We see many lower extremity injuries present at our oce in Winchester,Virginia. Whether the injury is plantar fascitis, achilles tendonitis, kneetendonitis, or any other inammatory disorder, they all have one thing incommon, the lower kinetic chain. Essentially, the lower kinetic chain is astack of joints starting in the foot, and rising through the ankle, knee, hip,and lower back. The relationship is very important to understand andaddress when treating any lower extremity injury. In other words, afaulty ankle or hip can lead to injuries such as plantar fascitis or patellartendonitis.In order to take care of the cause of the pain rather than the symptoms, itis imperative to evaluate each component of the kinetic chain. According to WebMD, "Plantar fasciitis (say "PLAN-ter fash-ee-EYE-tus") isthe most common cause of heel pain. The plantar fascia is the at bandof tissue that connects your heel bone to your toes. It supports the archof your foot. If you strain your plantar fascia, it gets weak, swollen, andirritated and inamed. Then your heel or the bottom of your foot hurtswhen you stand or walk." The question then is

“"

This is where I use our 5 step rehabilitation sequence to fullyaddress the lower kinetic chain.

YOU MUST ADDRESS THE SYMPTOMS OF PAIN AND SWELLING

Most Doctors and Therapist do this well. Anit-inammatories or NSAIDsand rest is the treatment of choice from most medical practitioners. Thisis an important part of therapy as it addresses the pain and attempts toget ahead of the inammatory process. Due to side the side eects of NSAIDs and the important properties that is part of inammation, Iprefer more proactive and holistic measures such as ice and stretchingand removal of the activities that may aggravate the condition. It mustbe understood that this approach alone does nothing for the cause of the fascitis. Therefore, most conditions return, or do not get better at all. The causative factor must be found and corrected.

JOINT FUNCTION MUST BE EVALUATED

Chiropractors and some Physical Therapists trained in joint mobilization,do an excellent job with this portion of the therapy. The motion of each joint in the kinetic chain must be evaluated and, any aws, corrected. Agood example of this is xation (immobility) of the ankle joint or of theSacro-iliac joint that may cause an abnormal gait. Mobilization ormanipulation can help correct the xation and create a more natural andless stressful environment for the fascia. These joint dysfunctions arepart of the cause of the fascitis, but generally more needsto be addressed.

Plantar Fascitis & Other Lower Leg Injuries

this article is authored by:

Dr. John Doepper, DC

Capitol Rehab of Winchester

230 Costello Drive, Suite 1Winchester, VA 22602-4300

phone:

540-665-4444

capitolrehabofwinchester.com

@drjohndoepper

on twitter

February 2010