By Dr. Jason Slagel | March 9th, 2021
Recently I have had a few patients in a row show up in my office with plantar fasciitis and they were surprised that it improved so much following the correction of their head and neck. As I was explaining to them why this happened, I thought it might be good to write it down for others since it is not a very obvious connection between the two.
So first off, what is Plantar Fasciitis?
In anatomy terminology, “plantar” has to do with the bottom or underside of something. In this case, it is the bottom or underside of the foot. Fasciitis is a combination of two-word parts: the root word is “fascia” and the suffix is “itis.” Fascia is the connective tissue surrounding muscles and organs, much like the shrink-wrapped plastic around a package of hot dogs. Fascia is what ligaments and tendons are made up of as well. In the following picture to the left, you can see how fascia covers the muscle and turns into the tendon and attaches to the bone.
The suffix “itis” means inflammation or pain. So when you put the full term together, you can understand that Plantar Fasciitis is inflammation and pain in the fascia on the underside or bottom of the foot. You can see what the Plantar Fascia looks like on the underside of the foot from the picture above on the right.
Ok, so here is the real question with Plantar Fasciitis: WHY DOES THE PLANTAR FASCIA HURT?
There are a few fairly common traumas to the calf and foot that can cause the Plantar Fasciitis (like a bone spur, a foot fracture, or a sprained ankle), but those are pretty obvious to most people and can be treated effectively by a skilled Physical Therapist. The question then becomes; what if there has been no direct trauma? Why does the Plantar Fascia hurt then?
Well, here is where we need to dive a little deeper into the fascia. Fascia surrounds muscles and organs in the body. This fascia connects to bones, muscles, and other fascia throughout the body to create increased stability. Well, it just so happens that there are certain lines of fascia that run throughout the body in certain patterns. These are called “Anatomy Trains.” Here is what these look like:
One of the Anatomy Trains in the body is called the Superficial Back Line. Here is what that one, in particular, looks like.
As you can see, the Superficial Back Line is a long interconnection of fascia going all the way from the skull down the back and all the way to the toes. It connects with muscles and bones the whole length of the way. It connects at the skull, the neck bones, the shoulder blades, the ribs, the spine, the hips, the sacrum, the femurs, the knees, lower leg, heel, and…. You guessed it, the underside of the foot. Now, if anywhere along that line gets disrupted, it can pull and tug on that whole line, and the pain can be felt anywhere else along that line. This is where a Structural Shift of the head and neck comes into play.
Here is what is happening in some people with Plantar Fasciitis:
THERE HAS BEEN A STRUCTURAL SHIFT OF THE HEAD AND NECK THAT IS CAUSING BRAINSTEM PRESSURE WHICH IS CREATING A CERTAIN POSTURE PATTERN.
That posture pattern hurts worse the further it progresses and the longer it stays, however, if the posture pattern is corrected back to balanced, then in some people the Plantar Fasciitis doesn’t have to hurt. So the Superficial Back Line is being affected by not only the Structural Shift of the head and neck (the very top of the Superficial Back Line) but also by the Posture Pattern that is created.
Here is how it works:
The Atlas (the top bone in your neck) is responsible for most of the range of motion of your head, so since it is so mobile, it’s not very stable. This is why it can be shifted out of place easier than any other bone in the spine. If you have an injury that damages the connective tissue (fascia) that holds the atlas in place, it can shift. The atlas surrounds the brainstem, which is why when the atlas shifts out of place it can put pressure on the brainstem. The picture below shows what this can look like.
Among other things, the brainstem controls muscle tone in the body. So, if you put pressure on one side of the brainstem, then this Brainstem Pressure causes the muscles (and therefore fascia as well) on one side of the body to squeeze more than the other side of the body. This is what the pattern looks like:
As you can see, many secondary conditions can show up as a result of Brainstem Pressure and the Posture Pattern it creates. If the fascia is effected, it just makes it hurt worse, but if you correct the Brainstem Pressure and the posture pattern straightens up and becomes balanced, then the Plantar Fascia hurts much less, and sometimes the pain completely resolves.
The really interesting thing is that the picture of the Posture Pattern created by Brainstem Pressure is ALMOST EXACTLY THE SAME as the picture of the Superficial Back Line. This means that not only are these two concepts very interrelated but also that correcting the posture pattern has a very high probability of correcting the fascia in any given circumstance…
The picture on the left is the posture pattern that Brainstem Pressure Creates and the picture on the right is how you should be standing after the Brainstem Pressure is corrected:
The way we correct this problem is by addressing the root issue, which is the Structural Shift of the atlas out of position. We take extremely precise x-rays of the head and neck and measure that shift down to 1/100th of a degree from all three dimensions. Then, we can measure exactly how the atlas has shifted out of place and we can calculate how to correct it. This is all without any twisting, cracking, or popping. Once the atlas is corrected back to its proper position, the brainstem pressure is removed. This means that through this the Plantar Fasciitis pain that some people have can actually improve and possibly resolve.