The Perplexing Plantar Fascia
Have you ever had nagging heel pain? The kind that stings when you step on your foot the wrong way? Or was it the kind that only hurts after you take your first few steps in the morning? Have you used shoe inserts or devices to stretch out your ankle and foot….and it still hurts?
Plantar fasciopathy (a.k.a plantar fasciitis) is a condition that confuses so many healthcare practitioners. As a result the general public is even more confused.
When I get patients with a plantar fasciitis diagnosis, I always approach the situation with skepticism because there are so many other structures in the heel that could create pain.
There a small nerve that lives in the area of the base of the plantar fascia that I find is one of the most commonly involved structures in heel pain. I also find that irritation of this nerve is commonly associated with sciatica because this little heel nerve branches off the great sciatic nerve.
Other common causes of heel pain can be due to restrictions in the ankle and foot joints, tendon problems and of course the dreaded plantar fascia.
Leg length is another component that must be considered. If your left leg is shorter than your right, then your feet will not impact the ground the same way. Without going into the details, there are many reasons why your legs can be different lengths and tons of treatment options to deal with this.
The lateral plantar nerve and calcaneal nerves near the plantar fascia insertion.
Image from: http://www.heelspurs.co.uk/heel-anatomy.jpg
Thorough testing of all these structures in an evaluation can take about 30-60 minutes. Generally, there is no one special test that rule in or out plantar fasciopathy. Correcting this condition requires careful examination by a qualified physical therapist. A healthcare provider must use various hands-on tests and watching how your body moves in order to gather all the puzzle pieces together and see the whole problem.
At El Paso Manual Physical Therapy, we take pride in paying attention to details. We make sure enough time is provided to get you on the right treatment pathway so that you can get back to doing what you love.