Plantar Fasciitis

Most people wouldn't think to go to their chiropractor for plantar fasciitis, but I'm here to educate you on the condition and why chiropractic care can help!

Definition and Causes of Plantar Fasciitis

Plantar fasciitis is a term often used for pain on the bottom of your foot or by your heel. We can start by defining it by looking at the parts: plantar means the sole of your foot, fasciitis (fascia + itis) means inflammation of the fascia. Fascia is the science word for the connective tissues that cover your muscles and tendons. The plantar fascia is the thick piece of connective tissue that runs from your heel bone (calcaneus) to each of your toes. Check out this anatomy pic below to see the thick band of plantar fascia. 

So now that you know the definition of plantar fasciitis and you can picture the plantar fasciitis, we have to figure out what CAUSES that inflammation of the plantar fascia. A likely cause is simply irritation either deep to the fascia or more superficially.

First we will look into causes of irritation deep to the plantar fascia (between the plantar fascia and the bones in your feet). Not to overwhelm you, but under the plantar fascia there are FOUR layers of muscles and tendons before you even reach the metatarsals! You have the abductor hallucis, flexor digitorum brevis, abductor digiti minimi; lateral plantar nerve and artery, medial plantar nerve and artery; quadratus plantae, lumbricals, tendons of flexor hallucis longus and flexor digitorum longus; adductor hallucis, flexor hallucis brevis, flexor digiti minimi; interossei. It's easy to look at your foot and go, "there's no way all of that is in there!" They are though. There are 26 bones in your feet! Your body needs to be able to control the movement in all of those joints. If any of those muscles get tight/spasm, they may alter the functioning of the joints in your feet. That may be enough to trigger the inflammation of your plantar fascia. 

Second we will dig in to a more superficial cause of irritation to the plantar fascia. What is more superficial than the superficial back line (well aside from skin)? Some of you may be thinking, the superficial back line? What does that even mean? Based on Thomas Myers and his book Anatomy Trains, there are fascial lines through out our body that work to support us and help us perform various movements/tasks. One of the contiguous fascia lines is the superficial back line. The plantar fascia is the first part of the superficial back line. The line consists of the plantar fascia, heel bone (calcaneus), calf muscles (gastrocnemius/Achilles tendon), hamstrings, sit bone (ischial tuberosity), sacrotuberous ligament, sacrum, the muscles that run along side your spine (erector spinae),  and the fascia on your skull. Many times when one of the parts of this fascial line isn't working properly, that imbalance travels along the fascial line, and pain/dysfunction follows. So a problem in any of those areas can present as plantar fasciitis.

Signs and Symptoms

Plantar fasciitis is often associated with walking, running, tennis, gymnastics, and basketball. This doesn't mean that it HAS to be a result of this or more problematic during those activities. 

People with plantar fasciitis usually have pain in their foot that is worse when they wake up in the morning or after long periods of rest. Pain often increases with toe rises or running. The pain can also increase towards the end of the day. The pain is often noticed along the inside arch of your foot close to your heel bone (calcaneus). There may also be pain/tenderness to the touch of the bottom part of the foot. 

Chiropractic Approach

First off, a chiropractic exam is performed to determine the cause of the plantar fasciitis. A series of orthopedic tests and palpation of the muscles and joints give us a good understanding of what is causing your pain. Through this exam, we can usually identify what the cause(s) of the pain are. The cause of the plantar fasciitis dictates the treatment. 

If the cause is deep to the plantar fascia, the treatment will be aimed at muscle release to the muscles in the foot and the muscles in the calf whose tendons run deep to the plantar fascia. After assessing the motion in the joints of the foot, often times adjustments may be performed on the foot. 

If the cause is along part of the superficial back line, the treatment will be targeted at the area causing the problem. Muscle release or work on the tendons and ligaments may be performed to help "slacken" the superficial back line and take pressure off of the plantar fascia. Adjustments may be performed on the back, pelvis, and/or the leg and foot. 

Some patients may have multiple causes contributing to their plantar fasciitis, so we treat all the causes. We are also a big fan of home stretches and exercises to help eliminate future flair ups. After your first treatment, we will go through those exercises and make sure that you are comfortable with your home care stretches. 

There is no need to live with insistent, irritating foot pain. Call us today! 

Recipe: Cauliflower Fried Rice

I love holidays. September has Labor Day, but that is more of a 1 day/ long weekend celebration. So in an effort to find more things to celebrate, I turned to the handy Google Machine. This informed me that September has TWO other fun month long observances:

National Childhood Obesity Awareness Month

Fruits & Veggies--More Matters Month

These two observances go hand in hand if you ask me. Eating more fruits and veggies instead of processed foods and grains will give your body more nutrients and fill you up with healthy foods! One way to easily add more veggies to your meal is with cauliflower fried rice! Click here for a printable recipe. 

Cauliflower Fried Rice

Prep time: 10 minutes
Cook time: 10 minutes

Ingredients

Head of cauliflower
1 cup of frozen mixed veggies
Egg
Soy sauce or coconut aminos
2 Tbs oil (I like olive oil or coconut oil) 

Directions

1. Cut off the florets of the cauliflower.  
2. Put the florets in the food processor to cut/rice in to small pieces (see photos below).
   It usually takes me a few rounds of running through the food processor to rice all the florets.
3. Heat 2 Tbs of oil in a frying pain over med-high heat.
4. Add riced cauliflower, mixed vegetables, and a drizzle of soy sauce over the mixture in the frying pan.
5. Cook for 5-7 minutes stirring occasionally to make sure all of the vegetables are cooked evenly. 
6. Add the egg over the top of the fried "rice", and stir to mix in to the mix. 
7. Cook for a few more minutes, and serve! 

The quantities in the recipe are flexible! If you like more mixed veggies, go for it! I often eat this with chicken or beef stir fry. Sorry I forgot to take a photo when I dished it up for dinner. 

Questions on how to incorporate this into your diet? Let me know! Happy eating! 

Hello Hydration

As we start to have more slightly cooler days, it is easy to forget to hydrate. Also all the students heading back to school can forget to stay hydrated during hours of sitting in the classroom. Then students often go to practice sports after school when they haven't hydrated all day, and they have problems. Dehydration can lead to loss of strength and stamina. It is also the main cause in heat exhaustion. This week we are going to talk about easy warning signs regarding dehydration and tips to stay hydrated. 

Dehydration Warning Signs

1. Feeling thirsty
   When you feel thirsty, you are already dehydrated! 
2. Feeling tired/difficulty concentrating
   If you feel tired and sluggish in the early afternoon, one cause could be dehydration! Remember that all that morning coffee you had acts as a slight diuretic (making you pee more and dehydrating you).
3. Headaches
   Many headaches are caused by dehydration, so if you feel a headache coming on, try water first! 
4. Back pains
   The discs in your back rely on water to help with shock absorption. So as you get dehydrated, the little cushions between your vertebrae aren't quite as cushion-y. They can no longer absorb shock as well, and this can alter their function. Overtime this can lead to back pain. 
5. Dark urine color
   Dark urine color is often a sign of dehydration
6. Constipation
   Your body needs water to help things move! From your joints to your bowels, water helps them move. 

Tips to Stay Hydrated

1. Drink enough water for your size!
   We aren't all the same size, so we don't all need 8 glasses of water a day. Many of us need MORE! We recommend aiming to drink half your body weight in ounces of water. Ex: You weigh 200 lb, drink 100 oz of water. You weigh 150 lb, drink 75 oz of water. 
2. Keep a bottle with you at work/school and in the car
   This one is easy - if you have water on you, you are more likely to drink it.
3. Weigh yourself before and after long workouts
   When you have a long workout, weigh yourself before an after. If you have lost weight in the course of your workout, it is likely due to water loss. Half a pound lost is roughly equal to an 8 oz glass of water. 
4. Add lemon for flavor
   Struggle with drinking bland water? Add a few slices of lemons or limes or any fruit really! Adding lemon to your water can also give you a slight boost in vitamin C and help with digestion.
5. Check your urine color
   Don't go for the gold! When you go to the bathroom, take a peek down at the color of your urine. Ideally it is a pale yellow color. Darker yellow color is usually indicative of dehydration. Note: other things can alter the color of your urine. If you supplement with a lot of B vitamins, you may notice your urine is a more neon yellow. Also if you consume a lot of beets, you may notice a pink tint to your urine. 

When You Need More Water

There are some times when you need more water! That's when this handy graphic from Fitness Jockey comes in to play. To learn more about these criteria, click on the photo to take you to their full article. 

Any other questions regarding hydration? Let us know! 

Backpack Basics

Summer is drawing to a close. Goodbye days of bare feet and beach attire (well at least on weekdays-–we do live in Southern California after all). It's time to go back to school. Heading back to school also means lugging backpacks, lunches, and often sports/band/extracurricular gear. All of that stuff can really wear students down! On top of that, wearing your backpack incorrectly over long periods of time can lead to back, shoulder, and/or neck pain. Improper fitting backpacks or just having too much stuff can lead to altered posture or gait. To keep your kids' bodies healthy, we have a few tips to help make sure your kids are wearing their backpacks correctly!

1. Pack only the essentials.
   Lay out all the items that you think you may need, and then decide what you can’t go without. Pack the essentials, and leave the rest at home. The ideal backpack weight should be no more than 10-15% of the wearer’s body weight. The smaller the child, the more important this is.

2. Pack with a plan.
   When loading the backpack, distribute the weight evenly. Make sure the heaviest items are packed in the center to prevent slouching or tilting to one side.
    
3. Adjust the backpack to the wearer.
   Make sure the straps are tightened so that the backpack is secure on both shoulders and rests on the curve of your back. If it is hanging down resting on your bottom, it is too low.
    
4. Wear the backpack with BOTH straps all the time.
   This promotes even posture. Good posture is its own reward!
    
5. Make sure it’s comfortable (and stays comfortable).
   Once a bag has been fitted, it doesn’t mean it never needs to be adjusted again. Throughout the school year, your child may grow and the straps may slip/loosen over time. Make sure to check the straps throughout the year, and note that the straps may slip/loosen asymmetrically.
    
6. Minimize wearing time.
   If your child has access to cubbies/cubicles/lockers encourage them to use them! This can keep their bags lighter and takes stress off their spine.

Any other questions regarding spine health and backpacks? Feel free to reach out to us! Or come by, and we'll assess that your child is wearing their backpack correctly! 

Lumbar Support in the Car

There is a growing awareness of how sitting all the time is bad for our health. There is a growing demand for the sit-to-stand desks in the workplace. People are opting to try and move more. However, sometimes we just have to sit in our cars as we are stuck in traffic. We can't really avoid it. All those hours in the car can contribute to low back pain. Especially if we get road rage and tense up all of our muscles. 

If we are stuck in our cars, at least we can drive with our low backs supported. You don't have to invest in the latest, greatest lumbar support pillow 2000. As seen above, you can make your own support from a towel you already have. Living in Southern California, I have an abundance of beach towels. I took one of those towels, folded it in half lengthwise, then rolled it up.  Voilà! A lumbar roll perfect for supporting your low back and promoting good posture while in the car. 

When placing the towel, you want it to be in the small of your low back, right above those hip bones (aka your iliac crests). It should help support the natural curve of your low back, and allow you to have better posture while in the car. (Thanks, R.L. Spine for modeling the proper placement of the lumbar roll!)

I'd also like to point out 2 more important safety tips for driving/riding in cars. 

1. Wear your seat belt!
2. Make sure your head rest is positioned properly. The top of your head rest should be level with the top of your head, so in the event of a collision, your entire head is held in line with your body to prevent whiplash. You should also try to minimize the distance from the back of your head to your headrest (4 inches or less).

Happy (and safe) driving!