Acupuncture for Plantar Fasciitis
Do you find it painful to walk first thing in the morning? You might have plantar fasciitis.
Plantar fasciitis is an inflammation of the fascia (connective tissue) on the sole of the foot. The hallmark sign of plantar fasciitis is pain—in some cases severe—in the heels or soles of the feet when you take your first steps of the day in the morning. The pain generally gets a little better throughout the day as you move, in some cases disappearing. But in bad cases you may have pain throughout the day anytime you are on your feet.
If you have experienced plantar fasciitis, you know that it can be debilitating and can prevent you from participating in your everyday activities. Fortunately, there are really helpful treatment strategies for plantar fasciitis, and acupuncture is one of them. Whether you are an athlete training for your next race or you simply want to be able to walk around in the grocery store without pain, read on to learn more about plantar fasciitis and what you can do to prevent and treat it.
FOOTWEAR MATTERS
If you have plantar fasciitis, the first thing you will need to address is your footwear.
If you are a high performance athlete and haven’t yet worked with a movement specialist to analyze your gait and to fit you with the right footwear, I would recommend starting there. On the other hand, if you are someone who spends a lot of time on your feet or has a history of wearing high heels, you may want to start by finding comfortable flat-soled shoes that have a wide toe-box and a cushioned sole.
What is wrong with high heels?
Traditional high heels are probably the most problematic footwear choice for several reasons, but any shoes with heels could potentially contribute to the development of plantar fasciitis. High heels change the gait and the body mechanics from the feet up through the hips and even into the low back, mid-back, and neck. (As usual, when we start to look holistically, we see that everything in the body is connected.)
Most notably, walking in high heels prevents the ankles from flexing with each step, which means that the calf muscles don’t have the opportunity to extend as usual, leaving them in a perpetually shortened and tightened position. Over months and years of wearing this type of footwear, the musculature and fascia of the calves and hamstrings can get more or less stuck in this tightened position, in turn pulling on the Achilles tendon and the fascia on the sole of the foot. Traditional heels also jam the toes forward, squeeze them together, and put too much weight on the ball of the foot, further distorting the foot and mechanics of walking and in some cases contributing to the formation of bunions, another common foot problem.
I recommend flat-soled shoes with a wide toe-box and a cushioned sole.
Flat-soled shoes are important, because they allow proper motion in the foot and ankle, unlike high heels. You want a proper heel-strike and movement through the ball of the foot with ankle flexion, because these movements are the foundation for proper mechanics up through the hips—including appropriate stretch in the calf muscles. The wide toe-box allows for a spreading movement in the bones and the fascia of the foot while walking, which is important for the mechanics of the gait and also for optimal blood flow in the soft tissues of the foot. Finally, the cushioned sole helps to soften the pressure on the heel bone, helping prevent inflammation in that area.
If you have changed footwear with no results, consider visiting a podiatrist.
A podiatrist can create custom insoles for you, which can be quite helpful for some people. Unfortunately, I find that I often see people in the clinic who have tried one or more custom insoles and not yet seen results. If that is the case for you, it doesn’t necessarily mean that the insoles aren’t the right fit, but simply that they aren’t addressing the root cause of your plantar fasciitis.
Whether or not you try custom insoles, if you have changed footwear with limited results, it’s time to seek out targeted therapy to address and heal the root cause of your plantar fasciitis.
COMMON FACTORS IN PLANTAR FASCIITIS
TIGHT MUSCULATURE
One of the reasons that custom insoles have limited success is that they don’t address a common contributing factor in plantar fasciitis, which is tight musculature in the hips and legs. Imbalances in the pelvis and shortened muscles in the calves and thighs can cause excess pulling on the Achilles tendon and the plantar fascia of the foot, leading to the inflammation and pain of plantar fasciitis.
INFLAMMATION IN THE HEEL
Regardless of the state of the calf muscles, plantar fasciitis is by definition an inflammation in the sole of the foot. Areas wrapped by tight fascia sometimes don’t get adequate blood flow, which is essential for healing damaged and inflamed tissues.
GAIT IMBALANCES
Whether or not a gait imbalance initially contributed to the development of a case plantar fasciitis, plantar fasciitis itself can cause disturbances in the gait. It’s nearly impossible to walk normally when we have pain in our feet, especially when that pain is chronic.
POOR CIRCULATION
A common feature of a local chronic inflammation like planter fasciitis is lack of optimal blood flow in the area of question. However, when an inflammatory condition like plantar fasciitis just won’t go away no matter what you do, you might consider that there could be a more systemic internal medicine factor at play. It’s possible that your circulation of blood and lymph in general is sluggish or that chronically high stress or high blood sugar is tanking your body’s ability to address the local inflammation in your foot.
ADDRESSING PLANTAR FASCIITIS HOLISTICALLY
Addressing plantar fasciitis holistically means targeting a variety of contributing factors.
For this reason, when I treat plantar fasciitis with acupuncture, I treat the area of pain, but my treatment extends well beyond the foot. Gentle work in the exact area of pain helps by directly increasing blood flow and reducing inflammation in the sole of the foot. When there is also dysfunction in the Achilles tendon, I do work around the tendon to increase blood perfusion around the tendon sheath. Further up the chain, I may do work on a variety of relevant muscles, including the calf muscles, hamstrings, and glute muscles. The muscular work may be a combination of trigger point therapy and motor point therapy, with the goal of lengthening and releasing chronically contracted muscles and also helping other muscles to fire on cue. Manual therapies like cupping can help to further reduce muscle tension, improve circulation, and break up adhesions in the connective tissue around the muscles. And finally, for those with more systemic issues that are preventing healing, I add custom Chinese herbal medicine therapy to help the body as a whole to speed the recovery process.
In my experience, plantar fasciitis responds very well with this holistic approach. These therapies increase local circulation and reduce local inflammation in the sole of the foot; support muscular balance, stability, and flexibility in the hips, thighs, and calves; and generally support the body’s ability to heal. I also frequently recommend complementary therapies like massage, physical therapy, and/or movement therapy where appropriate to support tissue health, muscle stability and balance, and proper gait and movement.
Want support healing your heels? I would be honored to help you get back to walking without pain!
