There are many professions providing Plantar Fasciitis treatments. My training in school on how to effectively treat this condition was abysmal to put it mildly. I was lucky compared to most Chiropractic students that I had additional training in athletic training and exercise rehabilitation. I knew that the nonsense that was taught in Chiropractic College regarding adjusting the spine to treat plantar fasciitis was ridiculous. I also knew plantar fasciitis could be treated both effectively and conservatively using various other methods. I knew this because I had seen it first hand and because I used to go to the library at the College and pull all of the research papers from medical journals, podiatry journals, physical therapy journals and athletic training journals to see how these professions treated plantar fasciitis. I began to unravel a common theme and was able to identify the treatments that appeared to cross over from one profession to another. I was also able to see which treatments had no basis in reality and were largely ineffective.
When I began private practice I was on my own. I had no one to go to with questions on injury management or to simply get another opinion. I continued to get my opinion from the premier sports medical journals and threaded the new information I read into my existing protocols. I also was able to “practice” my plantar fasciitis protocols on real patients and began to see the effectiveness of my kitchen sink style approach. Because I had taken the most effective treatment strategies from all of the professions and combined them into a single, conservative approach I was helping hundreds of runners and non-runners alike get rid of their painful plantar fasciitis…..usually within weeks! (Watch our 2 minute You Tube video http://sdri.net/running-injuries/plantar-fasciitis/)
Another thing I noticed, usually while taking the patients history was just how ineffective most of the doctors and therapists they had seen prior to me had been. It was fascinating to me that the very techniques I learned from podiatry journals were not being performed by the podiatrists. I was baffled that the most effective techniques I had learned from physical therapy journals were not being done by the physical therapist. Instead, patient after patient would report doing inane, useless treatments that did not help. I had trouble understanding this because as previously mentioned I had developed my protocols from THEIR journals…not Chiropractic journals. How then could they not be performing these treatments based on the most current medical evidence?
The answer was actually simpler that I had thought. One of my favorite teachers used to say “the hardest thing to do in practice is think”. One of my least favorite teachers once said “it is easier to stay the same than it is to change”. Unfortunately most people, which includes doctors and therapists continue to follow outdated treatment paradigms that for the most part are ineffective. Why? Because they were taught that in school. They wake up every day, go to work and punch the clock, following protocols that almost never work. I began to place these therapists and doctors into 3 categories. Category one consisted of lazy doctors and therapists who simply do not want to stay up to date with medical research because that would mean they have to think. Category 2 consists of ignorant doctors and therapists, meaning they simply don’t know about current treatment models and probably will remain unaware because it is easier to stay the same. Category 3 is the most sinister of the groups. This group consists of the liars. This group of doctors and therapists are fully aware of the current treatment guidelines and models but choose to ignore it, usually for profit. This unscrupulous bunch are intelligent and looking to profit at your expense. They often offer treatments that cost big money knowing full well they are usually ineffective. Here are some examples from each profession
Chiropractic: Will adjust your spine to fix your plantar fasciitis using the antiquated and preposterous theory the nerves from your spine are being pinched or “interfered” with and only they can adjust your spine, free your subluxation and correct your plantar fasciitis. Most of these Chiropractors fall into category 1 or 2, but be careful there are a few of the category 3 variety out there.
Physical Therapy: Physical therapists will typically offer ice and foot strengthening to correct plantar fasciitis. Many will also blame your plantar fasciitis on a weak “core” or “weak glutes”. All of this is useless and absurd. The research on what causes plantar fasciitis is abundantly clear and none of it cites a lack of ice, foot strength or core strength as a cause. For years I have been dumbfounded by how these PT’s have arrived at these conclusions as I have not read them in their very own journals. Most of the PT’s fall into category 1 and 2 but it appears from my vantage point that more and more are falling into category 3. This seems to coincide with reductions in insurance reimbursement and disreputable seminars geared at physical therapists that instruct them how to become a “cash” practice….at the patient’s expense.
Podiatrists: Continue to follow antiquated models that “believe’ the foot is hypermobile and everyone “over pronates”. Both of these theories have been disproven time and again in their very own research. The podiatric profession continues, in my opinion, to prescribe hard, rigid orthotics in an attempt to restrict movement of the patients foot or offer them surgery. Sometimes they offer cortisone injections blindly injecting the painful site again and again without a positive result. (Doing the same thing over and over expecting a different result is typically called insanity) This can be dangerous as cortisone is known to degrade and destroy the plantar fascia and predispose the patient to rupturing it right off the bone! In my opinion most podiatrists fall into category 3 and I have good reason to suspect this. I worked for a doctor that also owned a running shoe store for 10 years and saw many, many podiatry patients come into the store complaining how useless their hard, rigid orthotics were, how they hurt and actually aggravated their condition. I was there during Open House nights for local podiatrists to teach them about current running shoe design, over the counter orthotics and also provide them with specific patient feedback that might help them with future patients. Out of hundreds of San Diego podiatric doctors not one ever actually took advantage of this in any useful way. Oh many came for the free food and free shoes we doled out but none ever actually took advantage of the priceless patient feedback that was theirs for free. Again place them into category 1, 2 or 3 but based on my own personal experiences I choose 3 most of the time and for this reason can’t ever in good conscious refer a patient to a podiatrist.
Medical Doctor: The MD’s primary purpose is to either prescribe you a drug or tell you to rest. If you complain enough they may refer you for physical therapy or better yet prescribe a useless x-ray for your plantar fasciitis. Upon receiving the film they will often proclaim, “Nothing’s wrong” knowing full well x-ray show bone and they can’t deduce any useful information from an x-ray regarding your plantar fascia. In regards to plantar fasciitis most MD’s fall into category 2. They are simply ignorant and lack any real training in sports injuries or musculoskeletal injury. For this reason it is asinine that an MD is the average patient’s first point of contact when they have plantar fasciitis.
The burning question then is “How do I fix my plantar fasciitis”? The answer is
- Get it accurately diagnosed. Often patient’s with Heel Spur Syndrome are misdiagnosed as having plantar fasciitis. Another common diagnosis is plantar fasciosis. Plantar fasciosis is essentially scar tissue.
- If what you are currently doing is not working or not working enough check out our You Tube video http://sdri.net/running-injuries/plantar-fasciitis/ after watching it if you have any questions email us at email@example.com
- Let me tell you what typically does not work in the long run. Ice and NSAID’s (Ibuprofen, Advil, Aleve) and any kind of strengthening.
- Cortisone can work to help take the pain away but be forewarned! Cortisone is not a healing agent. In fact it is a powerful steroid that has a long term negative effect on the plantar tendon. Many patients have found themselves in chronic pain after having 3 even 4 injections. I know a few runners who ran after an injection and ruptured their plantar fascia…and still have not run again.
- Stretching can be VERY helpful. The question you should ask is “How long do I hold a stretch?”, “How often do I do each stretch?”, “Are there certain times of day that I should definitely stretch?” and “How intense should the stretch be?”
- If you have tried a night boot and it was uncomfortable did anyone ever offer you a Strassburg Sock? If so and that was uncomfortable did anyone ever show you how to modify it to increase its comfort and effectiveness. If not watch the video http://sdri.net/running-injuries/plantar-fasciitis/strassburg-sock-fixing-plantar-fasciitis/ if you need to purchase a Strassburg Sock email firstname.lastname@example.org
- Did anyone ever offer you custom orthotics? Did they meet the 3 main criteria? 1. Were they comfortable? 2. Were they practical (did they fit in your shoes) and 3. Were they effective? If you answered no than whomever made your orthotics failed you. Orthotics come in many densities and flexibilities. They can also be modified. Watch our video http://sdri.net/services/custom-orthotics/videos-how-to-choose-the-right-orthotic-for-you/ after if you have any questions email email@example.com
In my experience many patients think they have “tried everything”. After they are seen by our clinic and properly instructed on how to do home care in addition to following our plantar fasciitis protocol they are generally amazed at how quickly they begin to see improvement and begin getting better.
If you have plantar fasciits and are tired of it and the pain associated with it either call our clinic at 858-268-8525 or email firstname.lastname@example.org so that I can answer your questions.
The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.