In the previous blog, we talked about what causes Plantar Fasciitis and other foot conditions. This blog will cover how to resolve your foot pain. If you have not checked out part one of this blog series then go to our website to read all about it.
A major issue that is a common cause of foot pain is footwear. By changing this we can cause a long term decrease in your symptoms.
Firstly finding a shoe that has a very small heel and that has a wide toe box to allow your toes to sufficiently spread out. The less a shoe does to your foot, the better it is for your foot. Then as you walk during the day the muscles in your foot will strengthen.
There are lots of brands to choose from when picking a barefoot shoe for example Vivobarefoot, Bearfoot Athletics, Lems, Xero and Feelgrounds. Finding brands that blend foot function with fashion will help your transition.
If you do not wear barefoot shoes often then you may not be ready for a complete jump to barefoot shoes. For example, if you could not swim you would not jump in at the deep end straight away. The same applies to your feet. Slowly building your capacity through the foot will help to gradually build your strength and motion in the foot, reducing the chance of injury and discomfort.
Start off at one hour of being barefoot and then gradually increase the time spent each day by 20 minutes to help your transition.
Toe Extensor Stretch
It is common to stretch the plantar fascia. This is based on the idea that the tissues are tight and shortened. But because modern footwear actually lengthens the plantar fascia we should focus on the opposite side of the foot rather than stretching something that is already lengthened.
Start with a stretch to the toe extensors:
Pull one or both feet behind you and position the top of the foot on the ground.
Pull your heel back and towards the ground. This action should allow a good stretch to the top of your foot.
Hold this position for 30 seconds before relaxing. (It is common to get a cramp in the arch of your foot, the more you practice this stretch the better it will get).
Soft Tissue Mobilisation
A common fix for plantar fasciitis is rolling a ball under your foot, this is effective because when deep pressure is put into the plantar fascia, blood flow is stimulated. This can speed up healing and also act as temporary pain relief.
Find a small ball, either a golf ball or a sliotar and roll it slowly on the bottom of your foot. When you come to a painful point, hold this pressure for 20 seconds before moving off the area. Do this for 3-5 minutes and see if your symptoms are less than before.
Strengthening The Foot
Improving the strength of your foot should be a major factor in the rehabilitation of your foot injury. As mentioned earlier, just switching to a barefoot shoe can significantly increase the strength of the muscles in your foot.
But you may need to further foot strength can work on the small muscles of the foot.
The Toe Scrunch:
Place a small towel under your foot.
Slowly grasp the towel with your toes and pull it towards your heel.
Do this for 10 reps of 3 sets.
Moonwalks:
Strengthening the tight foot extensors (which are the muscles on the front of your shin) can also be beneficial to your foot pain. Moonwalks are an effective way to do this.
Do this exercise for 20-30 reps at a time.
Then when you have the ability to create a strong foot position you can progress to maintaining it while loading the foot. For example, squats and single-leg RDL’s without any shoes on will help create foot stability in multiple planes of motion as you will be constantly shifting your weight through the foot and forced to adapt.
If you suffer from foot pain or have any questions then contact the clinic today on 0578678904, direct message us on Facebook or book now.
Yours in Health
The Lawlor Clinic: Spine & Sport, Portlaoise, Laois
Foot injuries can be frustrating because they affect you constantly in the day. It hurts to run, jump, squat, getting up in the morning and can stop you from doing activities you love.
A common condition people are diagnosed with is plantar fasciitis. The plantar fascia is a thick sheet of connective tissue that lies on the bottom of your feet. It runs from the inner part of your heel and spreads under your foot, attaching to the base of your toes. The function is to act as a shock absorber for the arch of your foot when moving.
Imagine the plantar fascia as a rubber band. When you are not standing up the rubber band is relaxed. But as the foot hits the ground when walking or running, it is pulled taut. This is useful for two reasons.
Maintains your foot arch.
Allows the foot to be more rigid allowing the body to push off the ground propelling itself forward more efficiently.
Imagine you are trying to run through quicksand. It is hard to push off and gather speed because you have not got a firm surface to push off. But the plantar fascia creates an effect in the foot turning this quicksand to a firm surface so you can generate force efficiently and with more power.
For a long time, Plantar Fasciitis was thought to be an inflammation of the plantar fascia and more of a repetitive stress injury. But the true cause of this condition comes down to a problem with blood flow.
When your big toe is pulled inward for example in a narrow shoe or if you have a tight foot, a muscle on the inside bottom of the foot is under tension, this is your Abductor Hallucis. You can test this and see it for yourself. If you pull your big toe inwards and look next to the inside of your heel, you can see the stretching occurring.
This tightening of the muscle leads to pinching of a nearby artery that runs underneath. This restricts blood flow to part of the bottom of your foot.
This leads us to an important point. Poor blood flow limits the body’s ability to recover from stress.
Symptoms:
Most people who are diagnosed with plantar fasciitis have pain on the bottom of their foot (usually near the inside side of the heel) that is especially extremely painful when taking their first few steps in the morning after waking up.
A common description is a knife-like sensation stabbing the bottom of the foot. While these symptoms may get better through the day but are then made worse with loading. For example when you go for a run or stand up for long periods of time.
Mortons Neuroma: A very common condition that causes pain in the foot is Morton’s neuroma. It is a painful enlargement of a small nerve in your foot that runs between your third and fourth toes. But why is the nerve painful in the first place? The answer is often inappropriate footwear and a dysfunctional foot.
The three problem features of shoes contribute to nerve irritation.
Elevated heel: This causes the toes to be in an extended position. This will increase the amount of load on the nerve
Toe spring: Lifting the toes also increases the load on the exposed nerve to an even greater degree.
Narrow toebox: If the toes are pushd together, the nerve can be pinched between the third and fourth toes.
Symptoms:
This extra loading on the nerve and pinching causes symptoms of burning or electrical shock-like pain into the third and fourth toes. It also often gives an uncomfortable sensation in the foot and is often described as a feeling of a pebble in peoples shoes.
Next week we will cover the ways to help manage and fix these issues.
In the meantime, if you suffer from foot pain or have any questions then contact the clinic today on 0578678904, direct message us on Facebook or book now.
Yours in Health
The Lawlor Clinic: Spine & Sport, Portlaoise, Laois
Plantar fasciitis is one of those phrases that gets thrown around a lot in conversations. But do you know what it actually means? What is the plantar fascia, what causes irritation to it, and how can you prevent and treat the cause of the problem using Active Release Techniques?
What is the Plantar Fascia?
The plantar fascia is not a muscle or tendon, it is actually a connective tissue structure that supports the bottom of the foot. It runs from the heel bone to the toes and lies on top of the deeper muscles of the foot. But it is not the plantar fascia on its own that causes the problem. The fascia works in conjunction with the flexor digitorum brevis and quadratus plantae muscles, both are flexors of the toes.
What causes Plantar Fasciitis?
An irritation and inflammation to the previously mentioned tissues and muscles, to state it very basically! But what causes the irritation? Biomechanical issues in the foot and ankle, tightness or damage in muscles of the feet or calf, sudden increase in activity that is too much too soon, some even say too much sitting around (underactivity) can cause the problem.
But when you do get it, you want it to go away as fast a possible because it can be very painful!
Some common symptoms include:
Pain at the heel or anywhere along the bottom of the foot
Cramping at the bottom of the foot
Pain worse first thing in the morning
How can ART® help plantar fasciitis?
Active Release Techniques ART® is a hands on technique for helping to restore normal function to the soft tissue. So release of the plantar fascia and other contributing muscles in the foot, might be uncomfortable but the results will be noticeable within 3-4 treatments.
Along with ART®, manipulation of the joints in the foot using Chiropractic techniques can help to restore normal biomechanics to help prevent this from recurring in the future. To help speed up the healing process we commonly use Laser Therapy and you will always be given exercises and stretches to do at home.
If you think you might have plantar fasciitis, don’t keep suffering, give us a call today to see if we can help you get on the path to healing!
Yours in Health
The Lawlor Clinic | Spine & Sport, Portlaoise, Laois
Our feet play an essential role in how we transfer our body weight when we move, provide vital information to our brains for position awareness and sometimes are even called upon to help out our weak cores. We need to look after them and have them strong enough to meet these many demands. Modern foot wear, orthotics and lack of time walking around bare foot all contribute to weak intrinsic foot muscles and it is these which we need to strengthen.
Try the following movements shown in the video below to see how strong your feet are
1. Foot Crawl
2. Big Toe Up while keeping other 4 down
3. 4 Toes Up keeping big toe down
4. Toe Pianos
5. Toe Spreads
“In order to master it you need to practice it”
Start with doing any weak or difficult movements everyday for 1 minute
If you would like to book an appointment please contact us today for a quick chat to see how we can help!
Yours in Health
The Lawlor Clinic, Portlaoise
Chiropractic, Golf & Sports Injuries | Active Release Techniques (ART®)
Plantar Fasciitis (PF) can be quite a debilitating disorder. It is commonly described as having pain under the heel of the foot or along the arch of the foot. It is a progressive disorder, where the first few steps in the morning are painful, along with barefoot walking, or pain wearing flat shoes. Prolonged standing, walking or running can aggravated the pain. Many different treatment options have been proven to be effective in treating PF, such as deep tissue work, stretching and manual therapy. But, are there any additional therapies that are effective at treating PF, for example, if the hands-on approach is not yielding results to your liking?
At the Lawlor Clinic, we utilise Class 4 Laser Therapy for a variety of conditions, including PF. But, is it any good? Are there positive results with this approach? Or is it all a load of nonsense? Let’s see what the evidence says.
Class 4 Laser Therapy
With laser therapy, a light beam is placed on the injured area in an effort to affect cellular metabolism, protein synthesis, wound healing and immune response. The idea is that this will fight the inflammation in the fascia, reduce heel pain, and increase recovery time. 2 papers have evaluated the effectiveness of Class 4 Laser Therapy on chronic PF, and have a strong quality of evidence as they appear on the Cochrane Database of Research.
Macias, 2015
Kiritisi, 2010
Participants
69
25
Laser Treatment
X2/week for 3 weeks
X1/week for 6 weeks
Follow Ups
Before, 1week, 2weeks, 3weeks, 6weeks, 8weeks
Before and at 6weeks
Results – Plantar thickness
DNA
A difference in plantar thickness, but not statistically significant (not meaningful)
Results – Pain
Statistically significant improvement (p<0.001)
Statistically significant improvement (p=0.001)
These two studies demonstrate that after 6 sessions of Laser Therapy, the PF pain had significantly reduced when compared to placebos. This shows that laser is effective in treating PF, but it is important to explain to patients that research suggest that the most effective treatment approach is 6 treatments either x2/week for 3weeks or x1/week for 6weeks and then the patient can make up their mind which they would rather.
Comparing Laser to Extracorporal Shock Wave Therapy (ESWT)
The idea behind ESWT is similar to LLLT. In ESWT, a probe is placed on injured area and shockwaves are pulsed in through the skin to stimulate angiogenesis (new blood vessels) and neurogenesis (new nerve cells). In theory, these aspects stimulate wound healing mechanisms. Again, 2 high quality papers compared the use of LLLT vs ESWT:
Cinar, 2013
Suleymanoglu, 2014
Participants
55
81
Treatment
X3/week for 3weeks of either ESWT / Laser
X3/week for 3weeks (ESWT)
X3/week for 4weeks (Laser)
Both given stretches for 3 months
Follow Up
Before and at 3 weeks
Before, after 1st session, after 3 months
Results – Plantar Thickness
DNA
Reduction in plantar thickness, more significant reduction in ESWT
Results – Pain
Statistically significant reduction in pain with Laser, not in ESWT
Statistically significant reduction in pain with ESWT, not in Laser
The data above suggests there is no difference between using Laser or ESWT for treating PF. This is because of the conflicting evidence above.
In summary, the evidence demonstrates that Laser (once completed for 6 sessions between 3-6weeks) is very effective in reducing pain levels in those with chronic PF. If you are suffering with PF, or any foot pain, please do not hesitate to contact us today
