Dr. Fox trained in Chiropractic Extremity Adjustment to the Foot and Ankle

Dr. Fox recently participated in additional training for Sports and Occupational Injuries of the Foot and Ankle, presented by International Speaker Dr. Mitch Mally, who is considered a "10th degree black belt in extremity adjusting.



Common injuries and pathologies of the foot and related mechanics were covered, including inversion sprains, plantar fascitis, achilles tendonitis, high ankle sprains, avulsion fractures, and arch problems, just to name a few. Specific Chiropractic adjustments were demonstrated by Dr. Mally for each type of foot imbalance. Major areas of focus were in adjustments to the Calcaneus, Talus, Navicular, Tarsals, Cuneiforms, Metatarsals, and Phalanges.



Dr. Mally's review of the literature further supported altered gait and mechanics throughout the body, including tibial torsion at the knee, femoral bone anteversion, sacral & lumbar spine unleveling, piriformis muscle strain, and other global symptoms.



The emphasis is added that the imbalance of the foot, in any situation, is going to alter muscle and other supporting structures of the body which are likely to cause pain. This is clear evidence that a doctor must have a whole view of the body when treating pain disorders.



The most common type of foot and ankle pain is due to inversion sprains of the ankle. Over time, the affect on the arch is usually pronation of the foot and a valgus deformity of the ankle or mortise joint. This type of fallen arch causes the tibia bone to internally rotate and force the quadricep muscle to over-work in order to keep the knee aligned. Medial knee pain or anterior knee pain over the infrapatellar tendon is a common result. This can lead to a condition called Osgood Shlatter's in children or Chondromalacia Patella in adults. Dr. Fox received specific one-on-one instruction in correcting this type of tibial torsion or rotation in the weekend symposium.



Furthermore, an inverted type foot imbalance will cause femoral head anteversion, which literally means the femoral head has internally rotated and move anterior to the acetabulum. This type of motion stretches the piriformis muscle and psoas muscle, causing multiple biomechanical and postural changes. The piriformis muscle is particularly problematic because it may cause a general imbalance to the entire spine by shifting the sacrum from its normal position and causing a mal-alignment of the foundation of the spine.

The most common symptom of a Piriformis imbalance or Piriformis Syndrome is Sciatica. A properly trained Chiropractor can easily detect if the imbalance lies in the spine, pelvis, or lower in the foot and ankle. At times, an orthotic may be necessary to correct a foot and ankle problem once the ankle has been adjusted into a correction position and supported by muscular rehab.

Due to the precision of the body's proprioceptive mechanism, foot imbalance can cause pain symptoms throughout the body, including head and neck (including headaches), jaw & TMJ, low back, pelvis, and knees. After a visit to a Chiropractor, symptomatic relief of pain usually occurs in a short amount of time yet stabilization and correction of the imbalance take time in order to allow proper healing.

Plantar Fascitis Commonly Caused by Long Term Foot Imbalance and Pronation

The first step out of bed in the morning can be a painful one, particularly if you have plantar fascitis.

Plantar means 'bottom of the foot', Fasciae means the 'connective tissue', and (Fasc) "itis" tells us that the tissue is inflammed ("-itis"). That's where Plantar Fascitis is derived.

Common foot imbalances, included dropped or fallen arches contribute greatly to the development of plantar fascitis due to long-term strain that is created in the muscle and surrounding tissues. Not only does your body need to send minerals, vitamins, proteins and other factors to the tissue to allow it to repair, the tissue also needs to be able to flush itself out. In other words, you need materials to repair the inflammed tissue, meanwhile get rid of toxic by-products created by normal muscle and connective tissue metabolism.

This essentially opens a can of worms when it comes to treating plantar fascitis because it allows us to recognize that their are structural components (muscles, joints, tendons, tissues, etc.) as well as chemical components (b-vitamins, hormones, antioxidants, omega 3 and 6 fats, etc.) that need to be addressed to completely correct a case of plantar fascitis.

The best first approach is to seek the consult of an Applied Kinesiologist. This type of doctor, usually trained in Chiropractic, has the ability to evaluate the structural as well as the chemical factors preventing your healing.

In many instances, a properly fitted CUSTOM orthotic will help to maintain any imbalances of the foot after the foot has been evaluated and treated. This process doesn't occur overnight, but it typically relieves pain and discomfort within a short period of time, meanwhile allowing the muscles and tendons a chance to recover from their previously strained state.

The occurrence of plantar fascitis commonly affects women more than men. The reasons can be multiple, but the underlying difference probably lies in the sensitivity of the female hormone system, diet, nutrition, and susceptibility to stress.

Common signs of a foot imbalance include foot, ankle, knee, hip, and low back pain. The development of a bunion on the Great Toe is also a clear sign of a foot imbalance, generally due to a fallen meta-tarsal arch or fallen medial longitudinal arch of the foot. Once a bunion has formed, an orthotic is unlikely to correct it, but it will certainly keep the bunion from getting significantly worse.

Adherence to a semi-strict nutrition program and eating style provides a lot of relief to fatigued muscles and other joints that are not repairing or healing well. See my list of food ingredients to avoid to get yourself pointed in the right direction to eating better. It is also reccommendation to follow the Standard Process 21 Day Purification Cleanse as a method of initiating a change in diet. This process helps curb cravings and other poor food habits, meanwhile allowing you to eat all you want, lose weight, and gently cleanse the bowels, liver, gallbladder, and other organs of detoxification.

In order to provide fast relief of Plantar Fascitis, a combination of chiropractic techniques have been developed in our office, including chiropractic manipulation, myofascial release, reflexology, and acupuncture. A combination of one or all of these techniques usually offers significant relief of pain in the plantar (bottom) surface of the foot. These results will often be permanent if the proper lifestyle modifications can be made. Please call our office to speak with our physician about your individual needs.

Which is it...Piriformis Syndrome or Lumbar Disc Herniation

The low back can be a Great-Masker of pain symptoms. Is there Nerve Compression, Disc Bulging, Muscular Sprain/Strains, or simply a Joint that is out of place?

A neurogical, orthopedic, and physical exam can determine the cause of low back pain, sciatica, or other types of radiating back pain. Doctors of Chiropractic are well trained to detect such dysfunctions in the low back.

The most serious situation affecting the low back is a lumbar disc herniation or disc bulging, often called a "slipped disc". Although a disc can't actually "slip", it can certainly place pressure on nerve roots exiting the spinal cord, causing a wide array of symptoms, such as buttock pain, thigh pain, calf pain, or just foot pain. There is no apparent discrimination as to "where" the pain will occur, and at times the pain can radiate from the back to the entire leg and foot. Sitting is usually difficult and pain is often increased by coughing or sneezing.

A condition called Piriformis Syndrome can also cause radiating leg pain which mimics Disc Bulging or Disc Herniation. In this condition, the sciatic nerve is pinched or compromised where it passes through the Piriformis muscle as it courses to the lower leg. The muscle can be in a stretched or shortened position, resulting in buttock and leg symptoms. Sitting cross-legged and driving in a car often will exacerbate these symptoms.

The typical treatment offered by a Chiropractor is a series of 8-10 visits over 2-4 weeks. With Piriformis Syndrome, symptoms normally reduce greatly after the first several visits, yet the imbalance will persist until the underlying mechanical imbalances in the muscles and pelvis are resolved, which is toward the end of the treatment plan. Exercises and lifestyle modifications are suggested.

For more information or to speak with a musculoskeletal specialist about a specific condition, contact the Chapel Hill Chiropractic Centre to speak with one of our health professionals.