Plantar Fasciitis or “Eee gads! Was that glass I just stepped on?!”

Plantar Fasciitis is a condition that affects the bottom of the foot. “Plantar” refers to the bottom of the foot. There is a sheath of fascia or connective tissue on the bottom of the foot that can get injured. The suffix “-itis” usually refers to an inflammation or injury. Put the parts together and you’ve got: bottom-of-the-foot connective tissue injury. In this case, the injury might be better thought of as a tearing or fraying of the tissue. It can be quite painful and can “come out of the blue.” I have a client with this condition. She told me the story of being on a trip and sleeping in a tent. She stepped out of bed in the middle of the night and extreme pain shot through her foot. In the dark and confused by never having symptoms before, she swore she had stepped on glass. After turning on the lights and searching her foot and the floor thoroughly, she concluded she had not stepped on glass but remained confused about what had happened.

What causes it? Plantar fasciitis can have many causes. One that experts point to is overpronation of the foot. Here’s a great article from the Runner’s World website showing short videos about overpronation. Overly tight calf muscles can contribute to the condition as well as flat feet.

How is it treated? A variety of techniques are used to recover from plantar fasciitis. All of the following can be recommended: stretching, injections, night splint, ice, & massage. According to Whitney Lowe in Orthopedic Massage (Mosby Elsevier 2009) “Stretching the gastrocnemius and soleus muscles is very important in plantar fasciitis treatment. Stretching several times during the day is best if possible.” (p. 88) Some people freeze a water bottle and roll their feet over it when they feel pain. A night splint is a medical device that keeps the foot in a certain position while the person sleeps so that the repair process the body goes through each night is more effective. These can be difficult to sleep with, but extremely effective, especially during the acute phase of the condition. I’ve included a picture of what a night splint looks like.

It doesn’t always hurt – why? People with plantar fasciitis often report that the first step out of bed in the morning is excruciating, but that as the day wears on, they feel less pain. One explanation is that as we sleep our feet are in a neutral position and the plantar fascia stitches a “patch” on the injury site in that position. When we step onto the foot we place weight on that patch and tear it apart (eee gads!?!). As the day wears on the body stitches together a new “patch” in a mobile, weight-bearing posture which isn’t constantly being torn apart. Also the fascia is warmed up which makes it more pliable.

Can massage help?  Yes, massage can play a role in recovering from plantar fasciitis. It’s important to follow a treatment plan diligently to overcome this condition. Massage alone will probably not do the trick. “Massage assists the effectiveness of a tension splint by reducing tightness in the connective tissues and muscles of the plantar surface of the foot and posterior calf.” (Lowe p. 88)

I’m happy to work with you if you are experiencing plantar fasciitis. We can set up several shorter sessions initially to help you get through the acute phase. We can also work it into longer sessions as a priority. Call for an appointment 626-660-6856. Tell your story in the comments below.

Disclaimer: I’m not a doctor and this is not medical advice. This article hits some of the highlights about plantar fasciitis and is not intended to be an exhaustive treatment of the condition. Lastly, diagnosis is outside the scope of a massage therapist‘s practice so be sure to visit a physician or other healthcare professional if you have questions or concerns.


Tips & tricks: Post-hiking Muscle Care

My friends at Flintridge Family Chiropractic have hosted some great local hikes on Sunday mornings this summer. The last hike was a great experience for me. We climbed Echo Mountain in Altadena. As often happens, the day of the hike and the next day I was not sore at all. The second day after the hike I was really feeling it: shin splints. This is a common term you may have heard before. It’s basically soreness in the tibialis anterior muscles. Here’s an easy trick to help decrease that soreness after a hike or another type of exertion that stresses these muscles.

Step 1: Fill some dixie cups with water half full and stick them in the freezer. I should have cropped this photo so you wouldn’t see the Snickers Ice Cream bars. My husband bought them, I swear.

I have dixie cups at the office if you want some next time you come in. I’m happy to share.

Step 2: Peel down the edges of the cup. You’ll rub the ice on the muscle. Having the paper surrounding the ice makes it easier to handle. Your leg muscle gets iced but your hand doesn’t.

One of my clients graciously agreed to model for me. Nothing like getting iced down before a massage, eh?

Step 3: Rub the ice along the muscle for a few minutes, until it’s numb or until you can’t stand it any more. The tibialis anterior muscle is the muscle on the side of the shin bone on the lower leg. This muscle gets a work-out on an uphill/downhill hike. Other activities that might strain this muscle include running, jumping and dancing to name a few. One of the reasons this muscle can get so sore is that it’s trapped between the 2 lower leg bones. When we work it hard and it produces metabolic waste products, the waste products have a harder time exiting the muscle post-work-out because of the limited space around the muscle. Icing the muscle down (even before you experience soreness) can help decrease any inflammation that has occurred in your work-out and speed your recovery. Try it after your next hike!

Step 4: You can include some self massage also. Try using the backs of your knuckles. Run them up and down the muscle, creating some heat/friction. You can also press your thumb into the muscle along the length of it. These simple strokes can help flush the metabolic wastes out of the muscle. By the way, the next hike is at Sturtevant Falls Sunday, September 9 at 8 am. Click on the link above to get all the details. I’m hoping to be there myself.