provide short term pain relief and resting it is also
short term, no treatment that they may recommend is a stretching program.
There's many stretches out there, but let me show you some of the most common ones.
Runner strips like this is one of the most common ways to do it.
And the way that you'll be coached to stretch is by putting your feet in this position and
then bending this back knee while keeping your heel down and it really stretches the
back of the calf and Achilles tendon.
It may provide a slight stretch to your heel and your plantar fascia, but it doesn't really
do a whole lot for the plantar fascia.
Another version of this stretch is to put your toes on the wall and then bend your knee
again to make your ankle bend more.
And that similarly stretches your calf and your Achilles tendon it may add a little bit
more stress to your plantar fascia.
But this doesn't solve the root problem.
Your doctor or podiatrist might also recommend that you use a night splint to stretch your
plantar fascia and the way those work they usually a sock that you put on, that goes
all the way up to your knee.
And it's got a strap that goes on the ends of your toes.
And you attach that strap to the front of your shin where the sock starts and is pulling
your toes up in this angle all night long.
And it is very uncomfortable.
I've never had a patient come back the tribe that come back and tell me they loved it.
It's always a very, not a fun treatment to go through.
If you end up seeing a podiatrist for your plantar fasciitis heel pain, they've may recommend
you get orthotics or that's a fancy word for insoles and things that you put inside your
shoes that help support your arch and do other things.
When it comes to insoles orthotics.
There's two types, there's custom ones that are made specifically to fit your foot and
correct your problem.
And then there's over the counter ones that you can find at a store.
They haven't been stores that have pharmacies, Walgreens CVS, a Walmart will have them and
of course you can order them over the internet.
When it comes to custom versus premade, the customer ones are going to usually be double
triple if not more, compared to the ones that you can get at the store over the counter.
And if you're still having trouble, the next line of treatment is going to be prescription
strength pain medication.
And if that isn't making your heel pain go away, then the doctor will usually resort
to giving you an injection of cortisone injection in the plantar fascia.
And if that doesn't work, there actually are surgeries where they do plantar fascia release
surgeries.
Now these surgeries are extremely rarely done, they're not super common.
Of course, a foot doctor is probably doing them all the time.
But you're going to have difficulty finding doctors that do these on a consistent basis.
And the ones that have good outcomes are also hard to find to see you need your plantar
fascia and to release it there.
They're just cutting the edge of it.
Sometimes they completely detach it.
And then you have to ask the question, What the heck is supporting your arch if you no
longer have your plantar fascia attached, this has the potential to leave you worse
after you recover from the surgery.
I've seen patients sadly in this condition, struggling tremendously with other problems
as a result of having their plantar fascia released.
And very often doctors will send you to physical therapy before they send you to the surgeon.
And you'll do stretches like the ones that I showed you, as well as other exercises like
for weight exercises where you move your foot inwards outwards, up and down against the
resistance band, they may make you do circles with your foot and ankle and also spelling
the alphabet in order to get movement in your ankle.
And those exercises are focused on mobility for your ankle, foot and toes.
But they're not focused on addressing the root of the problem which is getting those
toe muscles stronger.
One exercise that you might do in physical therapy is a marble pickup or a towel scrunch
with your toes, they'll put a bunch of marbles on the floor and you have to pick them up
with your toes and put them into a cup or put them into a bowl so that you can practice
grabbing with your toes.
And then they'll do another version of this where you grab a towel on a towel floor, some
smooth surface so that you can scrunch up the towel under your toes.
Now these exercises are good in theory, except you don't typically use your toes like that.
So it doesn't translate to everyday life.
It's important to make sure you learn how to use your toe flexor muscles in a way that
you would normally use and throughout the day, which is in activities like standing
and walking and exercising.
That leads me to solving the root problem of plantar fasciitis, which is getting more
toe strength.
When you get your toes stronger, good and curl your toes your K and you do that you
can see an arch automatically develops.
So getting more toe strength is going to be critical to solving your plantar fasciitis
problem.
And I talked all about this in videos that we have here on our channel.
There's other things you can do to mitigate the pain and make sure that that pain calms
down in your heel so that those first steps in the morning are much more tolerable than
relax, but being able to get your toes curled like that in you using them in everyday activities
is going to be how you solve plantar fasciitis problems for the long term.
If you want to learn more about diagnosing your plantar fasciitis and treating it and
seeing if it's a sciatica problem potentially go down into the description below and find
the playlist called plantar fasciitis help, you'll see all our videos that we have on
the topic.
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