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Dr. Brian Abelson

Plantar Fasciitis: Symptoms to Solutions


Abstract Image of Foot

Plantar Fasciitis is one of the most common conditions we treat at our clinic, so much so that we wrote a book about it—Resolving Plantar Fasciitis, published in 2015. This painful condition affects millions annually, particularly those who spend long hours on hard surfaces or have muscle imbalances.


We know how frustrating it can be to try various treatments without success. Our approach focuses on effective, lasting solutions, helping you find relief and confidently get back on your feet.


Our Success Rate is Over 90%

Our 90% plus success rate in treating Plantar Fasciitis demonstrates the effectiveness of our comprehensive, interdisciplinary approach. We focus on pain relief and restoring function, offering tailored treatments that work even when other methods have failed.


Article Index:


 

Symptoms of Plantar Fasciitis


Understanding the symptoms of Plantar Fasciitis (PF) is crucial for its diagnosis and management. A common foot condition, PF often presents with specific and identifiable symptoms. Individuals suffering from PF typically experience:


  • Morning Discomfort: Intense pain in the foot and heel upon first standing in the morning, causing some to avoid putting weight on their heels and to walk on their toes instead.

  • Pain Reduction with Movement: A noticeable decrease in pain as they become more active throughout the day.

  • Pain with Prolonged Standing: Pain that increases, often centred in the heel, during prolonged standing or weight-bearing activities.

  • Varied Heel Discomfort: The nature of heel discomfort can range from dull aches to sharp, burning sensations.

  • Heel Pulling Sensation: A feeling of pulling in the heel area.

  • Difficulty with Hard Surfaces and Stairs: Challenges walking or running on hard surfaces and climbing stairs.

  • Nerve Pathway Symptoms: Numbness, tingling, or pain along the lower leg and foot nerve pathways.

  • Extreme Tenderness: Those with PF often report extreme tenderness when touching the inside of their heel (medial tubercle of the calcaneus).

  • Altered Walking Patterns: The foot pain can lead to changes in walking patterns, potentially causing related pain in the ankles, knees, hips, and back.



 

Anatomy & Biomechanics


In exploring the complexities of Plantar Fasciitis, it's essential to understand the structure and function of the plantar fascia itself. This knowledge not only aids in diagnosing and treating the condition but also highlights the interconnectedness of foot mechanics and overall musculoskeletal health.


  • Understanding the Plantar Fascia:

    • The plantar fascia is a robust, fibrous tissue on the underside of the foot, connecting the heel bone to the base of each toe.

    • The central part, known as the plantar aponeurosis, is especially thick and plays a key role in transferring force from the Achilles tendon to the forefoot during movement.


  • Function:

    • Arch Stabilization: Supports the arch, preventing it from collapsing under pressure.

    • Shock Absorption: Cushions during impact, reducing strain on the foot.

    • Propulsion: Assists in pushing the foot off the ground during walking or running.


Understanding these functions is crucial for diagnosing and effectively treating Plantar Fasciitis.


Plantar Fascia - Your Body’s Windlass Mechanism

Windlass Mechanism

Usually, when we think of a Windlass Mechanism, we think of a mechanical lifting device that consists of a horizontal cylinder turned by a crank or motor, around which a line or cable is wound.

In the foot, the Plantar Fascia simulates the cable in a Windlass Mechanism, with the foot bones forming the frame around which the fascia or cable is wrapped.


Windlass Foot Image #1

Here is how it works in your foot:

  1. The Plantar Fascia loosens and tightens with each change in the weight-bearing forces of the foot.

  2. As you push off with your foot, the Plantar Fascia winds around the forward bones of the foot (heads of the metatarsals), reducing the distance between the heel bone (calcaneus) and the toes.


Windlass Foot Image #2

3. By doing so, the Plantar Fascia elevates the foot arch (medial longitudinal arch). It prevents the arch from collapsing, allowing for effective shock absorption and powering the propulsion mechanism. The Windlass Mechanism packs the bones of the foot together to create a rigid lever for more effective propulsion during push-off.


 

Kinetic Chain Image

The Kinetic Chain of Plantar Fasciitis


Plantar Fasciitis (PF) is often influenced by more than just the foot itself; it’s connected to the entire body’s movement system.


  • Key Muscles: Muscles in the foot, like the Flexor Digitorum Brevis, play a role in PF by connecting foot pain with other injuries.

  • Muscle Tension: Tightness in calf muscles can affect how your foot moves and contribute to PF.

  • Body Balance: Muscles in your legs, like the hamstrings and quads, are crucial. If they’re weak or tight, they can lead to abnormal walking patterns that strain the plantar fascia.

  • Hip and Gluteal Impact: Sitting too much can tighten hip muscles and weaken your glutes, leading to poor posture and leg instability. This can cause foot issues like PF.


Understanding these connections can help manage and treat PF effectively.



 

Physical Examination


The videos below showcase commonly used orthopedic, neurological, and vascular procedures during the assessment of Plantar Fasciitis.


Effective Ankle and Foot Examination

This instructional video uses orthopedic tests to thoroughly assess common ankle and foot conditions seen in clinical practice. The conditions covered include Ankle Sprains (especially inversion sprains), Cuboid Syndrome, Talar Dome Lesions, 5th Metatarsal Fractures, Syndesmosis Damage, Morton's Neuroma, 2nd Metatarsal Stress Fractures, Plantar Fasciitis, and Bunions.


Lower Limb Neuro Examination  

The lower limb neurological examination is crucial for assessing the motor and sensory neurons in the legs. It helps identify nervous system impairments and provides valuable insights for targeted treatment. This exam is used for both screening and diagnosis, offering a clear view of the neuromuscular health of the lower limbs.


Peripheral Vascular Examination

The peripheral vascular examination is an indispensable diagnostic tool for identifying vascular-related pathologies and is critical in everyday clinical practice. Its ability to detect and help treat Peripheral Vascular Disease (PVD) can be instrumental in minimizing cardiovascular and cerebrovascular risks.



 


Differential Diagnosis Image

Differential Diagnosis of Plantar Fasciitis


When diagnosing Plantar Fasciitis (PF), it's important to differentiate it from several other conditions:


  • Tarsal Tunnel Syndrome: Involves nerve compression, leading to foot pain and tingling, differing from the localized heel pain of PF.

  • Achilles Tendinopathy: Causes pain and stiffness in the Achilles tendon, while PF primarily affects the heel and arch.

  • Stress Fractures: Pain during weight-bearing activities, often sudden in onset, unlike the gradual onset of PF.

  • Fat Pad Atrophy: Reduces heel padding, causing pain similar to PF, but more common in older adults.

  • Morton’s Neuroma: Causes sharp, burning pain in the ball of the foot, often with numbness, differing from the heel pain in PF.



 

MSR Treatment for Plantar Fasciitis


Manual therapy is vital in treating Plantar Fasciitis (PF) by alleviating pain, improving foot mechanics, and restoring function. Our approach integrates myofascial release techniques with fascial research and acupuncture principles, targeting tight structures contributing to PF.


Gentle foot and ankle manipulation enhances joint mobility, while addressing calf and hamstring tension aligns the leg and foot, reducing strain on the plantar fascia. Our goal is complete resolution of PF, using a comprehensive method that includes MSR (Motion Specific Release) techniques for the feet, calves, and hamstrings. Stay tuned for demonstration videos showcasing these effective treatments.


Resolve Plantar Fasciitis - MSR Procedures

n this video, the Motion Specific Release (MSR) protocols for resolving plantar fasciitis are showcased, demonstrating several effective techniques for alleviating this common foot condition.





Eliminating Calf Restrictions

In this video, Dr. Brian Abelson demonstrates procedures to restore relative motion between tissue layers, which can eliminate calf pain and improve overall function. The calf muscles form the Achilles tendon, which connects directly into the plantar fascia. Addressing calf muscle function can significantly reduce strain on the plantar fascia, providing relief for plantar fasciitis and enhancing overall foot health.




Hamstring Muscle Release

In this video, Dr. Abelson demonstrates Motion Specific Release (MSR) techniques for releasing the hamstring muscles. These muscles are essential for more than just movement; they play a key role in posture, gait, and injury prevention. Proper hamstring function reduces strain on the feet, particularly in conditions like plantar fasciitis, by improving overall lower body mechanics. This release technique helps ensure balanced movement and supports foot health.



Facial Expansion: MSR Foot Pain Protocol

Treating plantar fasciitis with fascial expansions offers a holistic approach by integrating modern fascia research, kinetic chain relationships, and principles from acupuncture and traditional Chinese medicine.


This method connects fascial lines with specific acupuncture points (ST44, LV3, LV2, K3, B60) to create an effective treatment plan. By addressing the inflammation and tension associated with plantar fasciitis, the approach reduces pain, enhances tissue mobility, and manages scar tissue.



 

Treatment Frequency Recommendations


Initial Phase:

  • MSR Manual Therapy: 2 sessions per week (can be reduced to 1 session if a 30-minute appointment is used).

  • Home Exercises: Daily as prescribed.


Response Assessment:

  • After 3-4 weeks, evaluate progress:

    • Positive Response: Reduce to 1 session per week; continue daily exercises.

    • Persistent Symptoms: Maintain 2 sessions per week; adjust exercises as needed.


Maintenance Phase:

  • Treatment: Monthly or as needed.

  • Home Exercises: Daily exercises are done to maintain benefits, with periodic professional reviews.



 

Exercises


A phased exercise regimen is essential for resolving plantar fasciitis (PF). Begin with mobility exercises to reduce tightness and improve foot and ankle movement. These exercises prepare the body for strength training, targeting muscles that support the foot arch and calf, which are vital for proper foot mechanics and reducing strain on the plantar fascia. Finish with balance and proprioceptive exercises to enhance spatial awareness and prevent re-injury. This comprehensive approach not only alleviates PF symptoms but also strengthens lower extremity health to prevent future issues.



Foot Pain Relief - Daily Self Myofascial Release

Foot mobility is paramount in preventing injuries, enhancing sports performance, and managing various foot conditions, such as plantar fasciitis and bunions.






Daily Mobility Exercises

With their 26 bones, 33 joints, and over 100 muscles, your feet form the foundation of your body's biomechanics. Keeping them mobile and strong is crucial for optimal movement and stability, particularly for preventing and managing Plantar Fasciitis. The saying "Use It or Lose It" is especially relevant here. Regular foot mobility exercises can significantly enhance your foot health, reducing the risk and impact of Plantar Fasciitis.



Effective Foot and Toe Strengthening

Strong ankles, feet, and toes are essential for injury prevention and optimal sports performance. The anatomy and biomechanics of the foot and ankle complex play a vital role in maintaining the body's stability, balance, and movement.


Improve Your Balance - Exercises for Beginners

Balancing exercises are crucial components in Rehabilitation and Sports Performance training. They should not be overlooked, as they can bolster one's capacity to stabilize the body during functional movements. You can enhance balance and avert injuries by incorporating straightforward balance exercises into a progressive training program.


Note: We typically advise patients to combine strengthening and balance exercises, performing them every other day. However, specific recommendations will vary based on each individual's unique case.



 


Why Choose Our Approach for Plantar Fasciitis


Our comprehensive approach to treating Plantar Fasciitis (PF) consistently achieves a 90% success rate in reducing pain and restoring foot function. Here's why our method stands out:


  • Established Expertise: Developed by Dr. Brian Abelson, our MSR methodology is backed by over 30 years of clinical experience, successfully treating over 25,000 patients.

  • Thorough Assessments: We conduct detailed evaluations to identify all contributing factors, including kinetic chain issues and muscle imbalances.

  • Advanced MSR Procedures: Our Motion-Specific Release (MSR) techniques precisely target fascial restrictions and the entire kinetic chain.

  • Customized Exercise Programs: We design individualized exercise plans to enhance foot mechanics, increase mobility, and strengthen the entire kinetic chain, including balance training.

  • Evidence-Based Approach: Our treatment protocols combine manual therapy, exercises, and supportive measures for a comprehensive and lasting solution.


Choose our proven, patient-centred approach for effective, long-term relief from Plantar Fasciitis. Take your first confident steps toward recovery with us.



 

References


  1. Abelson, B., Abelson, K., & Mylonas, E. (2018, February). A Practitioner's Guide to Motion Specific Release, Functional, Successful, Easy to Implement Techniques for Musculoskeletal Injuries (1st edition). Rowan Tree Books.

  2. Buchbinder, R. (2004). Plantar Fasciitis. *The New England Journal of Medicine*, 350(21), 2159-2166. doi:10.1056/NEJMcp032745.

  3. Chaitow, L., & DeLany, J. (2011). Clinical Application of Neuromuscular Techniques: The Lower Body (Vol. 2). Churchill Livingstone. [Specific sections on Plantar Fasciitis and Manual Therapy].

  4. Cleland, J. A., Abbott, J. H., Kidd, M. O., Stockwell, S., Cheney, S., Gerrard, D. F., & Flynn, T. W. (2012). Manual physical therapy and exercise versus electrophysical agents and exercise in the management of plantar heel pain: a multicenter randomized clinical trial. *Journal of Orthopaedic & Sports Physical Therapy*, 42(8), 672-685. doi:10.2519/jospt.2012.4110.

  5. Crawford, F., & Atkins, D. (2006). Interventions for treating plantar heel pain. *The Cochrane Database of Systematic Reviews*, (3), CD000416. doi:10.1002/14651858.CD000416.pub2.

  6. DiGiovanna, E. L., Schiowitz, S., & Dowling, D. J. (2005). An Osteopathic Approach to Diagnosis and Treatment (3rd ed.). Lippincott Williams & Wilkins. [Chapter on Plantar Fasciitis and Manual Therapy Techniques].

  7. Irving, D. B., Cook, J. L., & Menz, H. B. (2006). Factors associated with chronic plantar heel pain: A systematic review. *Journal of Science and Medicine in Sport*, 9(1-2), 11-22; discussion 23-24. doi:10.1016/j.jsams.2006.02.004.

  8. Landorf, K. B., & Menz, H. B. (2008). Plantar heel pain and fasciitis. *BMJ Clinical Evidence*, 2008, 1111.

  9. Martin, R. L., Davenport, T. E., Reischl, S. F., McPoil, T. G., Matheson, J. W., Wukich, D. K., ... & McDonough, C. M. (2014). Heel Pain—Plantar Fasciitis: Revision 2014. *Journal of Orthopaedic & Sports Physical Therapy*, 44(11), A1-A33. doi:10.2519/jospt.2014.0303.

  10. McMillan, A. M., Landorf, K. B., Barrett, J. T., Menz, H. B., & Bird, A. R. (2009). Diagnostic imaging for chronic plantar heel pain: A systematic review and meta-analysis. *Journal of Foot and Ankle Research*, 2, 32. doi:10.1186/1757-1146-2-32.

  11. Orchard, J. (2012). Plantar fasciitis. *BMJ*, 345, e6603. doi:10.1136/bmj.e6603.

  12. Renan-Ordine, R., Alburquerque-Sendín, F., de Souza, D. P. R., Cleland, J. A., & Fernández-de-Las-Peñas, C. (2011). Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: a randomized controlled trial. *Journal of Orthopaedic & Sports Physical Therapy*, 41(2), 43-50. doi:10.2519/jospt.2011.3504.

  13. Riddle, D. L., Pulisic, M., Pidcoe, P., & Johnson, R. E. (2003). Risk factors for Plantar Fasciitis: a matched case-control study. *Journal of Bone and Joint Surgery*, 85(5), 872-877. doi:10.2106/00004623-200305000-00015.

  14. Sullivan, J., Pappas, E., & Burns, J. (2015). The role of exercise and physical activity in the management of plantar heel pain: A systematic review. *Foot & Ankle International*, 36(1), 105-112. doi:10.1177/1071100714551026.

  15. Thomas, J. L., Christensen, J. C., Kravitz, S. R., Mendicino, R. W., Schuberth, J. M., Vanore, J. V., ... & Kravitz, S. R. (2002). The diagnosis and treatment of heel pain: a clinical practice guideline–revision 2010. *Journal of Foot and Ankle Surgery*, 49(3), S1-S19. doi:10.1053/j.jfas.2010.01.001.

  16. Wearing, S. C., Smeathers, J. E., Urry, S. R., Hennig, E. M., & Hills, A. P. (2006). The pathomechanics of plantar fasciitis. *Sports Medicine*, 36(7), 585-611. doi:10.2165/00007256-200636070-00004.

  17. Young, C. C., Rutherford, D. S., & Niedfeldt, M. W. (2001). Treatment of plantar fasciitis. *American Family Physician*, 63(3), 467-474.


 

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DR. BRIAN ABELSON, DC. - The Author


Photo of Dr. Brian Abelson

With over 30 years of clinical practice and experience in treating over 25,000 patients with a success rate of over 90%, Dr. Abelson created the powerful and effective Motion Specific Release (MSR) Treatment Systems.


As an internationally best-selling author, he aims to educate and share techniques to benefit the broader healthcare community.


A perpetual student himself, Dr. Abelson continually integrates leading-edge techniques into the MSR programs, with a strong emphasis on multidisciplinary care. His work constantly emphasizes patient-centred care and advancing treatment methods. His practice, Kinetic Health, is located in Calgary, Alberta, Canada.


 


MSR Instructor Mike Burton Smiling

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Enroll in our courses to master innovative soft-tissue and osseous techniques that seamlessly fit into your current clinical practice, providing your patients with substantial relief from pain and a renewed sense of functionality. Our curriculum masterfully integrates rigorous medical science with creative therapeutic paradigms, comprehensively understanding musculoskeletal diagnosis and treatment protocols.


Join MSR Pro and start tapping into the power of Motion Specific Release. Have access to:

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Integrating MSR into your practice can significantly enhance your clinical practice. The benefits we mentioned are only a few reasons for joining our MSR team.





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