Plantar Fasciitis Symptoms & Treatment

What is Plantar Fasciitis?

Plantar fasciitis is inflammation of the thick connective tissue on the sole of the foot. This tissue, the plantar fascia, connects the heel bone to the toes and creates the arch of the foot. This is one of the most common musculoskeletal complaints in the foot. It is often also known by policeman’s heel or jogger’s heel.

What causes plantar fasciitis?

Improper footwear or repetitive stress can result in overpronation and further causing constant tension of the plantar fascia resulting in inflammation of surrounding tissue. When you are not on your feet, scar tissue begins to repair the injury; but when you get back on your feet after being seated or wake up in the morning the newly formed scar tissue is re-torn resulting in acute pain.

What are the symptoms?

The most common complaint is pain and stiffness in the bottom of the heel and along the arch of the foot. The heel pain may be dull or sharp while the  bottom of the foot may also ache or burn.

The pain is usually worse:

plantar fasciitis

  • In the morning when you take your first steps
  • After standing or sitting for a while
  • When climbing stairs
  • After intense activity

The pain may develop slowly over time, suddenly after intense activity, or with a change in footwear/activity.

Risk Factors

  • Flat feet or very high arches
  • Obesity or sudden weight gain
  • Long-distance running, especially running downhill or on uneven surfaces
  • A change in footwear
  • Tight calf muscles and/or Achilles Tendon (the tendon connecting the calf muscles to the heel)
  • Shoes with poor arch support or soft soles

Research has found that heel spurs are not necessarily factor for this condition as previously believed. On x-ray, heel spurs are seen in people with and without plantar fasciitis.


In the acute phase ice will aid in the reduction of inflammation. The biomechanical issue needs to be corrected to take the chronic strain of the fascia by way of manual manipulation of the bone and further support with a custom orthotic.

If you’re suffering from Plantar Fasciitis, call 604-737-1177 to schedule your consultation with us or book online

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Tennis Elbow-Lateral Epicondylitis

Tennis ElbowTennis elbow also known as lateral epicondylitis is inflammation, soreness, or pain on the outside of the elbow and can extend down into the forearm. The condition is generally brought on by repetitive stress to the elbow joint, overuse, and also there may be a partial tear of the tendon fibers. The tendon fibers are what connect the muscle to the bone, so if there is inflammation here, then ultimately any movement of the joint will be painful. The tear may be at or near where these fibers begin, on the outside of the elbow.


Signs and Symptoms

  • Elbow pain that continues to worsen
  • Pain that travels from the outside of the elbow to the forearm and back side of the hand when attempting to grab something or twist the arm.
  • Less grip strength


Risk Factors

  • Any repetitive or overuse activity
  • Racquet sports
  • Occupations that require repetitive motions such as painters, plumbers, cooks, and butchers.
  • Desk/office work with poor ergonomic design or excessive mouse use.

At Alliance Wellness, we will help you manage pain associated with Tennis Elbow and increase your ranges of motions. Call 604-737-1177 to book your consultation.

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Whiplash Causes & Syptoms

Whiplash is an acceleration-deceleration mechanism of energy transfer to the neck. It is caused by an atypical movement or force applied to the neck resulting in movement beyond the neck’s normal limit. It may result from motor vehicle accidents, sporting activities, accidental falls, repetitive stress injuries involving the neck, and assault. The impact may result in bony or soft tissue injuries, specifically to the ligaments, tendons, and muscles, which in turn may lead to a variety of clinical manifestations.

Signs and Symptoms

Whiplash, also called cervical sprain, cervical strain, or hyperextension injury, is characterized by a collection of symptoms that occur following damage to the neck.

Symptoms of whiplash may not present for 24 hours or more after the initial trauma. The most common symptom after a whiplash injury is neck pain or stiffness. People who experience whiplash may develop one or more of the following symptoms, usually within the first few days after the injury.

Hyperextension and Hyperflexion Whiplash

  • Neck pain and stiffness
  • Headaches
  • Dizziness
  • Pain in the arms, shoulders or between the shoulder blades
  • Low back pain
  • Altered sensation such as pins and needles or numbness
  • Weakness
  • Ringing in the ears or blurred vision
  • Difficulty swallowing
  • Difficulty concentrating or remembering
  • Irritability, sleep disturbances, fatigue
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Shin Splints Symptoms & Treatment

What are Shin Splints

Shin Splints is an overuse condition commonly caused by running and other weight-bearing activities. There are two varieties of shin splints, posterior and anterior. This condition is caused when the tibialis anterior muscle or tibialis posterior muscle respectively become tight and pull on the connective tissue (Periosteum) lining the tibia or shin bone. This tension creates a painful inflammation along the shin between the knee and ankle that is made worse with activity and contraction of the involved muscles.

What Causes Shin Splints

When someone over-pronates or pronates too rapidly, either or both of these muscles may be called upon to work harder than normal. As a result, fatigue sets in, leading to inefficient force production which leads to micro-tearing of the soft tissue and therefore an inflammatory reaction.

What are Shin Splints Signs and Symptoms

  • Tenderness over the inside shin area (may start as a dull ache and progress to a sharp pain)
  • Pain starts with activity and then seems to disappear, but may return at the end of activity, as shin splints get worse the pain may last longer
  • May see lower leg redness (rubor)
  • Lower leg swelling
  • May feel a lump or bump on the lower leg
  • Pain with toes or ankle pointed downwards

Risk Factors

  • Running on uneven surfaces
  • Running downhill
  • Resuming activity (exercise) after a period of no or reduced activity
  • Weak muscles in the front of the leg (stronger muscles in the back of your leg)
  • Over-pronation (when your foot rolls to the inside and your arch flattens)
  • Wearing inappropriate shoes (worn-out or incorrect for your foot type)
  • Training too hard too soon (not increasing your activity gradually), because muscles that fatigue
  • quickly lose their ability to absorb shock and therefore more stress is placed on the bones


First, rest and ice to decrease damage being done and inflammation. Following the acute phase, orthotics are prescribed to reduce the over-pronation and help take the load of the muscles that will be over-worked if the pronation is not controlled.

Not sure which professional to see or which treatment will be best for you? Call 604-737-1177 to schedule your free consultation or book online

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Knee pain

Knee pain can have a variety of causes and presentations. Here is a list of common causes of knee pain including a description, common causes and risk factors.

Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome (PFPS), is caused by chronically tight and overused muscles in the thigh pulling on the knee cap. This condition caused when a tight and inelastic IT Band (the connective tissue band that runs down the outside aspect of the thigh from the hip to just below the lateral knee) and the lateral quadricep muscle (vastus lateralis) pull on the outside aspect of the knee where it attaches to the bone and knee cap (Patella). In general patellofemoral pain syndrome occurs when the patella does not move or ‘track’ in a correct fashion when the knee is being bent and straightened. This movement can lead to damage of the surrounding tissues, such as the cartilage on the underside of the patella itself, which can lead to pain in the region. Pain is increased with activity and deep knee bending on the affected side.

PFPS is often confused with another condition known as Chondromalacia Patella. This is damage to the cartilage which lines the underside of the knee cap. CMP can be a result of PFPS, although it can also occur independently, usually due to damage from an impact.

Patellofemoral Pain Syndrome


  • Aching pain in the knee joint, particularly at the front, around and under the patella.
  • Tenderness along the border of the kneecap.
  • Swelling sometimes occurs after activity.
  • Pain is often worst when walking up or down hills or stairs.
  • A clicking or cracking sound may be present on bending the knee.
  • Sitting for long periods may be uncomfortable.
  • Wasting (atrophy) of the quadriceps muscles in prolonged cases.
  • Tight muscles including calf muscles, hamstrings, quadriceps (especially vastus lateralis on the outside) and iliotibial band.

Risk Factors/Contributing Factors

  • Lack of proper stretching pre/post exercise
  • Weak medial thigh muscles (vastus medialis and adductors)
  • Long-distance running
  • Running uphill
  • History of a previous knee dislocation
  • Overloading – Bending the knee increases the pressure between the patella and the femur. Thus sports such as running, where repeated weight-bearing occurs, may result in PFPS.
  • Over pronation- Pronating sometimes exhibited as ‘flat’ feet lead to an increased biomechanical stress on the knee joint. This may affect the alignment of the patella particularly during movement.
  • Q-angle – Some people have a larger than normal femoral angle (known as the Q-angle) resulting in a ‘knock-kneed’ appearance (genu valgum). When the person straightens their leg when weight bearing, the patella will be forced to the outside of the knee. With repeated bending and loading, this motion may lead to damage of the underlying structures and cause pain. A larger Q angle is common in women due to their wider pelvis. This is why more women suffer with this condition than men. Strengthening the abductors (Gluteus Medius, Minimus and Tensor Fasciae Latae) and lateral rotators (Gluteus Medius and Maximus) of the hip can be beneficial when a wide Q angle is thought to be a contributing factor.


The knee and ankle are common locations for sprain and strain injuries. These types of injuries are often seen in sports such as football, hockey and soccer. They are also common in slips/trips when out walking and running. A sprain is damage to a ligament that supports a joint. These include the medial and lateral collateral ligaments (MCL/LCL) and the anterior and posterior cruciate ligaments (ACL/PCL) in the knee. In the ankle, the most commonly injured ligaments are on the outside aspect of the ankle and includes the anterior talofibular ligament, calcaneofibular ligament, talocalcaneal ligament, posterior talocalcaneal ligament and the posterior talofibular ligament. A strain, on the other hand, is a damage to a muscle in the affected area. Both strains and sprains can range from mild tearing to complete rupture and often need to be differentiated from a fracture by a healthcare provider due to trouble weight bearing, excessive swelling and bruising to the area.


Knee Sprain

  • Swelling ranging from mild and localized to severe with a larger area affected
  • Possible bruising also ranging in severity
  • Pain with active motion
  • Pain with passive motion
  • Pain with walking and weight-bearing
  • Sense of instability or “giving out”


  • Blunt trauma to the area (ie tackle, impact)
  • Tripping or stumbling
  • Falling
  • A quick pivot and change of direction in sport
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Piriformis Syndrome

The Piriformis muscle is a small muscle (3-5cm) located in your buttock. It runs from the bottom of the spine to the top of the hip. Its function is to help the leg rotate outwards.

Piriformis syndrome occurs when the piriformis muscle becomes tight, usually from overuse. Other problems, such as a burning sensation down the back of the leg, may occur when this tight muscle compresses the sciatic nerve which may run above, below or right through the piriformis muscle.

Signs and Symptoms

Piriformis Syndrome

  • Sitting tolerance is limited to 15-20 mins before onset of pain
  • Pain, numbness or tingling down the back of the leg
  • Tender area in the buttock region
  • Difficulty walking due to pain


Risk Factors

  • Trauma, Muscle spasm or muscle imbalance
  • Overuse
  • Improper sitting posture or abnormal walking patter

If you are experiencing the symptoms of Piriformis Syndrome, Call 604-737-1177 to schedule a free consultation or book online

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Carpal Tunnel Syndrome

Carpal tunnel syndrome is pressure on the median nerve – the nerve in the wrist that supplies feeling and movement to parts of the hand. It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.


The median nerve provides feeling and movement to the “thumb side” of the hand (the palm, thumb, index finger, middle finger, and thumb side of the ring finger).

The area in your wrist where the nerve enters the hand is called the carpal tunnel. This tunnel is normally narrow, so any swelling can pinch the nerve and cause pain, numbness, tingling or weakness. This is called carpal tunnel syndrome.
Carpal tunnel syndrome is common in people who perform repetitive motions of the hand and wrist. Typing on a computer keyboard is probably the most common cause of carpal tunnel. Other causes include:

  • Sewing
  • Driving
  • Assembly line work
  • Painting
  • Writing
  • Use of tools (especially hand tools or tools that vibrate)
  • Sports such as racquetball or handball
  • Playing some musical instruments


  • Numbness or tingling of the palm of the hand
  • Numbness or tingling in the thumb and next two or three fingers of one or both hands
  • Pain extending to the elbow
  • Pain in wrist or hand in one or both hands
  • Problems with fine finger movements (coordination) in one or both hands
  • Wasting away of the muscle under the thumb (in advanced or long-term cases)
  • Weak grip or difficulty carrying bags (a common complaint)
  • Weakness in one or both hands

At Alliance Wellness, we will help you manage pain associated with Carpal Tunnel Syndrome and increase your ranges of motions. Call 604-737-1177 to book your free consultation.

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Iliotibial Band (IT Band) Syndrome

Iliotibial band syndrome is a common conditions which usually presents as pain on the outer side of the knee. The IT Band is a thick band of connective tissue that crosses the hip joint and extends down the outer thigh and attaches just below outer side of the knee. IT Band syndrome is caused by excessive friction at the distal portion of the IT Band as it rubs over the outside portion of the knee. This is most common in runners and cyclist, but also other sports that involve repetitive knee bending because it leads to inflammation in this area.

Signs and Symptoms

Iliotibial band syndrome

  • Sharp or burning pain at the outside of the knee
  • Swelling or thickening of tissues in this area. Snapping or popping sound when bending the knee
  • Pain during or after activity, that is aggravated by running downhill and by prolonged sitting with knee bent


Risk Factors

  • Tight IT Band, Hip muscle weakness or imbalance
  • Very prominent lateral femoral epicondyle (bony structure on the outside of the knee)
  • Sports with repetitive knee bending, such as running and cycling, running up and down hills
  • Recent increase in track or interval training, Crowned running surfaces
  • Internal rotation of legs, Bowlegs

At Alliance Wellness, we will help you manage pain associated with Iliotibial band syndrome and increase your ranges of motions. Call 604-737-1177 to book your free consultation.

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Benign positional vertigo is a condition in which a person develops a sudden sensation of spinning, usually when moving the head. It is the most common cause of vertigo.

Causes, and risk factors

Benign positional vertigo is due to a disturbance within the inner ear. The inner ear has fluid-filled tubes called semicircular canals. The canals are very sensitive to movement of the fluid, which occurs as you change position. The fluid movement allows your brain to interpret your body’s position and maintain your balance.

Benign positional vertigo develops when a small piece of bone-like calcium breaks free and floats within the tube of the inner ear. This sends the brain confusing messages about your body’s position.

There are no major risk factors. However, the condition may partly run in families. A prior head injury (even a slight bump to the head) or an inner ear infection called labyrinthitis may make some people more likely to develop the condition.


People with this condition feel as though they are spinning or moving, or that the world is spinning around them. They may experience:

  • Nausea, vomiting, hearing loss, and a loss of balance
  • Vision problems, such as a feeling that things are jumping or moving

The spinning sensation:

  • Is usually triggered by moving the head
  • Often starts suddenly
  • Lasts a few seconds to minutes

Most often, patients say the spinning feeling is triggered when they roll over in bed or tilt their head up to look at something.

Our doctors will help to diagnose if this is the cause of your symptoms and rule out other possible causes including ear infections and other inner ear disorders. Treatment consists of a maneuver designed to reposition the calcium deposits thus eliminating the vertigo sensation.

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Thoracic Outlet Syndrome (TOS)

Thoracic Outlet Syndrome (TOS) is an umbrella term that refers to the compression of nerves and blood vessels as they travel from the neck to supply the arm. More specifically, the Brachial Plexus (a group of nerves carrying sensory and motor information), and the subclavian artery and vein become entrapped. The compression of these neurovascular structures occurs with the narrowing of small spaces in the Thoracic Outlet. The Thoracic Outlet extends from the borders of the collar bone (clavicle), first rib, and neck muscles (anterior and middle scalene). There are 3 common sites within the Thoracic Outlet that can become entrapped: between the scalene muscles, under the collar bone, and beneath the tendon of the pectoralis minor muscle.


  • Motor vehicle accidents (ie. whiplash), Tramatic Injuries
  • Repetitive strain, Carrying a heavy backpack
  • Congenital / extra cervical ribs



  • Neck, shoulder, and arm pain
  • Weakness in the arm and hands
  • Reduced sensation in the hands
  • Tingling sensation into the arm
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