The topic of foot pain came up multiple times while treating athletes at an Ironman triathlon in Whistler, with heel pain being the most common. There are many possible reasons for pain in the heel or foot as there are small nerves that can become crushed or irritated, bone spurs that can form, fractures, joints that are stuck or cause pain when they move, as well as just strained muscles.
The most common reason for heel pain is plantar fasciitis, basically a painful inflammation of the fascia (fibrous tissue) on the bottom of your foot. This usually results from the surrounding muscles being severely overused or tight, which causes pain in the arch or heel of the foot. The first thing to keep in mind is that pain is just a symptom of a foot problem- pain killers and steroid injections can definitely help reduce pain and inflammation, which is great for keeping you active, but the problem will almost always return, and usually worse the second time since it still hasn’t had any actual treatment.
The first step in treating plantar fasciitis is to rule out other causes of foot pain, like the ones mentioned above, and figure out if this is an acute (came on all of a sudden) or chronic (ongoing for a long time) injury. Chronic injuries typically take longer to heal since your body becomes more pain sensitive as it stays in pain, and you likely have changed the way you walk so that it’s more bearable.
There are 26 bones in the foot and over 30 joints that must all move well to allow proper movement of the foot. For example, a tight ankle joint means that your shin bone can’t move properly on top of the foot, which means that your body will start taking shorter steps, since you don’t have the flexibility to walk normally. This also means that the rest of your toes won’t be getting much of a stretch either, since they need a good sized step to move through their full range of motion. This can also cause a common compensation called ‘pronation’, when you roll onto the inside of your foot when walking, causing a chain reaction of your knee falling in and your hip dropping down on that side. Not only are you now setting yourself up for hip/back and knee pain, the constant rolling to the inside of your foot causes an uneven loading to the foot, making you more prone to foot pain.
Having proper motion in the joints of the feet is important for preventing plantar fasciitis and other foot pain, as it can help stabilize the foot’s normal arch while being active. Proper movement of the foot, combined with reducing any tension or scar tissue in the muscles of the foot will help to quickly knock down any foot pain, get your feet moving better, and help prevent any foot pain in your future.
Techniques like the chiropractic adjustment, Active Release Technique (ART) and Instrument Assisted Soft Tissue Mobilization (IASTM) can be combined to effectively break up the scar tissue in your foot that forms with chronic tightness within muscles and fascia.
Before treating any type of foot pain, it is important to rule out any other potentially serious problems of the foot to figure out why exactly you have the pain and how you can fix it. Your chiropractor or other healthcare provider can provide appropriate recommendations for your injury that may be similar or different from what is discussed here.