Understand and Fix your Chronic Foot Pain

By Unpain Clinic on June 18, 2021

Welcome to the Unpain Clinic podcast and Youtube channel. Youtube people hi, and hi to the podcasters too. I’m your host Uran Berisha from Unpain Clinic, located in Summerside Edmonton. Today, I’m actually very excited to talk to you about a condition called plantar fasciitis. Commonly referred to as heel or foot pain. It has many different names. I want to specially talk to people that have been in pain for a minimum of three months and have tried all other options. If you or somebody that you know has been experiencing heel pain, particularly during the first couple steps in the morning or every time they are active after sitting for long periods, and have gone through physiotherapy treatments, massage therapy, have tried stretches for plantar fasciitis, using the sock at night, rolling, using a frozen bottle underneath their feet to eliminate the pain but the pain keeps coming back again. What I’ve learned from my personal experience or our experience at Unpain Clinic is that [it’s very rare when there is an obvious cause for plantar fasciitis or heel pain]. So I want to talk you through the body anatomy and how the body functions because there are two different things. As a practitioner when we learn about anatomy in school we learn all the parts and those body parts have names. We kind of create a language to communicate with each other and to tell other practitioners what we worked on, and where the problem is. But we have to understand, or we almost forget that in the real world that for our nervous system, for our actual body, there are no names inside.

So, because you call it a fart* (is this right? – KL) in front of the body, it is just the pushing block. You call the muscles biceps, triceps, quadriceps, but these are just the fancy names. But inside your body, it’s a mechanism that’s going to flex your arm, extend your knee, or help you perform a motion. So if those mechanisms become dysfunctional, for whatever reason, then your body is forced to pick the next available one. That’s how we create what we call dysfunctional muscle patterns that have been forced on you, due to an injury, due to surgery, or due to changes in your life and activities. You try to do your old routine but the patterns inside the body have changed. [For that reason, we end up with chronic pain and you go and try to fix this with exercise but it doesn’t work. The main reason it doesn’t work is that it’s as if the wheel of your car is out of alignment and you’re trying to drive faster and hoping that it will align the wheel]. You’re just going to go faster with the car so you don’t feel the misalignment as much. The same thing happens with exercise when you are trying to correct chronic pain. You are just making the muscles and the mechanisms in the body that are already working properly, actually have to work a little bit more, so then they can support your system and therefore you feel bad. But as soon as you stop, that the pain comes back. So with plantar fasciitis or any foot condition you should consider, how come your foot is not the size of your thigh? If everyone talks about the foot, it’s actually holding the whole body weight so then it should be a big bone because whatever produces power in the body, whatever is responsible for bodyweight is big. You have huge muscles like your quads, hamstrings, glutes, lats, core muscles, pecs, and these are the muscles that can handle impact in the body and the body weight. [Your hands and feet are the sensors of your body. They are not designed to handle your body weight. They are designed to sense either the ground against your feet or to perceive what you are touching. That is why they have so many nerve ending]. So talking about feet, the feet feel the ground, so we are meant to walk barefoot. I am not going to go down the rabbit hole about the whole concept of barefoot versus shoes and all that. I’m going to touch it because it’s very important. But just imagine 10, 000 years ago people probably just had a piece of leather on their feet so it would keep their feet warm. That’s how they functioned and we don’t know if they had plantar fasciitis or not. But the fact that the humans feel this much means that they were probably just killing the problems in the past, otherwise we would not have survived as a species. But nowadays we have all kinds of fancy shoes, and brands, that are very expensive, that claim all kinds of stuff like they will support your arches. But you have to remember that man walks on their feet. You have intrinsic muscles in your feet that support the 52 bones (26 per foot). What happens is the foot feels the ground and gets information, if it’s flat, if it’s high and sees that information to the nervous system, and the nervous system responds back. Using big muscles groups to handle and support you wherever you are going. But, now if there is dysfunction in those muscles that impact is going to go back now, trying to find what is the next muscle but there is no next muscle, and that pressure will go back to the foot. So for example, if you had any surgery in the abdominal area, such as a C section, tummy tuck, appendectomy, gall bladder, open-heart surgery, you name it, those surgeries make the muscles communicate in a dysfunctional way, so your body cannot really communicate with your core muscles. It will move the impact to the glute muscles, but if you’re somebody sitting all day in the office or driving then you’re neurologically shutting down those muscles so then that impact is going to move to your hamstrings. They will get super tired working and it moves to impact your calve muscles, and the calve muscles will get super tight. Gradually then they start pulling on your Achilles tendon past your plantar fascia and then start putting pressure on the plantar fascia. Now because the bodyweight is going down and putting more pressure on it, it starts thickening up the plantar fascia, and the plantar fascia actually starts rubbing against the heel spur. The heel spur is a normal anatomical structure there, but because the plantar fascia started rubbing it started getting irritated. It starts giving you inflammation and then there might even be micro-tears in the plantar fascia. [The plantar fascia is a structure designed by the body to be more solid than the muscles, and therefore it does not have a very good blood supply circulation.So any tendon, ligament, or thick fascia is designed to support the area]. So, once it is created it wants to be more solid, drier, and build more collagen fibres. What happens is when you have micro-tears, those collagen fibres are very dense, and after a while, if your body if you don’t have enough collagen, if your nutrition is not good, if you’re not walking, if you’re not stimulating your body to create more collagen or to rebuild something else, then your nervous system can detect space in the area and thinks, well I haven’t had an injury in the system, let me create some vessels, and some capillaries to really nourish that area, and then start actually putting blood vessels instead of collagen fibres into the plantar fascia. [What happens is now you have a plantar fascia that is meant to be built with collagen fibres now has some weeds in between those fibres, and these weeds are blood vessels. Although blood vessels are good, and it’s going to be needed to supply the structures, it’s not meant to be there]. Then what happens is now you end up in this vicious cycle because the body cannot really rebuild the collagen fibres back, and the plantar fascia gets weaker. You still have the same dysfunction in the system, you’re compensating the same way, you’ve got orthotics to support the foot because your feet are still hurting. And now you’ve made those foot muscles even weaker because there is something artificial supporting your foot. So the muscles become lazy, they don’t get used, they don’t get stimulated. That’s how you end up in this vicious cycle. So we are probably more than kicked off with information about plantar fascia and all this. Honestly, but it’s really important, this is how we think out loud, this is how we look at your plantar fascia condition. But what do we do about it? We use shockwave therapy. Shockwave therapy is the same technology they use to break up kidney stones. So now if you’re not from Edmonton, people here are lucky they have had the Unpain clinic here now for eleven years, but hopefully, we are going to start opening more locations to help people in other cities but we’re willing to help anybody in need. Wherever you are in the world, contact us through our website at unpainclinic.com, give us a call, or send us an email and wherever you are we will guide you to the right place for your True Shockwave treatments. Out there in the marketplace and the world, there are two types of shockwaves. [So there is one that is called radial pressure wave or radial shockwave for plantar fasciitis, and typically that is not a true shockwave. It is just an ordinary sound wave, it is important to note that a true shockwave does not sound like a jackhammer]. So that is how you can distinguish it, you do not really feel it on the skin but you will feel it when it hits the bone, so you need that. If you are lucky and are able to find a place like Unpain clinic where it offers three types of shockwaves, the electromagnetic system, electro-hydraulic shockwave, radial pressure/radial shockwave. We combine these systems based on your needs, and that’s what you need to look for. So with true shockwave, what it does is breaks down scar tissue and adhesions effectively over 0.5 centimetres into the body. [But by removing those scar tissues and other adhesions we create optimal conditions for healing, we pretty much reset the healing process, and that stimulates your body to create new blood vessels to angiogenesis, and then it triggers all the stem cells to come to the area and start repairing. And it literally does all of this without any side effects]. So even though this is an amazing tool, we still don’t go and just jump in and treat the plantar fascia. [If you have any surgeries like I said you will have dysfunction on the hip area, on the core and we have to actually go and treat those first. So we create the foundation, we remove the compensation first, then we go after the plantar fascia]. And we can do all of this in one session. So we don’t charge per body part or what we treated. When you come to Unpain we will ask what is one thing that you want to improve first and that you’re happy with your progress. [If you’re dealing with plantar fasciitis or heel pain, that would be your focus/main concern. But now whatever we find that is related to that main concern, we are going to treat all of that. We don’t look at you in pieces because that is not how the body functions]. So, we typically do about three to five sessions, but most of the time it’s three sessions, once a week. You can still do anything that you have been doing because your foot still needs stimulation, you still need to move. I learned this in school, they said [the door handle that constantly moves never gets rusty. So moving is very important, and not doing anything is the same as overdoing it]. So that is why when we do the treatment we take care of the reason you have to be active. You have to get the body going gradually so you can go back to normal. So all our goal is to bring it to point zero, so when you get up in the morning you don’t feel pain and can do anything you want after that. So, we can optimize even athletes to perform more than what they are capable of with other protocols, but today are just talking about plantar fascia.

Another thing that I want to talk about today is the heel spur. So if you have been diagnosed with a heel spur, it’s interesting because it’s almost an attack, they want you out of the office. So, it’s pretty much the same mechanism but the heel spur is a normal anatomical structure on the foot. So what happens is hard calcium building up on the outside. I’d seen this at a shockwave conference where most of the guests were orthopaedic surgeons and trauma surgeons who repair plantar fascia or heel spurs, but it’s not typical for orthopaedic surgeons to use shockwave in Europe and other countries around the world. Yes, there are a lot of orthopaedic surgeons that have started reducing the amount of surgeries, and started using shockwave. So what I learned to form them is that calcium build up on the bones is not how it looks on the X rays, it is not solid it is softer, almost like toothpaste. To the point that they actually did research on turkeys, turkeys legs are fully calcified and they never feel pain. So particularly when there’s calcium buildup in the bone it means two things. There is no maintenance, there’s no good blood circulation in the area, or there was a previous injury. Heel spurs are an example of your body putting more pressure on a bone, so your system now is sensing that it needed to strengthen that bone. But because the calcium build-up is actually soft that is not the typical cause of the pain. So if you are following me so far, what I find from my personal experience is that the cause is from the dysfunction of the hip, lower back, core. But when you go see your medical doctor they will get an x-ray and that’s when they see a bigger heel spur, and because of the x-ray, a picture of your body from one second, they say this is where the pain is coming from. [But I want you to remember, pain is a signal that is telling you that something is off in the body. It doesn’t tell you where that pain is coming from. Therefore even if you’re a health care worker you have to follow the kinetic chain, you have to follow the basic formulas. If you have a dysfunctional muscle, you’re going to have a problem with a tendon. If have problem with the tendon doesn’t get fixed then the joint will be overloaded, and then you will end up with joint problems]. So even if we want to treat, that’s what we have to follow, we have to reverse that process. Another interesting thing I learned recently and I have always seen at work and instinctively I’ve done those treatments. But now there is science behind it, that is like Woah. I cannot believe that what I was actually already doing now has scientific evidence now. I want to credit this to a virtual conference that I took in Berlin. It is the biggest fascia conference that happens every four years and the top experts from the world talk for three days, and it is mind-blowing. What they were able to find from these the layers in the body and how everything is connected and how much it’s actually involved. We forget we have only been talking about fascia for probably the last ten years but recently it has become a very popular topic. [There’s an expert doctor that talks specifically on foot conditions. She said that every time when there is a pain in the plantar fascia, there is actually an Achilles problem as well and vice versa. So that’s one single structure. So, if you have a foot thing you most likely have Achilles thickening, but you just don’t feel it there]. Or you have an Achilles condition and your plantar fascia is super tight. So when you have to treat that, you have to treat it all at once. I recently had a guy with an unbelievable thickness on the Achilles tendon, and I was treating it. I did three sessions of shockwave, and there was no change only about twenty or thirty per cent. It was driving me crazy, like why is it not improving. so by the first time with Achilles tendinitis, our goal is to get you over seventy-five per cent. Then I said I’ll go and touch and check the plantar fascia. I treated them right after the first session, and right after the treatment, there was an improvement. So then I started treating them like that, but eventually, I learned from this conference that those two are very important and they are one condition.

So that is it for today for plantar fasciitis/heel pain from Unpain Clinic. If you’re somebody that needs help and you’re lucky and in Edmonton or Alberta it’s worth it for you. Or wherever you are in the world, this is available to all clients. Feel free to go on our website at unpainclinic.com and look up free telehealth session with any of our therapists. Then we’ll see how we can help you. Okay, thank you and see you next time.