Is That a Rock in My Shoe? Or is it Plantar Fasciitis?

Is that a rock in your shoe? Maybe not. It could be plantar fasciitis or heel spurs.

The plantar fascia is a thick, broad, inelastic band of fibrous tissue that courses along the bottom (plantar surface) of the foot. It is attached to the heel bone (calcaneus) and fans out to attach to the bottom of the metatarsal bones (long foot bones) in the region of the ball of the foot. Because the normal foot has an arch, this tight band of tissue (plantar fascia) is at the base of the arch. In this position, the plantar fascia acts like a bowstring to maintain the arch of the foot.
Plantar fasciitis is a self-limiting condition that is the most common cause of heel pain on the sole of the foot. It refers to an inflammation of the plantar fascia. The inflammation in the tissue is the result of some type of injury to the plantar fascia. Typically, plantar fasciitis results from repeated trauma to the tissue where it attaches to the calcaneus. This repeated trauma often results in microscopic tearing of the plantar fascia at or near the point of attachment of the tissue to the calcaneus. The result of the damage and inflammation is pain.

If there is significant injury to the plantar fascia, the inflammatory reaction of the heel bone may produce spike-like projections of new bone called heel spurs. The spurs are not the cause of the initial pain of plantar fasciitis, they are the result of the problem. Most heel spurs are painless. Occasionally, they are associated with pain and discomfort and require medical treatment or even surgical removal.
Pain on the bottom of the heel most prominent with the first steps taken in the morning is the most common presenting complaint of plantar fasciitis. Typical morning pain is caused by the foot resting in a pointed position (plantar flexion) during the night, allowing the fascia to contract. With the first steps of the day, the irritated fascia is stretched, resulting in pain. Pain also occurs with the onset of activity such as walking and running. It typically starts as a dull, intermittent pain in the heel and may progress to sharp, constant pain. This pain may decrease as activity progresses, but it usually returns after resting and then resuming activity. In severe cases, the pain may occur with any weight bearing. Although the pain usually occurs in the heel, it can radiate throughout the bottom of the foot toward the toes.
Plantar fasciitis is common in runners and dancers who use repetitive, maximal ankle and foot range of movement. It is also common in those who experience sudden weight gain and in overweight individuals who increase their activity level.

The condition is usually caused by a change or increase in activities, no arch support, lack of flexibility in the calf muscles, being overweight, a sudden injury, using shoes with little cushioning on hard surfaces, using shoes that do not easily bend under the ball of the foot, or spending too much time on the feet.

Factors that could be contributing are fallen arches or rolling in when running, age, poor shoes or support and a rapid increase in activity.

Consult your local PhysioPro to treat the problem. They will use ultrasound, deep tissue massage, prolonged stretching, and a specific exercise program to improve flexibility and elasticity of plantar fascia. Secondary to therapy, self-care is a vital component in the rehabilitation process. The use of non-steroidal anti-inflammatory medication (NSAIDS) e.g. voltaren, nurofen, aspirin, can help significantly to reduce the amount of irritation and inflammation in the plantar fascia. You will also get a home program which will include deep tissue massage, foot rolling with a golf ball or similar, stretching the calves and plantar fascia and avoidance of repeated impact and stress.

 

So get that rock out of your shoe and get into see the PhysioPro team today.

Compression Session

In the physio world compression garments were originally reserved for the hospital setting to prevent post operative DVT’s and improve patients circulation. They are now however used widely by athletes to assist them in the sporting goals and to improve their performance. People who use compression garments report a series of benefits.
Delayed onset muscle soreness (DOMS) is that sore feeling that you get for the next couple of days after you push the limits with the leg work out. It’s when you suffer with every step on the way to work the next day. People report their muscles feel better and less DOMS with compressions which means that you can back up training better and reduce the sore off days.
Patients can feel their muscles work better with compression which can help with feeling a muscle stretch which means that you can pull up early instead of tearing or straining the muscle.
They can lock in warmth and take away moisture which is important in the middle of winter when you are training outside with a stiff breeze. If you are training in summer they also double as sun protection. If you suffer from chafing they can be a godsend.
Compressions are now used for almost every part of the body to help with soreness and improve performance. It is however important that they are good quality and fit well so as to not feel restrictive and will allow for stretch so that they will last the distance.

Related Tags: Sports Massage Perth

Hot to Trot or Ice Ice Baby

There is always a lot of debate as to what is the best for the treatments of injuries. Do you put on a heat pack or is it better to ice? It is funny that there could be so much debate for a fundamental of injury management.

The principal revolves around blood flow and inflammation. If you apply heat to the area you will cause the blood vessels to widen which brings nutrients to the injured area. If you apply ice to the area you will cause the blood vessels to narrow and reduce bleeding and inflammation.

As soon as you sprain a joint like an ankle or suffer a corky you should always apply ice to help narrow the blood vessels and slow the bleeding and rate of inflammation. This should be applied for 2-3 days dependant on the severity of the injury. After this the ruptured blood vessels close and the inflammation stops progressing. It is at this stage that heat is best as you now want to bring good nutrients with more blood flow to the area.

Where it gets tricky is what do you do when you injure an area that is too deep for ice or heat to penetrate. An example would be a back injury. If you have injured a joint in your back then the ice will not penetrate deep enough through the muscles to affect the injury. It will numb the pain but it won’t reduce inflammation. The best in this instance is to apply heat. Heat will relax the surrounding musculature and will also have a natural pain killing effect.

It is better still to try to avoid the injuries all together to avoid the heat vs ice argument!

If the Shoe Fits Wear It

If the shoe fits wear it. Right? WRONG! We all have a different foot and arch shape and we should look for shoes accordingly. A good shoe will help alignment of your feet, knees, hips and back. Poor shoes can both cause and reduce healing times for injury. If you can grab your current shoes and you can wring them out with your hands then then imagine what is happening when you put all your body weight through them.

How often you should buy new shoes will depend on what surface you use them on, your weight, the way you run and your usage. So if you have decided to look for a new pair of shoes then which type? Well that depends on your foot.

A neutral shoe is for a normal foot which needs cushioning for shock absorption and a small amount of stability. High motion control shoes are for people who have a low arch commonly known as flat feet or for the person who’s arch pronates or collapses on impact. Some people have high arches and their are shoes for this person known as a supinator who’s arch doesn’t collapse at all on impact.

Some people wear orthotics because of previoius injury or for extra support. This should be taken into account when purchasing a new pair of shoes.

It’s best to go with a brand that suits your work, sport and foot needs. Consult your local shoe sales represenatative for advice. A good salesperson will look at your walking, standing and running pattern. They will also ask you about injury history. It can also be helpful to bring in your old shoes to see where the tread is wearing on the underside for clues as to which type of runner you are. Good fitting shoes is also critical. Some people have 2 different sized feet so it is also important to also take that into account for sizing.

Disc Pain

Could that pain in the back be something more than a little niggle that will go away by itself? If you have pain coughing, sneezing, laughing,with prolonged sitting and pain down your legs you may have injured your disc.

Discs sit between the vertebrae in your back and are design for cushioning and shock absorption. We can injure our discs either through wear and tear, being genetically vulnerable to degeneration or we could of suffered a sudden injury with lifting or playing sport. If it is significant you may get pain down the back of the leg or foot.

As we get older back injuries can be more common. In the case of disc injuries it may be because the center of the disc may start to lose water content, making the disc less elastic and effective as a cushion. You can injure your disc with a small trivial lift by not bracing your deep abdominal muscles.

You may have heard of bulging disc, swollen disc, herniated disc, ruptured disc, prolapsed disc and slipped discs which can mean different things to different people. To simplify physios grade them grade 1 – 4. Grade one being the lowest injury and grade 4 being the highest.

A higher grade disc injury can cause a pinched nerve when a disc can compress it through being swollen. Sciatica is a condition in which a disc presses on the sciatic nerve. This can cause pain down the leg and in extreme cases numbness and some loss of strength in your leg.

Ways to prevent disc injuries is to keep your weight down, exercise regularly, keep your core strong and practice good ergonomics whilst at home and at work. Ergonomics inlcudes how we lift, sit in front of a computer and how we do things at home.

In most cases, if a patient’s lower back and leg pain is going to resolve quickly it can be helped by consulting your physiotherapist and or doctor for advice

Confusion of Terms

The terms slipped a disc or hips are out are quite misleading terms however are utilised widely in layman speak for injuries. The problem with these terms is that they are quite emotive and can lead patients to believe that their injuries are worse than they are.

When you have hip pain it may be inflammation of the tendon or the bursa – the fluid filled sac that lubricates the hip or even the cartilage. That can cause spasm of the surrounding muscles – specifically the glutes which can make the patient feel like their ‘hips are out.’ This specific term makes the patient imagine that their hip is dislocated from the deep ball and socket joint – a rare presentation – usually reserved for large trauma.

The term slipped a disc is also quite misleading and gives the impression that the disc moves out of it’s position in the spine. Physiotherapists use four levels of disc bulging to describe a disc injury. From grade one where the inner disc puts some slight pressure on the outer layer all the way to grade 4 where the inner material completely protrudes out of the outer layer and pinches nerves causing pain.

Using correct terms to clarify injuries is important so people don’t perceive them to be worse than they are. So for all the discs that have slipped out like a bar of soap in the shower or for all hips that are out to the pub for a drink – have one for me.

Cramping has plagued sports men and women since the beginning of time

Sport Injuries

Why does cramping happen to some and not others. Why have with all the sports science advances have we not been able to cure the common cramp. It has affected athletes of all ages for centuries. The common thought on the cause of cramps are lack of electrolytes, dehydration and muscle fatigue. This is reinforced  by the fact that cramps happen commonly at the end of the game or sporting event. Patients are then encouraged to take in plenty of fluid, use magnesium sprays, tablets or powder and have a good balanced diet to maintaining adequate carbohydrate reserves before and during sport. Muscle conditioning to the demands of the sport is an important factor to reduce the fatigue.

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