Everything You Need to Know About Plantar Fasciitis

00:18-02:34What is Plantar Fasciitis
02:35-03:59Heel Spurs XRay
4:00-11:58The Kinetic Chain Reaction of Foot Pain
11:59-17:04How to Treat Plantar Fascitiis
17:05-18:06Phases of Heel Spurs
18:07-20:21Role of Orthotics
20:22-21:16Role of Massage and Acupuncture
21:17-23:14Role of Chiropractic
23:15-24:13Vitamin D with K2

Dr. Clayton Roach: [00:00:06] So tonight, we talk about your aching feet. You’re poor. Go ahead, buddy.

Dr. Ben Boudreau: [00:00:14] That’s right. So tonight we’re talking about plantar fasciitis. It’s the most common symptom of pain

Speaker3: [00:00:21] On the bottom of the foot.

Dr. Ben Boudreau: [00:00:23] And most of the time you’ll feel that pain on the arch or the medial side of the foot. You’ll feel it right into the heel. It occurs when the strong band of tissue known as the the hair becomes inflamed and flattened out. Y will get into that in just a second. So it’s a long, thin band. It lies directly beneath the skin on the bottom of your foot and it connects the heel to the front of the foot to support that healthy arch. It’s designed to support and absorb the high stresses and strains that you placed on the feet with every single step that you take when these forces are not distributed properly, which is what we’ll be speaking about this evening. It can lead to too much pressure on the arch causing damage in terms of the tissue. We’re going to talk a little bit about that going forward. Here’s how we explain what the fashion guys imagine. We have like this piece of flat meat.

Dr. Clayton Roach: [00:01:26] Red meat right here, and you placed a piece of stretch and seal, saran wrap, ran over that piece of meat, right? That piece of stretch and seal is the Fascher, so all Sasha is is a piece of thin lining that leads right on top of the muscle. And what happens when you have inflammation? Inflammation starts to infiltrate between these two layers right in through here. Right. So. Go ahead there, Mr. Bin.

Dr. Ben Boudreau: [00:02:01] Yeah, so one of the key indications of this

Dr. Ben Boudreau: [00:02:04] Little flat piece of fibrous tissue, I like to think it’s like a spider web that ties all of your muscles together. When it gets really tight, it’ll start to show an x ray, just like when we saw that enlargement of the skull enlargement that when you had the horn on your head. Oh, yeah, I remember when you talk too much on your phone or your texting too much and grow a horn, that was episode like.

Dr. Clayton Roach: [00:02:30] Three or four, I think

Dr. Ben Boudreau: [00:02:32] Three or four is the same the same idea. So the plantar fascia begins to pull on that heel because that’s where inserts. Right. And it’ll actually cause tiny little bone spurs there on that middle aspect of your heel. And it’ll present on the X-ray as some key indication of poor distribution of energy with every step in your. Your plantar fascia has taken the brunt of that, and it shows an x ray.

Dr. Clayton Roach: [00:03:03] Now, Ben, do you treat an X or do you treat the patient?

Dr. Ben Boudreau: [00:03:08] You always treat the.

Dr. Clayton Roach: [00:03:13] Patient, yes, so that said, that was a trick question, but you struggle on that one. So that said, the reason I say that is because you cannot look at an X-ray like this and assume that this person has pain.

Dr. Ben Boudreau: [00:03:28] Yes, and you’re exactly right, because actually one out of 20 people with these bone spurs. Don’t have any sort of pain or sorry, one out of the 20 people do have pain, the rest don’t. And so the likelihood of you actually having pain with the hospital is quite low.

Dr. Clayton Roach: [00:03:48] And you I mention that is because many people get an x ray. They had a heel spur and they give up like nothing can be done. Right, because they think that’s that’s why they’re there in the pain that they’re in. Big word here, kinetic chain, yeah.

Dr. Ben Boudreau: [00:04:04] And so this is kind of what I’m talking about, the distribution of energy, right. And so if the energy isn’t distributed properly, what you’ll begin to see is a lot of that pressure being dissipated right on that right on that plantar fascia. But then you’ll also begin to see issues further up the chain, whether it be in the ankle, knee, hip and low back.

Dr. Clayton Roach: [00:04:28] So what about been that when we take a look at a patient, one of the first things that I do, and it’s probably part of your routine as well in terms of being one of the first things you do is you look at posture because posture is the window to good health. Right. So one of the first things that I look at from back to front is to see what is the angle of the shoulder. Right. And then I go down to the hips and I see, OK. What are the hips doing? More often than not or ever, the shoulder is lower to the opposite, hip is lower, just like these arrows are already showing. I just wanted to use my pen there. So what happens then? You’re going to get internal rotation of the knees, which then forces that foot to go down so you can have the problem go from above down. Or you can have problems because your feet going from down to the higher chain. Right. So just wanted to point out.

Dr. Ben Boudreau: [00:05:27] Go ahead, buddy. Yeah. And so just like Dr. Roach said and what I’m going to dive into a little bit deeper now is when you have that flat arch, the foot tends to tilt in because the arches collapsed. The tibia, the next bone, like Dr. Roach said, internally rotates. What that does is it causes the knees to collapse into the middle. And so they would have done what we would call is a Voulgaris and at the same time the pelvis, then the hip starts to internally rotate and at that point, the lobach becomes involved because you’re further up that kinetic chain because we don’t have proper hip motion at that time, then it leads to either back pain. It’s always about looking at the distribution of energy. With every force that you take, the energy from the ground is going to be distributed up the body. And so we want to be able to make it so that the alignment of the structures can dissipate that force evenly and not just on one structure or another structure further up the chain.

Dr. Clayton Roach: [00:06:33] So take a look at all of these joints being able to absorb the force as soon as you walk and you hit the floor with your heel. All these forces go up the spine. So as soon as one of these joints is dysfunctional and by definition, by dysfunctional, we mean doesn’t have great range of motion. All those ranges, then all of a sudden it can absorb the force so it can adapt to that force. And over time things start to compensate. So now your hip goes lower, your shoulder goes lower, and the longer you go on the compensation’s, the more likely you are to having non-dramatic injury

Dr. Clayton Roach: [00:07:09] By definition in on traumatic injury shows up that Roache Chiropractic Center and then or Klayton ask you, how did this happen? And you just shake your head, you shrug your shoulders and say, I have no idea. Right. You did not get hit by a truck. You did not go in an accident. You didn’t lift anything heavy. Just things start to fall apart because of the amount of time you spent compensating from these forces going up your spine, not being able to be distributed equally because these joints were not ready to support that force.

Dr. Ben Boudreau: [00:07:43] Yeah, and how many people walk in the office

Dr. Ben Boudreau: [00:07:45] That just have plantar fasciitis? It’s very rare that you ever from plantar fascia pain alone and don’t have a knee issue or a low back issue. Just for example, today I treated plantar fascia. The individual had a tear in the knee on the exact same side and all his most of his low back pain is originating from the same side as well. And so when you look at a history and you’re picking apart and you’re like, OK, there’s something along the way that wasn’t treated properly or these biomechanical interactions were treated properly from the beginning. And so now we’re seeing compensation patterns turning into injuries later on.

Dr. Clayton Roach: [00:08:24] That’s the only thing on the health history of plantar fasciitis. Yeah, you happen to have a double neck pain. Oh, yeah, I can. It just

Dr. Ben Boudreau: [00:08:33] Goes on. Oh, yeah. Yeah, that’s right. About the knee. Had a fracture back here. Yeah. Yeah. That’s all. You want to align the spine as well. Inconsequent structures so that we can then have proper neural communication and force dissipation between the areas. Right. Yeah. Result in decreased stress in the overall nervous system and responses to those ground reaction forces. And so if we align everything, the reaction will be proper and you’ll have less pain, less injury, happy life.

Dr. Clayton Roach: [00:09:05] So here’s the truth. You may be able to solve the pain of the foot by just treating the foot, but you will never solve the whole kinetic chain by just treating the foot. Therefore, the pain, the foot will return if you don’t address all these other issues. It just it ain’t going to happen, right, so that’s why we’re not trying to avoid treating the foot, we just say there’s a bigger fish to fry up here at the pelvis. And meanwhile, we’ll work on the foot because maybe it’s been like this for a long time and we need to be stretching all that stuff. But, yeah, it definitely might not be the cause.

Dr. Ben Boudreau: [00:09:38] I just want to mention the x rays just off to the side. So a lot of times these alignments and structure and posture can welcome a lot of other things in the spine as well, especially if you’ve been doing these, you know, you’re taking a thousand steps a day and you’re taking a thousand steps the exact same way it can lead to changes in the actual anatomy. And you see it on x ray where those arrows are pointing to and they’re pointing a lot to the arthritic structures which are just posterior to the square vertebral bodies. And so this is where a lot of arthritis will start in the joint and we call it for Setara Thrombosis, where the arrows are pointing to the white radial opaque areas which become blurry. They should you should be able to see the nice lucid lines there. But because of the arthritis, it shows up on X-ray. It turns out to be white and blurry. So I just want to make people aware that if alignment isn’t proper and you’re taking a thousand steps the same way, the back is going to respond, even if you think it’s just the foot involved. Yeah.

Dr. Clayton Roach: [00:10:46] If you take a look at the I just want to point something, though, Ben, you were probably going to point this out, but if you take a look at the holes on the side, X-ray right here, everything is great until you get here. And then this whole here is just obliterated, right? Is this the same X-ray that

Dr. Ben Boudreau: [00:11:05] They’re meant to show the same thing at the same level?

Dr. Clayton Roach: [00:11:09] Yeah, yeah. And I mean, this is all white, so there’s a lot of stuff happening here. And also, if you take a look at the disk space over here, which you guys have become professional, is out by now. The displacing is very, very limited compared to what it is all the way up here. So, again, this could be the simple effect of having bad foot mechanics affecting knee, affecting the hip or the foot could be the problem because of what’s going on over here and how the pelvis is compensating and how it’s changing your gait every time you put your foot down on the floor. So what came first, the chicken or the egg? I guess at one point it doesn’t really matter. They’re both there and they both need to be they both need to be addressed. So let’s say we decide, OK, well, we’ve got to treat the foot. What are some of the things that we can tell people to do for plantar fasciitis? I’ll start with one will kind of go back and forth. One of the things you can do I want to go back to this here.

Dr. Clayton Roach: [00:12:11] One thing you will notice is over here you’ll have the Achilles tendon that will be right here, OK? The Achilles tendon ends right up there. And then the plantar fascia picks up right here and goes all the way down. So if your Achilles tendon is really, really tight. This will force your foot. To curl in here and shorten the fascia and start pulling on the heel, so one of the things you can do is just I’ll show you how to do it over here. Is to put your foot up against the wall and stretch the back of your calf, right. So that’s going to be the back of your calf stretch your calf. Sorry. And the key here is to hold the stretch for twenty five seconds to 30 seconds, do it three times and do it six times a day. Morning, mid-morning lunch, mid-afternoon supper. And before you go to bed, because most of the time stretching the fascia is not enough because you’re deleting this part here, which is very, very closely associated down here. All right. So that’s my thing. Go ahead, Ben.

Dr. Ben Boudreau: [00:13:27] Yeah. In the second thing that I would say as another quick point, if people feel this pain first thing in the morning, thumbs up. If you feel plantar fascia pain first thing in the morning.

Dr. Clayton Roach: [00:13:38] First step, always the most painful of plantar fascia,

Dr. Ben Boudreau: [00:13:40] Always the most painful. The first thing that you want to do is probably if the pain is too much, get an ice bottle, a bottle water, fill it up, put it in the fridge or in the freezer, freeze it and roll your plantar fascia, roll your foot over the top of that frozen water bottle. It’s a great way to help alleviate some of that pain with some ice. And as well, it sort of gets that foot rolling and it gets it moving in the morning. Yeah.

Dr. Clayton Roach: [00:14:08] Another thing you can do is before you get up in the morning as well, once you’ve put your foot down on the floor and hurts, you’ve now inflamed the area. So now you’re you’re backwards. Right now you’re trying to catch up and getting rid of the pain. So before you get out of bed, make sure that you if this was you on the side and this is your foot, bring your foot up and down, up and down. So essentially what you’re doing, you’re stretching your calf, you’re stretching your fascia and you do 20 of these before you get up. Now you’re ready to take that first step and hoping that that’s reduced a little bit of the tension that was there from you sleeping in the night and your toes somewhat relaxing, but keeping that fashion short. So when you go to stand, your foot is going to come down and it’s going to stretch that fashion might not be ready to do that. So that’s one more thing you can do. Go ahead, Ben. You got something else?

Dr. Ben Boudreau: [00:15:03] Yeah. Strictly speaking, if we’re talking a lot about improving biomechanics, one of the first and major structures that I would look at is the hip. And so if you come and see us in clinic, I will take a look at the hip and attempt to change the structure there and improve its range of motion. And so you always want to improve upon hip internal rotation. It’s one of the first movements to go as soon as you have a lower limb injury. And it’s shown that if you have reduced hip internal rotation, it can lead to increases in ACL injuries.

Dr. Ben Boudreau: [00:15:41] Greater trochanter pain syndrome,

Dr. Clayton Roach: [00:15:44] So that’s for sure. Yeah, hepatocyte is right on the side.

Dr. Ben Boudreau: [00:15:48] Yep.

Dr. Ben Boudreau: [00:15:49] As well as well. Plantar fascia pain. And so one of the main things is to have is to have a stretch done. And we do that a little bit in clinic with some of our soft tissue techniques. And that would be a huge one that I would recommend you seek help for.

Dr. Clayton Roach: [00:16:05] Yeah. One more thing. I recommend when people, when it’s inflamed, do not walk barefoot in the house. Right. You need a little bit of cushion there. So soft that you can wear in the house to try to heal and get rid of some of that inflammation as you’re doing the other things. Because if you’re doing the other things like putting ice and then said the cold, icy water ball and you’re doing your stretches, but then you walk throughout the whole day because a lot of us are working from home now barefoot on your hardwood floor. Well, that’s just not going to go too well for for your foot problems.

Dr. Ben Boudreau: [00:16:40] And don’t be afraid to keep moving. This is actually a condition that gets better with movement and you don’t want to rest because of the pain. Keep yourself moving and avoid your feet curling up into a tight ball.

Dr. Ben Boudreau: [00:16:55] And then there’s two things that we do in the clinic activities technique, which we actually stretch the Fascher and we can also do laser therapy on the FAFSA. And one of the things we did mentioned then we can close with this year. These Healdsburg go through two different phases. One is a calcified phase and one is an ossified things. The first part is calcification, but that is more sore bone and it can actually be broken down with some soft tissue work. Now it hurts. I got patients like they’ll be leaning back. They’ll be lean back and push it on their heel and they come right off, as they call it. What are you doing? But that can be broken down. Now, if it’s an ossified cap, there’s not much you can do to get rid of that Healdsburg. Now, again, it doesn’t mean because you have a Healdsburg. That’s because that’s why you have the pain. Because I’ve I’ve seen many plantar fasciitis case clear up and the bones were still there, but they have zero pain. Right. So don’t think that if you have the heel spur that that’s never going to get rid of the pain right now. The pain can be treated with without removing the heel spur. It does not have to be surgically repaired. The pain can be treated. So. So here’s a question then. Is orthotics or orthotics a bandage or part of the solution?

Dr. Clayton Roach: [00:18:13] So I’ll address and then you can chime in. OK, I think at one point, if the foot has been pronated for so long and the ligaments have been stretch. You will not regain the stability and the structure that you need in the foot, so at that point you may need an external device, meaning an orthotic, to prop the foot back up into into supination or get rid of the flat foot, so to speak, to help make the change to the knee and the and the hips. Now, however, I see a lot of people going to the orthotics prematurely, never even trying to solve the plantar fasciitis or the hip problem or the knee problem. So now people become dependent and all you’re doing, you know, everything looks great with your thighs as you go. You take it out. It’s still a mess. So it’s almost it is a Band-Aid at that point. So I always say treat the cause of the problem. And then if you need less of a correction on your orthotic or now, the orthotic will look different if you still needed it. Maybe you don’t need at that point, but if you do, you’ll look different if you’ve corrected some of the kinetic chain along the way.

Dr. Ben Boudreau: [00:19:29] And it’s always great to be able to try things that are conservative before going for something that you want to. I don’t want to say depend on. It’s just like a back brace, really. If you decide to use something to hold the structures together without trying to regain the strength yourself, I’ll do techniques and clinic with some of my patients where we do exercises to help strengthen the arch. Yes, if you have a flat arch and your arch is dipping or you have a really tight arch, but it’s not working properly, we try to address these issues and they are solvable. So we always like to try these sort of things before we recommend an orthotic, although we have seen great results with people who have done orthotics and they are a great tool to use. It’s just a matter of when and what is the most beneficial time to use it.

Dr. Clayton Roach: [00:20:21] And there was a questionable massage therapy and acupuncture, generic massage therapy on this, by the way, just not going to work. It needs to be specific, active. You need to bring the fash on the foot through the range of motion. So you’re actually getting the foot through the movement. You’re going to get your results in that last 10 percent of the movement. So we’re actually pushing the foot up as we’re maintaining pressure on the heel. And you’re going to get your results in that last 10 percent of the range of motion because you’re working that insertion point where that arrow is right here. And if you’re just lying there, you just rubbing the foot. Yeah, it might be good for you’re supposed to do that. You might get some bonus points and you’ll love it, but it’s not going to get rid of the plantar fascia. And acupuncture might dissipate a little bit of the inflammation. But again, it’s not going to correct. A needle is never going to correct structure. Right. So it might again alleviate some of the pain, but it’s not going to fix the structure. Great questions tonight,

Dr. Ben Boudreau: [00:21:14] Great questions I was about to say I adjust through the actual first phalanx there, I just threw that distal pharyngeal joint here. Yeah, I just threw there. And then I also just at the distal point as well.

Dr. Clayton Roach: [00:21:30] And that’s a good point, because what will happen is the rear foot. So here’s the calcaneus. And here’s the talus, right, there’s two bones in the rear foot and here’s the navicular right. Yeah, yeah. These three bones here will determine what’s happening over here. So a lot of people get pain, right? You need the toll is the rear foot determines what the forefoot does. So getting chiropractic adjustments to help with the structure. Is going to be phenomenal and most of the time the arch is falling because of what’s not happening back here, right. So don’t discount the power of a chiropractic adjustment. We don’t just adjust fines. We can adjust extremities as well. And the combination of everything else that we mentioned.

Dr. Ben Boudreau: [00:22:17] Yeah, for sure, and I always find people are always so surprised, I, I start doing palpation of the foot and I can tell where every single bone is and then I go and I just take the big toe and I just whip it up and they hear a huge pack. They’re like, oh my gosh, I’ve never had that release before. And then I have so much more movement through that big toe. I have never thought I’d be able to have that much motion. You’d be surprised when you get things moving, how much better you feel.

Dr. Ben Boudreau: [00:22:43] And that’s probably one of the most important thing is that big toe extension. Your ability for the big toe to be able to go up has one hundred percent correlation with back pain. So speaking of the kinetic chain, and unfortunately, where people get arthritis in the feet

Dr. Clayton Roach: [00:22:56] Is in that first big toe, right. So you lose that mobility, your gait is thrown off and all of a sudden you’re fine yourself with plantar fasciitis, but more importantly, back pain. Right. Again, veteran of the month, vitamin D three.

Dr. Ben Boudreau: [00:23:13] Yeah, yeah, great, great vitamin, we’ve had a lot of people come in and ask us about the vitamin D, three of us K two drops. Awesome, great, good job looking into it. You see the benefits here, natural sources, salmon, sardines, egg yolk, shrimp, yogurt, orange juice and of course, the sun, which we’re supposed to get a lot of it this week, hopefully. And we’d like to thank everyone who’s taken the recommendation for magnesium as well. You see a lot of people coming into the clinic and you’re seeing the benefit, especially with these orthomolecular products. They have a really strong absorption rate and they are a great product. See great results.

Dr. Clayton Roach: [00:23:52] Please just go ahead and click the share button, make sure you like our page. If you’re not following us on Facebook, there’s a difference between liking and following. Following you’re actually going to get notifications of your life liking you. Just get to the posts. Right. And if you’re watching us on New to make sure you subscribe now where you get the new episodes as are posted. Guys, I really appreciate everyone that’s chiming in. And the questions were amazing tonight, by the way. We love this. It spices it up a little bit. Right. So thank you so much. We appreciate you. And we will see you two weeks time. Humpday conversation. It’ll be episode number sixteen. Awesome, guys. All right. Cheers, you all take care. Bye bye.

Dr. Ben Boudreau: [00:24:36] Thanks, bye bye.

Dr. Clayton Roach: [00:24:39] What’s up? Listen, if you like this episode, you’ll probably like the other ones are pretty good. So here’s what you need to do. You need to like us and follow us on Facebook. Following means you get notified when these two guys are alive. Next, family, friends. You need to share these episodes because you never know. You might help them because they need this information as well.

Dr. Ben Boudreau: [00:24:56] And guys, if you ever miss an episode, make sure you subscribe to us on YouTube. That way, you can watch the episode over and over and over again.

Dr. Clayton Roach: [00:25:03] Guys, we love you and appreciate you.

Dr. Ben Boudreau: [00:25:04] Take care.