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Hi Everyone,

Any good tips on releaving plantar faciitis? Or, can maybe direct me to some information?
Thanks
C.

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Hi Carrie,

As you know Plantar Fasciitis is mostly inflammation of the plantar fascia at the heel bone. (calcaneus) So, reducing the inflammation should be the first action. Use Cryotherapy to reduce that and cross fiber friction on the heel and massage the whole leg muscles specially the tibialis posterior. Also do plantar stretching to lengthen muscles of the foot.

Behnam
I work at a chiropractic office and have worked on this condition quiet a bit. I believe proper arch support needs to be stressed to the client. If proper arch support isn't achieved this will continue to be an on going problem. Also if the person works out in any fashion it is important to stress stretching the feet before their work out begins. The client also needs to be aware that walking bare foot on cold hard floors can cause their plantar fasciiitis to get worse. It is important to wear socks or slippers so the feet stay warm. It is also important to teach your clients the importance of self massage of the feet before they get out of bed. If they warm up the plantar fascia it can help prevent more scar tissue from forming in the fascia when they take their initial steps out of bed. After all that is addressed the way to work on it, from my experience, is to make sure the plantar fascia is warmed up especially in the arch of the foot, but care needs to be taken to start from the bottom of the foot and work to the Achilles tendon. Once the plantar fascia is warmed up it is important to strip the plantar fascia in a motion that goes from the heel to the toes. With every pass follow from the heel down to every toe. I increase the pressure every time I go through all 5 toes, I do this about 5 to 10 times. But always make sure your client is somewhat comfortable, so you need to explain that there will be some discomfort but on a pain scale of 0 to 10 not to let you get past a 6. I then go to the heel and if the person is prone I stand by their feet facing towards their head. I then interlace my fingers with my hands palm to palm, leaving a gap between my palms. I then put my hands to where the heel is between my palms and begin doing circular motions with my palms all over the heel even up to the lateral and medial malleolus. After I do about 6 passes I then move on the the Achilles tendon and strip that with a movement going towards the back of the knee. There are other moves I do that help but these are the most effect techniques I have found, so feel free to incorporate other techniques into it to make it your own. I also incorporate some trigger point therapy if it is at all needed. There are some deep tissue seminars that address how to treat this problem. I would keep my eyes open for one. I hope this helps.
I have worked with an Acupuncturist in the past who had a high success rate of relieving PF pain after 2-3 sessions. If you are not able to bring the relief for your client I def. recommend referring them to the Acupuncturist in your referral network. And if you don't have one yet...it's the perfect time to reach out!

-erik.
A few years ago I developed a heinous case of this myself. Since I can reach my own foot, I was massaging away, getting others to work on it, icing it, etc. Finally went to the orthopedist, who wanted to cast it for six weeks. That did not fit into my schedule.

I did a lot of other things too, including addressing emotional issues with a therapist who was also a psychologist. Then I turned to the chiropractor. I had some problems in my hips--and getting those taken care of ultimately helped the PF. When you think about it, that makes sense. The muscles above the pain are shortened, so massage work aimed at lengthening my leg muscles all the way up to the gluts and getting my hips back to the right place finally did the trick. What a painful condition. I don't wish it on anyone.

One more thing, and that is that one night while I was hurting I was lying in bed extending my foot, and all of a sudden, I thought to myself, dummy--stretching it the wrong way! Dorsiflexion is the right thing to do, not extending it away.
I also use a MA roller, a large wooden dowel with grooves cut in it, you roll your heel area back and forth and this helps to do cross fiber friction on the area, and you can do it easily on yourself. Also as others have said, reduce inflammation, and don't walk bare footed.
What everyone else said. And, the reason the feet are so painful when first standing on them after sleeping or being off them for an extended period of time, is that while you are off of them it gives the inflammation time to expand. My podiatrist recommended using a plastic water bottle frozen to roll and ice the feet before bed. The rolling action massages and stretches, the ice cools the inflammation that has been building up all day.
Kirsten
Thanks for all the good tips everyone. I'll be sure to try these techniques as I have the issue as well as one of my favorite clients. Bright Blessings to all.
All of these seem like good advice. I myself had this problem a few years ago. I was in so much pain, I felt I was soon going to be on crutches and not be able to work. I had a lot of people working on my feet, but they usually hurt worse afterward. One day I happened to rest my elbow on my thigh and it slipped to the medial thigh and I discovered how extremely tight those muscles were. As I started to massage those muscles, I could feel relief in my feet. I had friends work on those muscles and my foot problems soon went away. I believe the problem started after I had bought a new pair of shoes a few months previous.
Some good tips have been mentioned. Don't waste too much time on the feet, PF is the symptom not the cause. The reason Physical Therapists and massage therapists fail miserably at PF and CTS especially, is that they focus on the symptom rather than on causation.

Simply put, strip the calf on the affected limb, both quads and both hips. Do a quick check for the tightest areas and concentrate on those only. Remember, both quads and hips as PF is a reactionary symptom of an issued further up the chain.

Our bodies were created to heal themselves with the correct help. Stay away from ice. It cools and feels soothing but at the same time, cold causes muscles other soft tissues to tighten up. Why would you want to tighten up an already tight area? The body heats injuries for a reason. Heat equals increased blood and oxygen needed for healing and cold equals increased constriction which slows healing.
I've worked on many, many runners/walkers who have developed PF. Use Deep cross fiber friction where the flexor digitorum brevis tendon attaches to the calcaneus, and deep tissue massage at the belly of the FDB for at least 10-15 minutes per session. Release the calf and posterior tibialis musculature. Encourage the patient to stretch the calves several times per day between sessions, and ice 2x daily and after heavy activity. Most importantly, they should be sleeping in a night splint that stretches the plantar surface of the foot (it should be no more than a 90 degree angle at the ankle). Every night when they sleep the tissue is plantarflexed and relaxed - this is the position in which the tissue tries to heal uninterrupted for several hours during sleep. Muscle tissue healing is also occuring in a shortened state. Then, first thing in the morning they step on it with the full force of their body weight - this stretches the fascia and FDB too quickly and causes microtears to the tissue that has just healed, thereby reinjuring the tissue. That is why the first step out of bed in the morning, or after sitting for a period, is so painful for PF patients. That pain is re-injury. The night splint keeps the tissue stretched and elongated overnight so the tissue fibers grow together in a more aligned pattern, and the fascia/FDB is already stretched out before they get out of bed and step on it.

Depending on the severity of the pain and how old of an injury it is, it can take several sessions to abolish the pain completely. But I have noticed the best results when patients use the night splint.

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