By: Andrew Kakishita, Chiropractic Intern
YOWZAA! My foot HURTS! Maybe I should see a chiropractor, but chiropractors only help backs, right? Wrong! Chiropractors are well-equipped to treat all kinds of foot conditions. Foot pain can be especially debilitating due to the need to walk, and sometimes diagnosing the issue isn't as simple as an online WebMD search. Could it be Plantar Fasciitis? How about Achilles Tendonitis? Or maybe it's something less known like Baxter's Neuropathy or Fat Pad Syndrome? Join me as we dive into these four foot conditions and what will help!
Plantar Fasciitis
Your plantar fascia is a thick piece of tissue that connects your heel to the base of your toes. It helps to maintain the arch in your foot and gives you the spring in your step... well, when it's not causing you pain. Despite the suffix, "-itis," meaning inflammation, Plantar Fasciitis is a non-inflammatory condition in which your plantar fascia begins to degenerate, most commonly due to overuse.
Diagnosis
Pain in the heel or arch of your foot with your first steps in the morning or after you've been seated for a while? Does the pain diminish as you walk? If yes, it may be Plantar Fasciitis. When you visit us, we'll ask you these questions and perform a brief exam involving tests such as the Windlass Test where a patient's toes are extended by the practitioner while the patient stands upright.
What Can WE Do?
Foot and ankle adjustments
Graston of the foot and calf
What Can YOU Do?
Exercise at a tolerable intensity
Use the 10% rule (exercise intensity should increase by a MAXIMUM of 10% each week)
Sleep with the sheets at the foot of your bed untucked. Doing so can help your plantar fascia relax and not flare up in the morning
Wear a Strassburg sock at night
Baxter's Neuropathy
Baxter's is a condition that closely imitates and often accompanies Plantar Fasciitis. It is the irritation of baxter's nerve, a nerve that wraps around the outer ankle bone. Baxter's nerve provides both sensation to the long plantar ligament, a ligament that runs alongside the plantar fascia, and motor ability to the pinky toe.
Diagnosis
If you try to splay your toes and your pinky toe doesn't move outwards very well, baxter's nerve may be involved. Additionally, the Extended Single Leg Raiser (ESLR) test can be performed. ESLR is a test in which the patient lies on their back, the practitioner points the patient's toes towards their head, lifts the corresponding leg, and then internally rotates the leg so that the knee cap is facing inwards. Pain in the heel during the test is a sign of Baxter's.
What Can WE Do?
Foot and ankle adjustments
Nerve flossing
What Can YOU Do?
Stretch and strengthen your foot and calf muscles
Nerve flossing
Fat Pad Syndrome (FPS)
FPS is an overuse injury that results from degeneration of the heel pad. If you have FPS, it'll feel like you're walking on a bruise in the center of your heel. Your pain may flare up if you've been walking for an extended period of time, especially when walking on harder surfaces or in shoes lacking heel support.
Diagnosis
If your heel pain gets worse the longer you walk, then it's time to start considering FPS. When in our office, we'll assess your heel to evaluate its thickness, and we'll have you walk a short distance on your toes. Toe walking keeps your heel off the ground, so symptoms should remain at ease. If symptoms were to become aggravated, we would be more suspicious of Plantar Fasciitis instead.
What Can WE Do?
What Can YOU Do?
Wear heel cups to give your heel a break and allow time for healing (pun intended)
Reduce the intensity of your exercise
If needed, switch from a high-impact activity such as running to a low-impact activity such as cycling or swimming
Achilles Tendonitis
The Achilles tendon is the strongest tendon in the body, sometimes bearing forces of 12 times a person's body weight. However, when the tendon is faced with loads greater than it can handle, muscle fibers begin to stretch and tear, resulting in tendonitis. Injuries resulting in Achilles Tendonitis most commonly occur when decelerating and then pushing off with all your weight on one foot. Pain is located in the back of the heel and ankle.
Diagnosis
We'll check your ankle for inflammation, as tendonitis and inflammation go hand in hand. We may performs tests such as the Calf Squeeze test (yep, we squeeze your calf) to assess ankle motion. Testing muscle strength can also give us a great idea of your Achilles tendon's condition.
What Can WE Do?
If tolerable, Graston or dry needling in the calf
Eventual calf muscle strengthening
What Can YOU Do?
Give your Achilles a break and limit activity for 2-3 days
Ice your ankle for about 20 minutes, 2-3 times per day
Foot pain is no fun, but no fret! We're here to help! Whether you have one of these four foot conditions or a different foot condition, you may be a good candidate for ALINE insoles or custom orthotics. Next time you're at our office, ask us about our free Foot Levelers assessment scan! It is also important to keep in mind that there are all kinds of conditions that can mess with our ankles and feet, and like Plantar Fasciitis and Baxter's Neuropathy, many of them can mimic each other. Come see us at Washington Park Chiropractic so we can figure out what's going on and how we can speed up your recovery!
Andrew Kakishita is a chiropractic student from Palmer College of Chiropractic - Davenport. He is completing his graduate education by interning at Washington Park Chiropractic and learning as much as possible from the pros.
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