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Acupuncture and Plantar Fasciitis

Plantar fasciitis is extremely painful, I should know I have had it myself and you have my full sympathy if you are suffering with it . Plantar fasciitis means inflammation of your plantar fascia. Your plantar fascia is a strong band of tissue that stretches from your heel to your middle foot bones. It supports the arch of your foot and also acts as a shock-absorber in your foot. Repeated stress on the plantar fascia causes it to become inflamed.

Common causes of plantar fasciitis

Some common causes of plantar fasciitis are being on your feet for a long if you are not used to it. In sports if you suddenly start running, training on a hard surface or increase the amount of exercise (intensity and/or distance) you do then these all can be contributing factors. If you are overweight then this will put additional pressure on the plantar fascia. Faulty biomechanics can cause over pronation causing the feet to roll in excessively putting greater pressure on the plantar fascia which can cause heel pain. Calf muscles that are too tight or weak can also contribute towards plantar fasciitis by contributing early or delayed heel lift or heel strike.

 A higher-arched foot lacks the mobility needed to assist in absorbing ground reaction forces. Consequently, its inability to dissipate the forces from heel strike to midstance increases the load applied to the plantar fascia, much like a stretch on a bowstring. The foot serves several important functions. It enables propulsion through space, adaptation to uneven terrain, absorption of shock, and support of body weight. Many forces stress the foot and could disrupt this process stressing the plantar fascia and must be identified to prevent future episodes from occurring.

Night splints can be worn which stretch the plantar fascia and calf muscles at night like the one below and shown in the video above.

A cushion-type running shoe can provide extra shock absorption. I would send my clients to a specialist running shop where they provide gait analysis to identify their unique running style and provide running shoes to provide extra support. In Bristol I send people to Moti or Easy Runner.

I personally will always refer a patient to have orthotics fitted. Orthotics is the medical name for braces, splints and supports that help correct and support the function of limbs. Having a professional who specialises in this is crucial in identifying any biomechanical causes that can be contributing towards the problem. You can also buy over the counter orthotics from local pharmacies which are a cheaper option but obviously are not customised to your precise foot shape.

Hot and cold therapy is where the foot is left in warm water for a few minutes and then placed on an ice pack and this is alternated for a few times. The principle is that the cold contracts circulation to the area and then the hot expands circulation to the area. By alternating cold and hot this acts together to pump the extra fluid out of the injured area.

One of the simplest ways is to use a spiky ball or golf ball on the plantar fascia as demonstrated in the video below.

You can buy the spiky balls from amazon as above and are relatively cheap but I think a golf ball is best because it really does get in there.

Acupuncture treatment for Plantar Fasciitis

My approach will always be to take a full case history to identify any of the above causes. I will perform some standard musculoskeletal test that may be contributing towards the problem. If I find any then some of the treatment may address these causes and stretching or strengthening exercises will be given to address the imbalances. In addition I will often use massage to address any tightness in the surrounding muscles. I will always look at the entire leg, get the patient to walk and use other tests to incorporate a global approach looking for dysfunction.

 In the first session I would use acupuncture directly into the plantar fascia, typically around 4 needles in each foot. In addition traditional acupunctures may be used if I felt this would be beneficial. I may also use acupuncture into the calf muscles as deep tension in these muscles are usually a major factor. In the next session I would then use electro acupuncture which provides a stronger stimulation to the area. Electro acupuncture is a form of acupuncture where a small electric current is passed between pairs of acupuncture needles. In my experience electro acupuncture speeds up the whole process and patients will often report a noticeable decrease in pain.

This would be repeated on a weekly basis until the symptoms subside which from my experience is around anywhere from 2 to 6 treatments.

I would also use massage into the plantar fascia and stretch tight muscles as below.

At the time of writing I found two papers that suggested electro acupuncture for plantar fasciitis and can be found here.

Personally I would use a combination of the above (insoles, massage, acupuncture, self stretching etc) for the best long lasting results.

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