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Plantar fasciitis is a common condition of the foot that usually causes pain in the underside of the arch and the heel. A number of health care professionals are qualified to diagnose and manage this disorder. Similarities exist in how these professionals may approach an examination for plantar fasciitis; however each professional brings a unique perspective and skill set to the table. As an expert in structural anatomy and biomechanics, the chiropractor may be an excellent resource for a comprehensive examination.
Your chiropractor will probably ask you a number of questions about the location, duration and severity of your pain. You may be asked about activities that aggravate or alleviate the symptoms. Your sport and leisure activities, occupational demands and other medical conditions should be discussed. Questions may also address the type of shoes you wear. Your history may provide clues to the cause of your plantar fasciitis.
Your examination will likely begin with a visual inspection of your feet to see if there are any structural issues that may require some sort of correction or accommodation. The alignment of the knees and hips, for example, can affect the weight distribution and gait patterns of the feet. Excessive inward or outward angulation at the knees may be the underlying cause for faulty foot mechanics. The visual inspection will also include the pelvis and lower spine. A pelvis that is not level or a low back that is poorly aligned may be contributing structural factors.
After evaluating the static structure, it is important for the chiropractor to observe the body in motion. Close observation of the gait during walking or running may reveal important additional information. Is the arch collapsing excessively during weight-bearing? Does it remain overly rigid? Is there tightness in a hip? Is there a lack of flexibility in the ankles or in the calf muscles? Are the pelvis and the lower back moving symmetrically and smoothly during walking and/or running? These dynamic findings may offer important clues to treatment strategies for your plantar fasciitis.
Based on your examination findings, your chiropractor may determine that you could benefit from wearing orthotic inserts. A 2009 study published in “Annals of the Academy of Medicine” showed that certain types of orthotics can reduce or redistribute pressures on the foot. This can be beneficial for some individuals with plantar fasciitis.
Your chiropractor may find that the joints of your ankles or feet are not moving properly. A chiropractor is typically skilled in manipulation and mobilization of these joints. A literature review in the January 2009 “Journal of Manipulative and Physiological Therapeutics” reports that there is good evidence for the effectiveness of this approach in the treatment of plantar fasciitis. Alignment and mobility issues of the spine, pelvis, hips and knees may also be addressed through manipulation, or through exercise.
Strategies including the stretching of certain muscles and tendons are often included in a comprehensive strategy to manage plantar fasciitis. Even with chronic plantar fasciitis, specific stretches were shown to produce long-term benefits in a study published in the August 2006 “Journal of Bone and Joint Surgery”.
A change of shoes, activity modification, alterations in sports training methods, icing or massaging the arches of the feet may be advised to prevent a reoccurrence.