Plantar fasciitis: The case of Elsie M.

Foot pain, Lower leg pain / Saturday, July 4th, 2009

Elsie was referred to my Neuromuscular Therapy center in Metro-West Boston for treatment of plantar fasciitis by a long-time patient whose foot pain I had treated successfully within the previous few months. She had such typical symptoms that I thought it would be instructive to review her case.

Elsie’s symptoms started after a party when she had been dancing on a concrete floor. The pain in the ball of her left foot was so bad that she went to a doctor and then a specialist who told her she had a Morton’s neuroma. She had the area injected with cortisone. She had her foot callouses scraped and she began a course of Physical Therapy. She was fitted for orthotics by a reliable medical podiatrist to correct her foot mechanics. A bodywork person also identified problems in her lower legs. That was 8-10 years ago. A couple of years ago she went through a period of time when she could hardly walk for six months after wearing high heeled boots one day. She had responded well to massage therapy with energy balancing  for treatment then, but she was often bothered by these pains that had been identified as the result of plantar fasciitis.

At present, her symptoms are not terribly acute, but she says she still feels the fasciitis everywhere. Pain is mostly in the balls of her feet, left more than right, with pain also in her heels. In yoga class, she has trouble bending her toes under for downward-facing-dog pose. She has trouble walking in the morning at first, but limbers up after a while. The episode that brought her into my office started with pain after an aerobics class, in fact all of her recent foot pains have been related to exercise, a recent pursuit of hers after years of not exercising much at all.

Looking at her feet, she had very high arches, a Morton’s Foot Structure (long second toe), and her toes were contracted upward in a manner similar to hammer toes.

Plantar fasciitis is the standard diagnosis for typical symptoms like Elsie’s, but sometimes the underlying problem is in the muscles rather than the fascia. Read the next post for a Neuromuscular Therapy point of view.