QUESTION: I have a back and hip proble, but am now experiencing foot pain.  I’m not sure if it is plantar fasciits?  I use the elliptical and bike at the gym, but haven’t run for about 3 years because of a thigh and back problem. I feel like I’m falling apart.  I do have orthotics but am still having pain. What should I be doing if I have plantar fasciits? And what next?

Barb

ANSWER: Hi Barb, Great question…

I am not sure if you had any initial trauma/injury that caused your back and knee problem, but it is not uncommon to experience foot pain that is a result of back dysfunction (referred pain), especially given the length of time you have had your symptoms.

Depending on the length of time you have had your orthotics and the quality of them, you generally get some reduction in plantar fasciitis symptoms if it is related to foot and ankle dysfunction.

However, if you look higher up into the kinetic chain (which includes your knee, hip and pelvis) there are muscle imbalances that could lead to plantar fasciitis-like symptoms. If we look even higher up into your lower back we may discover mechanical issues in the joints, muscles and/or nerves.

Based on the symptoms you have described my first train of thought would be an issue with nerve mobility in and around your lower back, which in turn travels all the way town to the foot. I have treated patients in the past who present with plantar fasciitis symptoms (”a victim”) but their pathology/injury is in the low back (”the culprit”).

In regards to whether or not you are falling apart .. the answer is no. But I would recommend that you discuss your particular case and symptoms with a local physiotherapists how will “listen” to your impairments and activity limitations, perform a clinical examination and take you through their thinking process to provide you with a diagnosis, a prognosis and the development/implementation of a treatment plan.