Heel Pain Part 1 – Plantar Fasciitis
Recently a client asked me “is having heel pain first thing in the morning, just one of those things you have to put up with as you get older”?.
What are the causes of Heel Pain?
There are two major causes of heel pain, firstly a grumbling Achilles Tendon and secondly Plantar Fasciitis. This week I am going to focus on Plantar Fasciitis. Plantar Fasciitis is inflammation of the Plantar Fascia or the strong band of tissue on the sole of your foot that stretches from your heel to your toes that supports the arch of your foot and acts as a shock absorber when you walk. The usual site of the pain with Plantar Fasciitis is on the sole of the foot, see diagram below.
How can I tell if my heel pain is Plantar Fasciitis?
Plantar Fasciitis is characterised by the gradual onset of soreness and aching under the heel at its mid-point, which spreads forward along the inner side of the arch of the foot. The ache or pain is often for the first few steps when you get out of bed every morning or after sitting at your desk for a long period of time.
What causes Plantar Fasciitis
- Sedentary Lifestyles
- Being overweight
- Wearing shoes with too little arch support or cushioning
- Vigorous take off’s, landings are fast turns during weight bearing sports.
- Wearing high heels too much.
- Excessive foot eversion (your weight is too much on the outside of your foot).
What can I do to help myself?
If you are in pain, then simply rest and ice. A simple solution is to freeze a plastic water bottle which is about 75% full of water – when it is frozen wrap it in a tea towel, so you don’t burn your skin and roll it under the sole of your feet to provide pain relief.
The following exercises, done either with or without shoes on, can be used to help treat Plantar Fasciitis:
- Stand about 40 cm away from a wall and put both hands on the wall at shoulder height, feet slightly apart, with one foot in front of the other. Bend your front knee but keep your back knee straight and lean in towards the wall to stretch. You should feel your calf muscle tighten. Keep this position for several seconds, then relax. Do this about 10 times then switch to the other leg. Now repeat the same exercise for both legs but this time, bring your back foot forward slightly so that your back knee is also slightly bent. Lean against the wall as before, keep the position, relax and then repeat 10 times before switching to the other leg. Repeat this routine twice a day.
- Stand on the bottom step of some stairs with your legs slightly apart and with your heels just off the end of the step. Hold the stair rails for support. Lower your heels, keeping your knees straight. Again you should feel the stretch in your calves. Keep the position for 20-60 seconds, then relax. Repeat six times. Try to do this exercise twice a day.
- Sit on the floor with your legs out in front of you. Loop a towel around the ball of one of your feet. With your knee straight, pull your toes towards your nose. Hold the position for 30 seconds and repeat three times. Repeat the same exercise for the other foot. Try to do this once a day.
- Sit on a chair with your knees bent at right angles and your feet and heels flat on the floor. Lift your foot upwards, keeping your heel on the floor. Hold the position for a few seconds and then relax. Repeat about 10 times. Try to do this exercise five to six times a day.
- For this exercise you need an object such as a rolling pin or a drinks can. Whilst sitting in a chair, put the object under the arch of your foot. Roll the arch of your foot over the object in different directions. Perform this exercise for a few minutes for each foot at least twice a day. This exercise is best done without shoes on.
Finally, a deep tissue massage to the calf muscles, achilles tendon and foot will help too.
Related Posts
Anxiety reduction & massage?
I know that I often say that one of the benefits of massage is that it may reduce anxiety. I think most people would agree that being in hospital or undergoing hospital procedures may makes us feel anxious. So I was interested in a recent study that looked at the effectiveness of massage with or without guided imagery (a therapist talking you through a scene to help you relax), prior to cardiac catheterisation. As you can imagine anxiety is very common in patients prior to cardiac catheterisation, which can lead to high blood pressure and increase the amount of sedation necessary to complete the procedure. Fifty five patients opted to receive either a 15-minute massage (31 patients) and a 20 minute guided imagery (24 patients) in a quiet area of the hospital prior to cardiac catheterisation. Self-report anxiety levels, blood pressure and heart rate were evaluated in the research participants as well as matched for comparison to a control group not taking part in the study. The results indicated that massage, with or without guided imagery, produced significant reductions in self-reported anxiety, with the combined intervention having a more pronounced effect. In addition a lower diastolic blood pressure and heart rate were found when compared to the control group. In my experience slow, deep stokes help to reduce anxiety and as a team we often incorporate this into treatments. References Amstrong K, Dixon S, May S, Patricolo GE (2014). Anxiety reduction in patients undergoing cardiac catheterisation, following massage and guided imagery. Complementary Therapies in Clinical Practice 20 (4): 334 - 338.
Sleep
This week the press seem to be full of articles on sleep, ranging from recent research to the reasons why we lose sleep - the top reason being a heavy workload. I am sure that most people reading this blog post know that if they have a good night’s sleep they wake up feeling refreshed. So the recent discovery by scientists from University of Wisconsin which shows sleep restores your brain will be of no surprise. (For any geeks out there the research showed that sleep boosts myelin which is essential in the growth and repair of our brains. The research also revealed that deep sleep doubles the rate of reproduction of some cells.) While over in Stockholm researchers have discovered that people think sleep deprived individuals “look sad, unhealthy and unattractive”. For anyone that is struggling to get a good night’s sleep knowing science has proved that they look as awful as they feel isn’t exactly helpful either! So I wanted to share a few tips with you on getting a good night’s sleep.
- Try to go to bed and get up at the same time as bodies like routine and it will help you sleep better.
- Ensure your bedroom is quiet, dark, restful and the right temperature i.e. not to hot and not to cold. Remember it isn’t ideal to watch TV or work in your bedroom that includes trying to sleep while keeping one eye on your blackberry.
- Try to mentally and physically relax before going to bed by turning of the TV or computer and having a warm bath, listen to some relaxing music, read a book or simply sip a cup of Chamomile tea.
- Valerian is a dietary supplement that has been used since ancient times to help with a good nights sleep as it is known for combat insomnia and nervousness.
- While exercise is great to combat stress, exercising too close to bedtime can actually make it harder to sleep.
- It is best to avoid alcohol before your go to bed as for some people it will interrupt their sleep pattern later in the night.
- It is best to avoid coffee from later afternoon onwards as for some people it will keeps them awake.
What can help carpal tunnel syndrome?
Previously, I discussed what carpal tunnel syndrome is and how desk based workers have an increased risk. So what can you do to help youself:
- Vitamin B6 - Carpal tunnel syndrome has been linked to low levels of vitamin B6, so suplementing with the vitamin may help. In fact, several trials have found B6 may alleviate the symptoms, even in people who are not deficient in the vitamin.
- Yoga - In one study a yoga based therapy was more effective at easing carpal tunnel syndrome than improving grip strenght than wrist splints or no treatment.
- Acupuncture - In one radomised control trail, acupuncture was just as effective as steriod treatment,and it was also better at reducing sleep disturbance and improving never conduction than the drugs and came with minimal side-effects.
