Foot Pain Shocker: It Might Not Be Plantar Fasciitis
In this episode of the Unreal Results Podcast, I talk about heel and foot pain, which is commonly misdiagnosed as plantar fasciitis. There are a multitude of connections that can contribute to foot and heel pain including the viscera, neural connections, and of course lifestyle habits. I also provide some practical management tips for foot pain that include weight shifting and something very specific to stimulate and support the feet. Tune in to this week’s episode to get all of the details!
Resources Mentioned In This Episode:
Episode 7: 9 Years and 9 Lessons
Episode 44: Using Weight Shifting To Improve Movement Patterns
Episode 45: The Kidneys - Visceral Connection To Movement
Instagram Post About Weight Shifting
Blog Post - Revitalize Your Sole
Considering the viscera as a source of musculoskeletal pain and dysfunction is a great way to ensure a more true whole-body approach to care, however, it can be a bit overwhelming on where to start, which is exactly why I created the Visceral Referral Cheat Sheet. This FREE download will help you to learn the most common visceral referral patterns affecting the musculoskeletal system. Download it at www.unrealresultspod.com
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Anna Hartman: Hey there, and welcome. I'm Anna Hartman, and this is Unreal Results, a podcast where I help you get better outcomes and gain the confidence that you can help anyone, even the most complex cases. Join me as I teach about the influence of the visceral organs and the nervous system on movement, pain, and injuries, all while shifting the paradigm of what whole body assessment and treatment really looks like.
I'm glad you're here. Let's dive in.
Hello, hello! Welcome to another episode of the Unreal Results Podcast. I'm home. I am home. I've been on the road, basically, since Christmas. And, uh, I am happily back in my house in San Diego, California. The sun is out. I just, you know, I was messing around in my garden. I've watered all my plants. I am just catching up and, uh, it feels really good to be home.
With that said, this has been a crazy busy past week because I also, not only did I drive back home from Arizona. I was in Arizona for about eight of those weeks. Um, I, um, on that note, if you live in Arizona and you're like, oh, I didn't know that and I didn't reach out to me. Yes, it's not because I didn't want to.
It's because the eight weeks went by in like a blink of an eye. And. I am like locked in on the rehab with my athlete and we were spending like five hours a day basically rehabbing, you know between exercises and manual therapy and all the things and I just literally have been like doing my best to Fit in still taking care of myself and business stuff, so it was not a leisurely trip.
Um, with that said, also while I was in Arizona, the last weekend before I left happened to also coincide with the Movement Rev 10 year anniversary, which is a little mind blowing to me. Um, and this episode is not going to be about that, but I'll just, you know, also just want to say, say it, I put it on social media, I was like, wavering between like celebrating or not, uh, just because I've been so busy.
But, at the last minute I said, you know what, I'm going to do something for it. And so my two best friends from college came to town for the weekend to help me celebrate. They were actually both in town the weekend, or the week I, I left Exos and started Movement Rev. And started Movement Rev is always like loosely in quotes, I use the date March 7th as the anniversary because that is the day I was
drinking by the pool with my friends, Moscow mules, brainstorming on what was next. And we picked a name and bought the domain names on GoDaddy. And, um, I had multiple game, multiple domain names, was going to name it something like a movement revolution. One of the domains was movement rev. And then, um, my baseball athlete, Jacoby Ellsbury at the time was my first travel client.
So I was talking to him on our first trip the following month and he's like, I like movement rev. He's like, cause rev can be a lot of different things. And I was like, you know what? You're right. And then we picked that and we picked the colors and picked the logo, all the things. And so he was a really big part of the beginning of my business.
And um, All of my travel athletes have, and so, uh, and I'd say probably like 75 percent of them live in Arizona, and so that weekend, that last weekend I was in Arizona, I was like, you know what, I'm gonna invite everybody to a small dinner, and whoever can come, can come, and people can't make it, no big deal, but, um, that is who I wanted to celebrate my
business anniversary with, which was, um, my two best friends who helped me start it and, um, the athletes who trusted me enough to travel with them. So we had a nice little dinner. Obviously not everybody can make it, but the ones who couldn't make it sent me really thoughtful messages and, um, just made me very happy.
So. I'm going to record a podcast episode like I did last year, last year, I'll link it in the show notes. It was nine lessons in nine years, and I'm going to do something similar for the 10 year. Just haven't had the time to put my thoughts down because not only then, so last week I drove back to San Diego, unloaded my car, actually unpacked everything first time ever shout out.
That kind of was nice. I got home and I literally put all my clothes away and all the things and um, then I felt so much settled and And then, uh, the following day, people started coming into town for the Revitalize Mentorship Annual Mastermind Weekend, which is a three day weekend that I host people who have, um, are alumni.
People who've been through the in person LTAP and or the Revitalize Mentorship and are about to start the mentorship. Man, it is such a Soul, heart, and brain filled three days. So I had 18 people, all different professions, and uh, we just spent the three days, um, you know, refining the LTAP with them, applying it to cases, going a little deeper on the spine
assessment, the SI joint assessment, uh, we talked about the knee. We discussed my athlete's rehab up into this nine week mark for him. And, uh, that led into some great conversations on movement and coaching movement and letting go of old rules and trusting the body. And Not have not fitting people in shapes, and it was just wonderful I also got to treat them to one of my favorite things in San Diego, San Diego Which was a beach fire and we tried to go whale watching the first group's boat unfortunately got canceled due to ocean conditions And then the second group, a couple of them ended up not coming on the boat, but we did see a young juvenile gray whale in Mission Bay, which is actually super rare.
Um, but it was great because the ocean conditions were still really crappy. So, um, it was nice to see the whale and also super up close and feeding, which is not something you normally see, um, here in San Diego. So, well, it was a wonderful weekend. And, um, And I'm just I was even like considering not recording a podcast today for this week just because I've been kind of non stop but I really wanted to do it and I have a small window of time and one of the participants in the mastermind had messaged to me even before the mastermind asking for a specific podcast on plantar fasciitis, so Lisa this episode is for you.
So when I think of plantar fasciitis, there is a few things that come to my mind. Number one, uhh misdiagnosed. Number two, um, what are their habits around shoes and being barefoot and what is their weight shifting pattern? Also, um, is there a visceral component and is there a neural component? So I'm going to sort of break down all of that as well as always, you know, introduce sort of the world according to Anna.
Should be like a YouTube special, the world according to Anna, which is where I think about other things I've learned and how it might apply in this situation. I wanted to talk about that. So plantar fasciitis, the first and foremost, most, I think most of the time it gets diagnosed incorrectly. I said it.
So it's one of those things, kind of like patellar tendonitis. All knee pain on the front of your knee, near your patella, is not patellar tendonitis. Patellar tendonitis is a very specific pathology happening on the tendon and, uh, Where, while pain may be part of it, it's not always it. And so, same thing with plantar fasciitis.
Plantar fasciitis is a very specific thing happening to the tissue of the plantar fascia, which happens to create pain in a very specific spot. With that said, most People who have any sort of pain, especially first thing in the morning, are usually always diagnosed with plantar fasciitis, despite it sometimes not being in the actual spot of the plantar fascia, or plantar fasciitis itself.
And, pretty much just foot pain. So, so that's the first thing. That's, that's, that's the first thing, especially if you have a client that comes into you and is like, Oh, my doctor said I have plantar fasciitis. What should I do for it? First of all, evaluate them and decide if it truly is plantar fasciitis, because I'd say if 10 people have come to me saying they have plantar fasciitis, maybe two actually have plantar fasciitis.
The other eight of them just have foot pain. Secondly, whether it's foot pain in that area or plantar fasciitis itself, you cannot discount the influence of the viscera and the visceral referral to the medial side, the inside part of the foot are the urogenital organs. So bladder, uterus, prostate, ovaries.
Kidneys. These are the urogenital organs. So any of these organs, organs in front of the sacrum, so probably even the rectum, can be a driver of visceral referred pain to the medial foot, especially in the mornings. Kidneys is a big culprit, especially if it's a bilateral foot pain in the morning, that's a big culprit.
big time kidneys. Um, also super common, um, from hormonal involvement, um, in pregnancy, postpartum or menopause, postmenopausal. So you also want to consider the other endocrine organs. Um, so whenever we're talking about The, um, sex hormone organs. Um, you wanna look at the rest of the endocrine organs too. So therefore, you know, we could, we need to consider adrenals, um, pituitary, the thyroid, parathyroid, all those things too.
So that's important to note. And of course, like how do you do all that? Well, one, some of it's functional, right? You might wanna. Ask some questions about symptoms around those organs, you might want to ask them questions about just function of those organs, where they are in their general health and life, lifespan, life cycle, and pull in a functional medicine doctor if you need, um, if you have the skills from the LTAP, um, it is important to do the LTAP and see where is the body directing you, you might need it
be taken to their organs. You might not in, in, um, absence of having the skill of using the LTAP, just, just do something around those organs. Do some movement around the sacrum, do some pelvic floor exercises, you know, work around, do a gentle visceral massage with the gorgeous ball and see how that changes their symptoms.
That's the simplest thing that you can do. work on some thoracolumbar rotation around the kidneys, right? I just did a whole episode on the kidneys. I can link that in the show notes. So all of the things, if you, the next person that comes in, plantar fasciitis, like think, think that visceral referral first.
The other thing is the neural connection. So you cannot discount, and this is partly, so the neural connection is always part of the visceral connection. You cannot discount that oftentimes when people point to where their foot is, their foot is in pain when it comes to plantar fasciitis, they're actually pointing to their medial and lateral plantar nerves.
So medial lateral plantar nerves come right on the inside medial edge of the foot. They're right near where the classic painful spot of the plantar fasciitis may be. So I see a lot of athletes, especially my track athletes with heel pain or heel bruises actually come in and they're pointing to pain on their plantar nerves.
So this area, the plantar nerves can just be compressed and irritated. And also they can be entrapped. There's a lot of soft tissue that those nerves have to go through in order to get to the medial foot. And then the medial, foot itself can be in a trap inside. What happens, people sort of roll out the foot plantar fascia, but they actually never get to the fascial slip that the plantar nerves actually enter the foot from, which is more on the side of the foot.
So that's something to keep in mind. And then the, where did those plantar nerves come from? They come from the tibial nerve. So the tibial nerve can be entrapped in multiple places. It can be entrapped in the lower leg compartments. Deep posterior compartment specifically can be entrapped in the popliteal space behind the knee.
It can be entrapped at the proximal end of the popliteal, like, diamond up where the hamstring splits. It can be entrapped up at the lateral hip. Kind of like the space between the greater trochanter and the ischial tuberosity. It can be entrapped at the piriformis and it can be entrapped or affected, compressed at the lumbosacral trunk and the actual nerve roots to the tibial nerve.
So those are multiple places that might be entrapped or compressed or even getting overstretched that would create plantar fasciitis pain. So thinking more big picture. The next thing is spending life in shoes and socks. So, and this, this actually has to do with the world according to Anna thought too, but a lot of the times when I see someone with lenter fasciitis or heel pain in general, it's because they have too much weight on their heels.
Our heels, though it is a weight bearing bone, and it has a fat pad there, it is not where our weight, our center of mass, should be distributed on our feet. I mean, it is excessively. What happens is those tissues get pounded on and compressed, and over time, they can hurt. Over time, we can have a stress response start to lay down thicker tissue and bone spurs in the area.
Right? Um, so what is the solution for this? The quickest, easiest solution to shift someone's weight to more anterior from a heel striking position is to spend some time barefoot, to spend some time also on rock mats, exploring the sensory experience with their feet. And, uh, as Phillip Beach says, giving their feet a life.
So I have a whole entire blog post called Revitalize Your sole, S O L E, meaning the bottom of your foot. And it's all about how to bring a rock mat into your life and the importance of bringing a rock mat into your life. And the primary reason why, there's two, one, the sensory information. It is primarily pressure sensory information.
But that sensory information is carried up the nerves that innervate the bottom of your foot into the lumbar sacral plexus. And then that sensory information is used in determining a great motor output, which is one of the things that helps us to organize our pelvis and our core a little bit better, as well as our center of mass over our feet.
The other is a straight up pressure thing. Right? It's a, it's a physics equation. Pressure equals, um, force over area. The force is our body weight in gravity. That doesn't change that much day to day, but the surface area can. So if our center of mass, if when we stand on our feet, we tend to be more on our heels, the pressure we're going to feel is going to be higher.
So if you could shift your weight forward on your feet, and distribute the weight over your entire foot, then the surface area increases, which means the pressure decreases. That's what the rocks make us do, because it hurts when you put a rock on your heel and all your weight is on your heel. So what does it force you to do?
Shift your weight forward. What does shifting your weight do? Widens your sitz bones. Neutralizes your pelvis, takes it out of a chronic tight ass position, puts it in more of a neutral position, which is 12 to 15 degrees of anterior tilt, shifts your whole weight forward, connects your reflexively into your core.
And so then, Even the neural and the visceral structures are going to be way more happier in that core container and coming out of the pelvis, which if you have like a secondary entrapment or referral pattern to the foot, it's going to help you too. So anybody who comes in with the, um, plantar fasciitis diagnosis, whether it truly is plantar fasciitis or not, I give, um, Rock Mat Instructions too.
And the instructions is just to spend time barefoot on rocks or a rock mat safely and comfortably. Cumulatively up to 30 minutes a day. So it doesn't have to be 30 minutes at a time, but cumulatively. So I put a rock mat in front of my bathroom sink, oftentimes in my shower. So just the places I'm already standing, I put a rock mat there.
So that by the time I've even left the house for my first Patient or my first running errand or to go to the gym. I've already probably gotten the majority of my 30 minutes of, um, an interesting something for my feet to feel. Now you can just go outside. When you go outside, you also get the added benefit of grounding or earthing.
And so that's great, but also outside is not accessible for everyone and it's not safe for everyone. So depending on the environment you live in, maybe that's not ideal. And also depending on. How long it's been since you've given your feet a life, you might want to start a little bit safer and easier and more accessible.
And so the other thing too, is keep in mind, if it's too uncomfortable, it's not going to be helpful. So it's got to be comfortable and interesting. And that means you might need to be in a seated position to start not full body weight and just work your way up or put the rock mat on a carpet or put a towel over the top of it.
You know, Work your way up to full rocks and uh, each rock shape is different for everybody. Some people like the little pee pebbles, some people like the beach rocks, some people like an in-between and there. What I have found is there's no rhyme or reason to what type of rock you light, depending on what type of foot, but it should definitely always be something's comfortable and interesting in order to be beneficial.
So. That's a big one. So in this whole conversation too, of where our weight is on our feet and how we walk, right? So even to barefoot walking and running, it forces us to be on a little bit more forward position of our foot, which is where our fascial containers, our fascia of our foot and low leg can help to absorb some energy.
So an interesting study that I had, um, Saw presented at one of the fascial research congresses that I went to was talking about the incidence of It's talking about like Achilles ruptures. It was talking about the incidence of basically Why Achilles ruptures tend to happen, you know in older people and the thought process is be you know that the Achilles tendon and the plantar fascia are basically the same thing.
They're a continuation. As they go around the heel bone, there is an, that's a big fulcrum, right? That's what lifts us up. That's a lever that lifts us up. But, um, as they go around the heel, heel bone, they have a fat pad. There's a fat pad under there. The fat pad, obviously, you know, a little bit, the fat pad is for shock absorption when we are standing on our heel, but the fat pad also is to make that big old curve around that calcaneus, um, a little bit easier for the Achilles tendon and the plantar fascia.
And so it can move smoothly around a real bony curve. As that fat pad disintegrates, flattens, gets smashed, compresses over time, then you can imagine the, the Achilles tendon and the plantar fascia is almost getting like sawed around the, um, calcaneus. And so that might be the reason for this incidence of, uh, One plantar fascia.
That's not what the study said, but that's what I am extrapolating. But then also, um, the incidents of Achilles ruptures in older people, and then that goes back to so why it's so important to learn how to weight shift on your feet and have a more normal, upright, Center of mass position where you're a little bit more like 60:40 on your feet, so 60% balls of your foot and 40% heels.
So when we wear shoes all the time, when we walk in a really thick sold shoe, what happens is our gait changes. So we are like much more dominant heel strikers, then four foot strikers, and that just wears out. Um, the heel pad over time. I honestly think this is why so many of my basketball players and my football players can barely walk in the mornings is because the shoes that they wear tend to not have a whole lot of padding really hard.
And I just think that if you were to measure their fat pad, you might see that in those athletic populations, they diminish their fat pad a little bit faster than normal population or even other sports that we're. Different types of shoes or have different types of like running patterns. I don't know.
This is again world according to Anna. This is a little Insight into how my brain works. So that's it. I know it was a lot, but let's like review the basics plantar fasciitis. First of all, don't trust the diagnosis. Assess, assess, assess. Second of all, consider the visceral referral, which is urogenital organs.
Third, consider the neural connections. Is it actually a medial or lateral plantar nerve entrapment? And then fourth, where is their center of mass over their foot? If their weight's a little bit more on their heels, they're closer tilted, sort of tight ass position. fake heel strikers, you're going to want to do stuff to shift their weight forward.
So utilizing the rock mat is the first place to start with that. And then working on pelvic floor and ankle mobility, weight shifting. All of the things. So with that said, I'll link some of the episodes. I said, I'll link the blog post about the rock mat as well as a couple of videos about anterior weight shifting.
Oh, and the entire, I just recently did another episode on weight shifting too. So we'll link that as well. That's it. Wrapped it up. Got it done. Hopefully it was helpful. I know this is a big issue for a lot of people. So let me know what you think. Have a great day. See you next week.