Wahine
05-05-2007, 11:15 AM
I decided to post this because a lot of people have been asking questions about this particular problem or related problems of the lower leg/foot. So here's something I wrote up in another context that might help with understanding how to manage plantar fasciitis. Sorry it's long but hey, it's not a simple problem.
PF (plantar fasciitis) is definitely not the kiss of death. You treat it with ice, stretching+++++, exercise, anti-inflammatories and massage. It’s generally related to muscle imbalances in the lower leg and biomechanical issues in the way the joints of your foot move. It is very treatable.
Here are some things you can do to try to ease/heal PF:
Calf stretches (gastrocnemius and soleus muslces). This one is for the gastroc (upper calf):
http://www.row2k.com/physio/achilles.html
This next description tells you how to modify the stretch above for the soleus muscle:
For the soleus muscle:
As above, but your body positioned 2-3 feet away from the wall. Bend the knees until you feel the stretch--again, keep your heels on the ground.
I recommend that people hold a stretch for 20 seconds and repeat it 4 times on each side. That's a rehab schedule. If you didn't have a problem and were working on prevention it would be adequate to do it once a side but better yet to go 2 times a side.
Strengthening exercises:
Anterior Tibialis Strengthening Exercise
In standing, support yourself against the wall and flex your feet upward, ball of the foot towards the shins. Hold this position for 5 to 10 seconds, emphasizing on your endurance. Repeat 30 to 90 times with breaks as needed.
Intrinsic muscle strength
Place a towel on the ground and try to scrunch it up with your toes. Scrunch and release, scrunch and release….. Do this for 2 to 5 min.
Some people also advocate walking barefoot to increase muscle strength. This is OK for people who do not have severe biomechanical problems with their feet but it should only be done when the foot is not actively inflammed.
Here’s a device to help with icing and/or contrast treatments:
http://www.footsmart.com/P-Hot-N-Cold-Roller-10145.aspx
But you could do the same thing much cheaper with 2 small bottles of water. If you use small plastic bottles of water, stick one in the freezer. Then when you're ready, take the frozen one out, place it on the floor and put a damp face cloth (or similar) over it and start to roll back and forth. Do this for 1 minute then switch to a bottle with hot water in it for a minute. One of my client's came up with the brilliant idea of putting an old sock over each bottle and wetting it down. Got back and forth for 10 to 15 minutes. Finish with cold if your treating it right after a run or activity that may have irritated the area. Finish with warm if you plan on doing a lot of stretching afterward.
And of course there's good ol' Aleve or ibuprophen (Advil) for over the counter anti-inflammatories. As with any medication, check with your pharmacist before taking it, even if it’s available without a prescription.
Massage works well to help to get your shortened muscles to co-operate and lengthen. But be forewarned, this type of therapeutic massage is painful and not for the faint of heart.
As for orthotics, many people can get by with stretching regularly and may avoid orthotics altogether. Some people need more help with controlling the biomechanics of the foot. Superfeet make a great over the counter insert that is worth trying before you dole out the cash for a custom orthotic. Go to a reputable running store to pick these up and ask questions. There are different models and one will likely be more appropriate than another.
Taping works well for some people. But taping long term is a PITA, so if you need help with biomechanics over the long hual, try to find an orthotic that will work.
Please feel free to add to this. I hope this helps round out the picture for some people.
PF (plantar fasciitis) is definitely not the kiss of death. You treat it with ice, stretching+++++, exercise, anti-inflammatories and massage. It’s generally related to muscle imbalances in the lower leg and biomechanical issues in the way the joints of your foot move. It is very treatable.
Here are some things you can do to try to ease/heal PF:
Calf stretches (gastrocnemius and soleus muslces). This one is for the gastroc (upper calf):
http://www.row2k.com/physio/achilles.html
This next description tells you how to modify the stretch above for the soleus muscle:
For the soleus muscle:
As above, but your body positioned 2-3 feet away from the wall. Bend the knees until you feel the stretch--again, keep your heels on the ground.
I recommend that people hold a stretch for 20 seconds and repeat it 4 times on each side. That's a rehab schedule. If you didn't have a problem and were working on prevention it would be adequate to do it once a side but better yet to go 2 times a side.
Strengthening exercises:
Anterior Tibialis Strengthening Exercise
In standing, support yourself against the wall and flex your feet upward, ball of the foot towards the shins. Hold this position for 5 to 10 seconds, emphasizing on your endurance. Repeat 30 to 90 times with breaks as needed.
Intrinsic muscle strength
Place a towel on the ground and try to scrunch it up with your toes. Scrunch and release, scrunch and release….. Do this for 2 to 5 min.
Some people also advocate walking barefoot to increase muscle strength. This is OK for people who do not have severe biomechanical problems with their feet but it should only be done when the foot is not actively inflammed.
Here’s a device to help with icing and/or contrast treatments:
http://www.footsmart.com/P-Hot-N-Cold-Roller-10145.aspx
But you could do the same thing much cheaper with 2 small bottles of water. If you use small plastic bottles of water, stick one in the freezer. Then when you're ready, take the frozen one out, place it on the floor and put a damp face cloth (or similar) over it and start to roll back and forth. Do this for 1 minute then switch to a bottle with hot water in it for a minute. One of my client's came up with the brilliant idea of putting an old sock over each bottle and wetting it down. Got back and forth for 10 to 15 minutes. Finish with cold if your treating it right after a run or activity that may have irritated the area. Finish with warm if you plan on doing a lot of stretching afterward.
And of course there's good ol' Aleve or ibuprophen (Advil) for over the counter anti-inflammatories. As with any medication, check with your pharmacist before taking it, even if it’s available without a prescription.
Massage works well to help to get your shortened muscles to co-operate and lengthen. But be forewarned, this type of therapeutic massage is painful and not for the faint of heart.
As for orthotics, many people can get by with stretching regularly and may avoid orthotics altogether. Some people need more help with controlling the biomechanics of the foot. Superfeet make a great over the counter insert that is worth trying before you dole out the cash for a custom orthotic. Go to a reputable running store to pick these up and ask questions. There are different models and one will likely be more appropriate than another.
Taping works well for some people. But taping long term is a PITA, so if you need help with biomechanics over the long hual, try to find an orthotic that will work.
Please feel free to add to this. I hope this helps round out the picture for some people.