The Patient

• 63 year old male with a history of diabetes
• Otherwise unremarkable history

The Patient’s Complaints

• Severe left sided heel pain that began 3 months ago, and is made worse by walking and prolonged standing
• The patient to forced to limp when trying to walk
• Occasional left sided knee pain and lower back pain

Snapshot of My Examination Findings

• Patient demonstrates a loss of balance while walking
• Guarding (protective movement and positioning) of the left lower extremity
• Multiple areas of spinal subluxations (jammed spinal bones that irritate the nervous system)
• Painful range of motion of the left hip joint
• X-ray evaluation of the left foot and heel showed only mild degenerative changes (bony arthritis); no heel spur seen
• Extreme tenderness of the plantar aspect (bottom) of the left foot and heel when touched by hand
• Digital and visual evaluation of the arches of the foot revealed a severe arch drop of both his left and right arches

My Diagnosis

• Plantar Fasciitis and Excessive pronation (“fallen arch”) of the left foot
• Lumbosacral area joint dysfunction and pain
• Multiple spinal and left hip subluxations

My Recommendations

• A course of 12 visits of integrative care to include the following:
• Chirporactic adjustments of the spine, feet, left knee, and left hip
• Myofascial release to the feet, hips, and lower back area performed by massage therapist
• Wear custom spinal pelvic stabilizers (orthotic inserts) to support the arches
• Progressive therapeutic exercises targeting the feet and lower extremity, with a focus on restoring normal balance
• Ice the left arch at home as needed for 15 minutes per hour

The Prognosis

• Fair to Good

Discussion

Plantar fasciitis is a fairly common condition that we see in our practice.  It affects the section of soft tissue on the bottom (plantar surface) of the foot.  When the sheath (plantar fascia) of elastic (connective) tissue becomes over-stressed, it can become inflamed and very painful.  The most common problem occurs when the three arches of your foot drop too far or collapse (through time and stress), the plantar fascia becomes abnormally pulled and  stretched out.  This pulling can lead to inflammation and pain in your heel, your arch, and even in your forefoot.  In severe pain cases, a burning sensation can be felt going across the bottom of the foot, and walking would be very painful and difficult.

Upon following our advice and treatment schedule, this patient has had an approximate 75% improvement in 2 weeks of care.  He is virtually pain free and is now able to walk without limping.  The knee, hip, and lower back problems have also shown considerable improvements.

Our Approach To Plantar Fasciitis

If you were a new patient visiting our office, we always start with a thorough case history, consultation, and examination.  I may recommend diagnostic studies (x-ray or MRI) if I need more information. At this point, if I determine that care is appropriate and you decide to begin care, I will design a treatment plan for you.  If at any time I discover something beyond the scope of my practice, I won’t hesitate to contact your primary care provider to discuss a possible referral to another healthcare provider.

We follow a very effective  treatment strategy based on the letters ASR.  They stand for:

• A – Adjust (whole-body adjustment techniques)
• S – Support (spinal pelvic stabilizers and other joint supports)
• R – Rehabilitate (targeted exercise therapy/physical rehab)

My approach that works so well with the spine can be applied to other joints of the body. Virtually every articulation of your skeletal system is susceptible to fixations that can impair function and range of motion.  We have a variety of other treatment options to help you recover quickly and completely.  Some of our other treatment options could include:

• Massage therapy
• Laser therapy
• Electrostimulation treatment
• Home TENS unit
• Therapeutic taping
• Targeted rehabilitative exercises for the feet, lower extremity, and lower back
• Exercise modification
• Home exercise program
• Nutritional supplementation and dietary modification

We don’t want you to have to resort to dangerous medicines, injections, or surgery.  Our approach is to use chiropractic care and other natural therapies (such as massage or rehab exercises) to correct your plantar fasciitis problem quickly and  naturally.

Plantar fasciitis is a common condition that affects the section of soft tissue on the bottom (plantar surface) of the foot.  It is considered a stress irritation to the sheath (plantar fascia) of elastic (connective) tissues running nearly the entire length of the foot.  These connective tissues provide the primary support for the undersurface of your foot.

If the three arches of your foot drop too far or collapse (through time and stress), the plantar fascia becomes abnormally pulled and  stretched out.  This pulling can lead to inflammation and pain in your heel, your arch, and even in your forefoot.  The level of discomfort can range from mild to severe.  In severe pain cases, a burning sensation can be felt going across the bottom of the foot, and walking would be very painful and difficult.  For some the pain is felt every time they stand up.

By the age of 20, nearly 80% of us has some kind of foot problem, and by age forty almost all of us do.

http://www.footlevelers.com/conditions/foot_problems.php

The most common cause of plantar fasciitis is excessive pronation, which is considered the most common of all foot problems. In excessive pronation, some of the bones of the foot drop to a less stable position due to a structural weakening and misalignment of the foot arches and bones of the foot. The arches themselves may be unnaturally stretched causing a flattening of the feet.  This results in abnormal stress on the entire foot, which leads to abnormal biomechanical stress on the ankle, knees, hip, sacroiliac, and spine.

From the time you learn to walk, your feet assume three crucial functions: they support your body whenever you stand, walk, or run; they assist you in achieving movement from one place to another; and they help protect your bones and soft tissues from damaging shock stress as you move. Being overweight, having minor structural defects in the feet, or injuries — all of these factors can contribute to additional foot and body stress. So even though one-quarter of all the bones in your body are in your feet, having to perform these three strenuous tasks day after day can (and often does) lead to some type of foot and/or body problem. It’s not too surprising to learn, therefore, that by the age of twenty, nearly 80% of us have some kind of foot problem, and by age forty almost everyone does.

http://www.footlevelers.com/conditions/foot_problems.php

If plantar fasciitis or excessive pronation aren’t treated, they can lead to progressive development of foot malfunction and discomfort. Your feet can become “tired and achy” or you may experience burning pains.  Your walking may begin to feel “clumsy” as you try to move your foot in a way that avoids further pain.  Left untreated for a long time can result in the formation of a heel spur.  Heel spurs are small deposits of bone-like calcium on the heel bone (calcaneus), usually on or near the bottom of the foot where the long tendons of the arches (plantar fascia) insert into the bone.

Some experts believe that a spur is the body’s attempt to strengthen its foundation. Being overweight, having abnormal foot biomechanics, or running regularly on hard surfaces can cause excessive stress on the foot, which may lead to the production of a spur. Other authorities contend that spurs are a normal part of the aging process: some studies have shown that calcaneal spurs are more frequently found in people after age 50. The best data currently available projects that between 11% and 16% of the population have heel spurs. It is also interesting to note that spurs occur almost twice as often in adult females as they do in adult males.

http://www.footlevelers.com/conditions/heel_spurs.php

Foot pain means that you should make an appointment to be evaluated in our office right away.  But most problems of the feet are symptom-free (painless).  Even if your feet don’t hurt, the structural imbalance and weakening of your foundation can have a serious impact on the rest of your body. If you are currently having pain in your knees, hips, low back or neck, the reason may be because you have excessive pronation.  Your feet may not be properly supporting the rest of your skeleton.  The abnormal stress will work its way up into the rest of your of your body.

If you are having pain in your ankles, knees, hips, back or neck, contact our office to discover if your feet could be a contributing factor.

We follow a very effective  treatment strategy based on the letters ASR.  They stand for:

• A – Adjust (whole-body adjustment techniques)
• S – Support (spinal pelvic stabilizers and other joint supports)
• R – Rehabilitate (targeted exercise therapy/physical rehab)

I am pleased to announce the addition of the Foot Levelers Associate™ Platinum to our wellness practice.  A tool that will allow me to make a digital scan of the feet.  The Associate™ Platinum will help me efficiently and accurately screen for imbalances that contribute to problems in any number of places, like your knees, hips, and low back — even if your feet don’t hurt. It’s amazing what your feet can tell you about your spinal health!

Your feet are the foundation for your entire body. Like any structure, your body’s foundation must be balanced to properly support the weight above it. If your arches in one or both of your feet collapse, your body doesn’t get the correct postural support, causing an imbalance in your skeletal frame.

The Associate™ Platinum digital scanner will help me develop more precise care plans and use postural support, like custom-made orthotics from Foot Levelers, to obtain positive results in nearly everyone — from children to seniors.

I would like to welcome new patients to visit our wellness center in Huntingdon Valley for postural exams to determine their chiropractic needs. Our wellness center offers a variety of natural therapies for total body health and would be willing to provide on-site screenings with the Associate™ Platinum at health fairs and other community events.

If you’ve never had your feet scanned, you probably don’t know what they are supposed to look like. Don’t wait for aches and pains to tell you there’s a problem.

Call us now to schedule an appointment, and learn how your feet can affect your health!  Your entire body will thank you!

Our center’s mission is to promote superior health through natural therapy. And it’s amazing how powerful natural therapies can be… with the right knowledge backing it up.

Many of my clients have serious complaints that can be corrected rather quickly. In many cases our clients need to rely on our professional expertise to solve the problem. Sometimes it’s a matter of a series of adjustments or trigger point massage therapy. Sometimes it involves a course of laser therapy.

In other cases it’s just a matter of making changes to their lifestyle. This could involve tweaking an exercise program and eliminating harmful exercises. It could mean getting more sleep. It could mean learning how to activate the core muscles (which we teach in our center). It may involve learning how to better manage stress.

In the cases involving complaints in the lower extremities (the feet, ankles, knees, and/or hips), many times the solution can be found in proper support and balance.

I’ve found that excessive pronation is one of the most common problems that’s at the core of many lower extremity complaints. Excessive pronation is a condition where the medial arch of the foot is not doing it’s job in supporting the foot. It begins to drop too far upon weight bearing.

This means that every time you step down, the medial arch drops too far. This causes a cascade of problems working their way up the chain of joints. Foot problems have been shown to cause problems all the way into the spine and up even to the jaw.

Excessive pronation, poor support, and disturbed balance can cause these common problems:

• foot pain
• plantar fasciitis
• bunions
• hammer toes
• ankle pain or instability
• shin splints
• sciatica and piriformis syndrome
• knee pain
• hip or sacroiliac pain
• poor posture
• back pain

If you have any of the previous problems, please schedule an evaluation to have your feet checked by me or someone at our office. It only takes about 5 minutes to do a thorough evaluation, which could possibly uncover a problem that has an easy fix.

This small investment of your time could save you incredible amounts of pain and suffering. And if your lower extremity problem is interfering with your activities, we may be able to help you get back to enjoying an active lifestyle again.

In cases of excessive pronation or instability, I will almost always recommend these two things:

1. Start using spinal pelvic stabilizers by FootLevelers

The ones you can buy at the neighborhood pharmacy, can add a little padding but don’t support the arches properly. We use a digital foot scanner to evaluate patients’ arches right in the office. The scan is sent directly to a company called FootLevelers, who builds each spinal pelivic stabilizer based on the patient’s individualized scan. The custom-crafted inserts by Footlevelers provide support for all three of the arches of the foot, while remaining flexible to allow the foot to move normally. The style of insert is determined by the patient’s use. For example, athletic shoes and dress shoes require different styles. They make specific styles to accommodate special needs such as sensitive feet, golfer’s needs, wet environments, children, high heels, etc. I’ve been using FootLevelers spinal pelvic stabilizers since around 1999.  I’ve found them to be affordable, durable and comfortable… and they do the job very well.

2. Start wearing a good motion control shoe

The motion control shoe I recommend is the 1123 by New Balance. You can check them out online. It’s an excellent shoe that provides motion control, stability and cushioning. It’s a bit expensive, but it is very durable. I’ve heard that it can last twice as long as the typical running shoe. I just bought my first pair this week, so I don’t know first hand yet.

Focusing on body support and balance is a wise investment of your time and money and could save you a great deal of pain and suffering. Taking care of your problem now may enable you to get back to enjoying an active lifestyle again. Even if you don’t have any substantial pain, you may have a significant problem developing. If you suspect that you have a problem with support or body balance, give us a call today.

It is always easier to stay well than to get well.