When I asked patients like you to submit questions to me, one of them was:
“What kind of foot pain do you see most often in your practice?
And what can you do about that?”
A lot of times, I have patients who complain of general foot pain. Usually, they're talking about somewhere on the bottom of the foot. Obviously, they may have pain somewhere in the ankle, around the top of the foot, but probably the most common one that I get has to do with the bottom of the foot.
Maybe they've been to their general practitioner, or they may have self-described it as Plantar Fasciitis. That seems to be a kind of one-term-fits-all for foot pain, but the reality of it is that's not necessarily the case.
Often what I see in the office with plantar fasciitis is pain right along the bottom of the heel. All of the fibers and the tissue from the foot come from the toes and attach back behind the heel. And so when that's tight, it pulls on that attachment point a
nd creates pain. And it's a pretty specific location of pain that patients complain about. They also talk about getting up in the morning, and it feels like they're walking on glass because the bottom of the foot hurts. That's another potential indicator that the plantar fascia has tightened up and is uncomfortable.
But one of the foot pains that a lot of practitioners miss is a muscle that comes down from the back of the calf – deep in the calf muscle - around the bottom of the foot and actually wraps across the bottom of the foot. When we walk, it slows down the flattening of the arch- that's the posterior tibialis muscle. And when that's tight, it will actually pull on the attachment points on the bottom of the foot and create pain in the arches as well. More often than not, what I find is that if the pain is directly at the heel, it's probably more related to plantar fasciitis. And if it's more in the arch that is typically posterior tibialis muscle.
The nice thing is that, in my office, we're able to treat that both of those and also give the patients some home treatment to do.
For plantar fasciitis, we get patients to roll their foot on a tennis ball or golf ball, if they can tolerate it. And, we'll do some soft tissue work to stretch out the plantar fascia. We might use the Graston technique to scrape it. We also look at the structure and the bones of the foot to make sure that they're functioning like they're supposed to. Then at home I have them doing heat soaks.
For dealing with the tibialis muscle, I will actually do some active release type of treatment on that muscle to get it to release. I have the patient do some rolling on the calf muscle at home. Then we can also do some Graston scraping of the muscle and the tendon as it wraps around the foot.
The good thing for foot muscles is that with a combination of in-office treatment and home therapies, we can get a lot of pain relief – and correction – for people who have foot pain.