Wednesday, 4 June 2014

Plantar fasciitis....confusion

Plantar Fasciitis is a frustrating ailment to be troubled with. There is no quick fix and it takes ages to heal.

Plantar Fasciitis is simply swollen, damaged and stressed tendon

Muscle injuries heal relatively quickly. There is a good blood and lymph supply to the muscles and the body has a mechanism for building a quick temporary repair and the getting the details perfected later. But with tendons the process is much slower.

The body has a 2 phase healing system, quick fix then full repair. This is a bit like putting a board over a broken window. It might not be perfect but it keeps out the elements, keeps in the heat and keeps out intruders until a glazier can replace the window. However tendons - particularly plantar fasciitis - are more comparable with cracks appearing in the walls of your house. You can keep injecting them with fillers and you can keep filling the plaster and redecorating but ultimately, if the foundations have gone wrong then, you need to attend to that if you want the cracks to stop appearing.

Clients come to me confused having had conflicting advice from different health professionals.

Normally one of the following:

1. Giving the foot more support, thereby reducing the stress - a technique often prescribed by podiatrists.

2. Injecting the foot with hydrocortisone to remove the inflammation - a technique often prescribed by doctors.

3. Reducing activity levels/rest then slowly increasing exercise - doctors and physios often go for this

4. Massaging the calf and foot to reduce tension on the plantar fascia - massage therapists will offer this.

All of these work to some extent.

1.Increasing support works very well, but the problem may reappear disguised as knee pain or hip pain (a new crack).

2. Hyrdocortisone works brilliantly sometimes and fails dismally other times. Often, the plantar fasciitis returns after a few months. (different crack on a different wall, same problem)

3. Rest normally only works if the injury was the result of an unusual trauma or workload that isn't repeated. So if your wall crack was due to a one time stress like tree falling on the house.

4. Massage will reduce the discomfort and improve function (reduces the number of cracks appearing) but it still doesn't solve the problem.

~ It's not what you do but the way that you are doing it.~

We need to ask ourselves "What is causing this condition”

You need to look at form and not function.There is normally a specific set of dysfunctional movement patterns unnecessarily stressing the tendon.

Clients come to me completely confused and frustrated by all this different advice and all of it looks at relieving the symptoms, which is nice, but it does not address the cause.

It's the way you move and how you are using the foot that is stressing out these structures.

You will need to stretch and strengthen the feet legs and hips, wear shoes that that allow your feet to absorb impact and function correctly and you will need to re-learn how to move naturally in those shoes. But that, is a rant for another day!

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