Staging Plantar Fasciitis, A Progressive Disease!

Understanding Disease Derives From Observation.

“Observation is the act of studying the production and destruction of patterns.” David Kord Murray.

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Is staging plantar fasciitis the key to treatment selection?

All diseases that I’ve encountered, as a veterinary pathologist, progress through stages.

They move from barely discernible ‘niggles,’ to recovery, chronicity (never really go away), or death.

The diseases known as cancer, progress through stages, as described in Cancer Research, UK:

• Stage 1 usually means that a cancer is relatively small and contained within the organ it started in.
• Stage 2 usually means the cancer has not started to spread into surrounding tissue but the tumour is larger than in stage 1. Sometimes stage 2 means that cancer cells have spread into lymph nodes close to the tumour. This depends on the particular type of cancer.
• Stage 3 usually means the cancer is larger. It may have started to spread into surrounding tissues and there are cancer cells in the lymph nodes in the area.
• Stage 4 means the cancer has spread from where it started to another body organ. This is also called secondary or metastatic cancer.

The selected treatment follows the stage, from simple excision (removal) of stage one (IF you know it’s there), to surgery, including removal of drainage lymph nodes, combined with chemotherapy, radiation, and anything else you can throw at it, for stage 4!

Click image for link to the Interactive Map.

Aortic diseases are equally progressive, with treatments ranging from watch and wait, to emergency surgery!

What are the stages of so-called plantar fasciitis? NOTE: If you clicked that link, check your downloads folder!

Staging Plantar Fasciitis (recommended treatment in parentheses)

My best attempt, as of today - increase caution as it progresses!

• Stage 1 acute morning heel pain (write out history, and think it through: modify movement, by changing shoes if you so desire)!
• Stage 2 progressive, and relentless morning heel pain, with pain on standing after sitting, during the day (write out history, and think it through: track down the source of the problem and fix it, be it tight calves [stretch hamstrings, roll calves], self-induced imbalance or asymmetry, pelvic subluxation or muscular tightness, over-training, …]
  200 samples" width="300" height="121" srcset="https://i0.wp.com/athletewithstent.com/wp-content/uploads/2016/10/Two-Clusters-300.jpg?resize=300%2C121&ssl=1 300w" sizes="(max-width: 300px) 100vw, 300px" data-recalc-dims="1"/>

  Data from 216 cases: green improved, black no effect, red made it worse, grey not tested. You can see two main groups, left, greener - generally responded to treatments tested, right, redder and blacker, generally did not respond to treatments tested.

• Stage 3 crippling foot pain, throughout the day, that fails to respond to any treatments, from professional assistance to surgery, which in my opinion, is to be avoided at all cost (write out history, and think it through: you have to stop, and go back to basics. Whatever you do, don’t run, or stress area 8 on the map above. you could tear your plantar fascia. This will probably need surgery).
• Stage 4 tears or rips in the plantar fascia, and other organic foot damage (write out history, and think it through: now all bets are off, as you failed to fix it soon enough. This is not your fault, it’s due to a lack of appropriate research on this condition).

My current work indicates (see adjacent figure) that there are two forms of chronic ‘so-called plantar fasciitis’, stages 2 and 3: responsive versus non-responsive.

I still think that your best bet is to work on body movement corrections - the basis of our method - whether we are correct, remains to be proven. It certainly works in some cases, as do all advertised treatments. You could always try FitOldDog’s Body Meditation Course, or start with the exercises in Jack Heggie’s wonderful, Feldenkrais-based book, Running With The Whole Body.

Staging plantar fasciitis? Research is badly needed!