I often get patients walking in my office with a complain of heel pain. There are multiple causes of heel pain one of them being plantar fasciitis (plant-er-fa-she-eye-tes).
What is plantar fasciitis?
The name plantar fasciitis is somewhat misleading. The suffix “itis” means inflammation. And the plantar fascia is a band of fibrous tissue that extends along the bottom of the foot from the heel to the toes. Therefore plantar fasciitis should mean inflammation of the plantar fascia. However, in recent years it has been found that there is usually no inflammation present. What has been found is degeneration in the plantar fascia (scar tissue).
What is scar tissue?
With overuse of the plantar fascia, tiny tears form in the tissue. In the healing process our body attempts to repair that fascia with scar tissue, much like that scar that forms on the skin when you have scrapped or banged your elbow. As you can imagine, scar tissue is not as strong and flexible as normal, healthy undamaged tissue. Over time we can have a build up of this fibrous scar tissue if too much stress is put on the plantar fascia. This can lead to pain and dysfunction because this replacement tissue lacks the strength and flexibility of healthy tissue.
What are the symptoms of plantar fasciitis?
The classic symptoms of plantar fasciitis is pain under the heel that is worse in the morning or prolonged period of rest. The first few steps are really painful and that pain decreases with walking. When more advance there is also pain during normal activities.
How is plantar fasciitis treated?
Rest, ice and anti-inflammatory have traditionally been advised for plantar fasciitis with limited results. Some people may have this pain for months and even for more then 2 years with improper treatment. Since there is usually no inflammation but a scar tissue build up it important to break down the scar tissue. One soft tissue treatment technique that I use in my office is Graston technique. Patients usually notice an improvement of there symptoms on the first treatment. For more information on Graston technique visit my website at www.inbalancechiro.ca
Sunday, January 27, 2008
Wednesday, January 2, 2008
How's your balance?
One thing I always do when I get athletes coming in my office with lower limb injuries, is to check there balance. Balance is an essential function of the locomotor system. It is often ignored but no less important than flexibility, strength, endurance, or aerobic fitness. Balance is an important part of the rehabilitation of certain injuries. It is also important part of injury prevention programs in runners. Balance training has been shown to improve strength in the hips and legs and is less time consuming than strength training programs. It’s also important to note that in the past few years research has shown that people with weaker hip muscles tend to get more leg and low back injuries.
Poor balance in otherwise healthy individuals may be due to previous injuries that were not properly rehabilitated, muscle imbalance, poor sensation coming from the sole of your feet, or other causes. Balance depends on the somatosensory, vestibular and visual systems. The somatosensory system gets sensory information for balance from the soles of the feet, the neck, and the lumbar spine for inputs. If two of the previously mentioned systems are not working properly, our balance will be affected.
Do the following test at home. Stand on one leg. Begin with eyes open and practice once or twice on each side. Then by looking straight ahead close your eyes and try maintaining your balance. If the foot touches the opposite leg, hopping occurs, the other foot touches the floor, or the arms touch something for support the test is stopped. You have 3 chances on each side to reach your best time.
Depending of your age you should be able to stand on one leg, eyes closed for a minimum of the following length of time.
20-49 year of age→ 24.2 seconds
50-59 year of age→ 21.0 seconds
60-69 year of age→ 10.2 seconds
70-79 year of age→ 4.3 seconds
If you can’t reach these times it may be important for you to get assessed to determine the cause of your poor balance and prevent injuries.
One easy exercise to work on your balance is to try holding your balance on one leg for 30 seconds. Perform the routine three to four times per leg twice daily until you can comfortably keep balance for 30 seconds. After that proceed with your eyes closed until you reach 30 seconds again.
Poor balance in otherwise healthy individuals may be due to previous injuries that were not properly rehabilitated, muscle imbalance, poor sensation coming from the sole of your feet, or other causes. Balance depends on the somatosensory, vestibular and visual systems. The somatosensory system gets sensory information for balance from the soles of the feet, the neck, and the lumbar spine for inputs. If two of the previously mentioned systems are not working properly, our balance will be affected.
Do the following test at home. Stand on one leg. Begin with eyes open and practice once or twice on each side. Then by looking straight ahead close your eyes and try maintaining your balance. If the foot touches the opposite leg, hopping occurs, the other foot touches the floor, or the arms touch something for support the test is stopped. You have 3 chances on each side to reach your best time.
Depending of your age you should be able to stand on one leg, eyes closed for a minimum of the following length of time.
20-49 year of age→ 24.2 seconds
50-59 year of age→ 21.0 seconds
60-69 year of age→ 10.2 seconds
70-79 year of age→ 4.3 seconds
If you can’t reach these times it may be important for you to get assessed to determine the cause of your poor balance and prevent injuries.
One easy exercise to work on your balance is to try holding your balance on one leg for 30 seconds. Perform the routine three to four times per leg twice daily until you can comfortably keep balance for 30 seconds. After that proceed with your eyes closed until you reach 30 seconds again.
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