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                         UNDERSTANDING PLANTAR FASCIITIS

Exercises and Information to Help Treat Your Plantar Fasciitis

                                 Dr. Kelli DuCloux

 

Plantar Fasciitis is the condition where there is pain on the underside of the heel or the arch of the foot.

It is caused by a shortening, tightening, or inflammation of the connective tissue bands under the foot.

Plantar Fasciitis may be due to:

1. Over training,
2. Poor fitting or worn shoes, 3. Weight gain,
4. Over-pronation, or
5. Abnormal foot structure.

Treatments offer support and the resting of those connective tissues.

Extension of the toes upward is a treatment you can do at home. It makes the band of tissues that run from the heel to the toe, stretch out and become less tightened or strained.

Stretching and massage of the foot and calf are other similar home-based treatments that provide relief from individuals suffering from Plantar Fasciitis.

For pain, many sufferers use anti-inflammatory medications such as Ibuprofen which can be purchased over the counter.

Please see your private medical physician to help you with pain and for treating your individualized case of Plantar Fasciitis.

Besides stretching the calf, it is also important to stretch the plantar fascia.

As demonstrated in a paper published in the Journal of Bone and Joint Surgery (6), an effective treatment for plantar fasciitis is to sit in a figure 4 position (legs crossed with right ankle on top of left knee or vice versa) and pull your big toe back for 10 seconds.

This stretch is repeated 30 times per day. Compared to conventional treatments for plantar fasciitis, routinely stretching the big toe was associated with significantly better outcomes

.
Read more at:
http://running.competitor.com/2014/06/photos/new -techniques-treating-plantar- fasciitis_96398#1SS5526OZM5FK05B.99

 

Alternative to Surgery

Rather than cutting or injecting the plantar fascia with drugs that weaken connective tissue, an effective alternative is to perform deep tissue massage to the arch and calf.

The efficacy of manual therapies for lessening plantar heel pain was proven in a randomized controlled trial in which the addition of trigger point massage to a conventional self-stretching protocol produced superior short-term outcomes compared to stretching alone.

Read more at:
http://running.competitor.com/2014/06/photos/ne w-techniques-treating-plantar- fasciitis_96398#1SS5526OZM5FK05B.99

 

 

EXERCISES

1. Stretch the fascia. Prop your toes up against a wall, keeping your arch and heel flat so the toes stretch. Hold for a count of 10. Repeat 10 times three or four times per day.

2. Roll a frozen water bottle under the
arch. “Stretch first then roll out the arch for 10 minutes; you don’t want to stretch the tendon when it’s ice cold,” Clemens said.

3. Freeze a golf ball and massage the fascia. Roll the frozen golf ball under the foot, starting from the front and working your way back. Put good pressure on each spot—the medial, center and lateral positions—for 15 seconds before moving to the next area. Then, roll the ball back and forth over the entire foot.

4. Foam roll all muscles on the body above the plantar. “Even tight shoulders can cause the

condition, as your arm swing can throw off proper hip alignment and footstrike,” Clemens said.

5. Bump your arch. “Get a commercial insole with an arch bump to push on the plantar and keep it from flexing—it doesn’t matter if you’re an under or overpronator; the plantar needs to be supported and strengthened,” Clemens advised. “Wear the support in all shoes, if possible.”

 

Read more at:
http://running.competitor.com/2013/03/injury- prevention/five-do-it-yourself-remedies-for-plantar- fasciitis_50264#ChhceKJqlVeVik7i.99

Read more at:
http://running.competitor.com/2013/03/injury- prevention/five-do-it-yourself-remedies-for-plantar- fasciitis_50264#ChhceKJqlVeVik7i.99

 

 

MORE INFORMATION

Plantar fasciitis, also known as Runner’s Heel, is one of the most common injuries among athletes, characterized by a sharp pain in the heel and arch of the foot.

Approximately 10 percent of runners will have plantar fasciitis in their careers. They’ll join scores of other athletes and non-athletes with this painful and strange injury.

Because plantar fasciitis can strike a wide range of people — high-volume runners and overweight non- athletes — and little is known for certain about its exact cause, the term can often be used as a catch- all when self-diagnosing injuries.

“There are a variety of other soft tissue disorders that can mimic plantar fasciitis,” said Daniel Riddle, a professor of physical therapy and orthopedic surgery

at Virginia Commonwealth University, who has studied plantar fasciitis extensively.

Instead of plantar fasciitis, what you may really have is heel pain or a pulled muscle in the arch.

Plantar fasciitis specifically refers to irritation of the plantar fascia where it attaches to the heel bone and runs along the bottom of the foot.

The tell-tale signs that you have genuine, honest-to- goodness plantar fasciitis, said Riddle, are pain on the bottom inside of the heel that often comes with pinpoint tenderness and pain during your first few steps after arising in the morning, because the fascia have stiffened and shortened overnight, which eventually subsides as you move around.

The belief has long been that inflammation in the fascia causes the notable pain at the insertion point on the heel — hence the “itis” in the name of the injury.

 

But recent studies have actually found very few signs of inflammation in injured tissue. It’s now believed that the problem really is one where the plantar fascia thickens and the collagen fibers degenerate or weaken.

This may be caused by tears and stress in the soft tissue.

All this confusion could help explain why asking your friends for advice or searching online for plantar fasciitis treatments yields a disturbingly varied wealth of suggestions.

Some people swear that they switched to barefoot running and got better; others testify to the magic curing powers of super cushioned shoes.

 

That discrepancy, said Caleb Masland, a coach and elite runner, can simply be because what is important isn’t how you change your shoes, but that you change them.

If you don’t vary shoes or don’t strengthen the muscles in your foot, then “that can become a weak point,” said Masland. Variety is important to prevent the exact same repetitive stress from happening over and over.

In addition to reducing run volume or resting, the most commonly recommended treatments include

— Arch support and wearing inserts in your shoes — Changing shoes

— Taping the arch of the foot when walking or running

— ART or massage

— Rolling and stretching the foot — Rolling and stretching the calves

—Strengthening exercises— Wearing a splint at night to hold the foot in a semi-stretched position

— Medical treatments like cortisone injections or electro-stimulation

 

The only problem is that while many of these are very popular, they don’t necessarily have scientific research to back them up or have been proven to be only minimally effective.

And, most notably, plantar fasciitis tends to resolve itself eventually regardless of what you do, leading many people to run through it — possibly extending the injury — and ultimately swear by whatever treatment they tried last.

“The issue is that there are lots of treatments that might work but just haven’t been studied in much detail. Lack of evidence doesn’t always mean lack of effectiveness. Equally there are also a host of treatments that aren’t likely to make much difference but people try anyway,” said Tom Goom, a physical therapist at The Physio Rooms in the UK and creator of Running-physio.com.

 

As long as people reduce their training load, work on ankle and foot mobility, and strengthen the calf and foot muscles, then “I’m happy for them to use whatever treatments they find work for them,” said Goom.

Of course, one of the key treatments is figuring out what caused the problem in the first place; otherwise you might just end up right back on the injured reserve list. But when it comes to plantar fasciitis, it’s not always clear what causes the tissue degeneration, initial inflammation, or tearing.

“Anything that can cause repetitive stress or impact [can lead to plantar fasciitis],” said Masland. That includes sudden increases in running mileage or intensity, as well as sudden changes in foot strike or shoes, but it can also come from increases in standing or walking.

 

There have been studies showing that foot structure (really high or really low arches) can contribute to plantar fasciitis, said Riddle, as well as shortening of the calf muscles and Achilles tendon. That’s why strengthening and stretching those areas is an important part of treatment and prevention, but it may not be a golden ticket to being pain free.

There are a host of reasons,” said Goom.

While most runners try to self-treat and self- diagnose plantar fasciitis, if it’s chronic or fails to get better with multiple weeks of test, then it’s important to see a doctor to make sure you diagnosed and treated the injury correctly.

“Sometimes you’ll get lucky and it’ll help, but you’re more likely to see success if you seek help,” said Riddle.

 

Plantar fasciitis is incredibly painful — as I’ve learned all too well — but it’s not a severe injury. Most people will find that it heals itself in time and can be avoided through careful training, though that’s not particularly helpful when in the throes of an injury. In the meantime, I’m certainly not the only runner willing to try everything.

Read more at:
http://running.competitor.com/2014/03/injury- prevention/how-to-treat-and-beat-plantar- fasciitis_97607#5ehMPdM1gbXsszVI.99

Read more at:
http://running.competitor.com/2014/03/injury- prevention/how-to-treat-and-beat-plantar- fasciitis_97607#5ehMPdM1gbXsszVI.99

 

 

BACKGROUND ON PLANTAR FASCIITIS

In normal function the plantar fascia acts as a shock absorber and support mechanism for the arch of the foot. During gait, or movement, the plantar fascia acts like a spring to conserve energy and provide propulsion. Tension increases while the foot is on the ground to store the energy and is then released during toe-off to help with acceleration.

Plantar Fasciitis literally means inflammation of the plantar fascia, but most cases are more degenerative changes rather than inflammatory ones. A new term being used to accurately describe the condition is plantar fasciosis. The condition accounts for about 10% of runner related injuries and is twice as predominant in women than in men. Because of this high incidence in runners, microtrauma from repeated stress is believed to be the primary base cause.

 

Causes are often multifaceted and can range from biomechanical (poor form) to cellular (poor diet) and any combination of the possibilities in between.

Activities such as running, bearing significant amounts of weight for long periods of time, jumping, and dancing can all cause repeated stress along the plantar fascia – especially at the junction with the heel.

Those who pronate (roll their feet in during walking and running), are overweight, wear poorly fit or worn shoes, or who have abnormal foot structure are at greater risk of developing plantar fasciitis.

Heel spurs on the toe side of the heel are often the result of long term plantar fasciitis, but heel spurs on the back of the heel are a separate condition.

Training errors are also primary causes. Rapid increases in activity intensity or duration, abrupt addition of explosive movements or hill workouts, or a change to running on extremely hard surfaces can all be mistakes that cause plantar fasciitis. Using appropriate footwear and adjusting the training over time is highly recommended in addition to diligently stretching the plantar fascia and calf muscles throughout new activity.

 

Athletic shoes lose their cushion rapidly with intense activity and should be changed often to maintain healthy movement.

Tightness in the calf muscles or the Achilles tendon can greatly exacerbate or promote plantar fasciitis. Loss of movement in the ankle, weak or imbalanced leg and foot muscles, as well as the aging process can all be additional factors.

Pain is almost always felt on the underside of the heel and most often along the arch of the foot. Most individuals report that pain in worst with the few steps in the morning or after long periods of inactivity. Pain is generally made worse by walking barefoot on hard surfaces, walking upstairs, sprinting, or spending long periods of time standing. Often it is difficult bending down or bringing the toes to the shin and long time sufferers who remain active without treatment often have accompanying knee and hip pain. Taking weight off of the foot generally relieves pain. However, symptoms return as soon as the foot is again placed under weight.

 

Using KT Tape for this condition has shown tremendous results in alleviating pain and promoting the healing process. KT Tape provides comfortable and conformable support for the arch serving to relax the foot and reduce inflammation. Reduced activity, stretching the calves, massage therapy, weight loss in overweight individuals, foam rolling, ice, and NSAIDs can all serve to help alleviate symptoms and treat plantar fasciitis.

Stretch the calves and plantar fascia before going to bed and before getting out of bed.
Additional recommendations include:
1) Wear appropriately fit shoes with the appropriate support

2) Stretch well prior to exercise

3) Avoid hard surfaces

4) Ice after activity

5) Avoid long periods of standing still

5) Implement multiple activities for cardiovascular exercise such as swimming, cycling, rowing, etc.

6) Seek conservative wellness care

 

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