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.

the accidental tanner

If my allergies indicate anything, spring is in full force here in Southern California and summer is peeking around the corner. Everything is blooming, buzzing, and heating up. Over the weekend, the co-housing community I live in held its annual spring clean retreat. We have 3 retreats a year and the theme for our spring retreat is deep cleaning. Working alongside great neighbors is the only way cleaning is fun in my opinion.

For someone who works indoors in a dimly lit room, a spring clean day can present the opportunity for an accidental tan. Tanning is the old fashioned term for exposure to ultraviolet radiation. It does sound better. In the relatively short span of my lifetime to date, Americans have gone from sun-foolish to sun-phobic as we’ve learned of the ill affects of ultraviolet radiation. In all things there must be a balance, for we do, in fact, need the sun’s rays for our health. But, having said that, we must also be sure to protect ourselves and our kids from overexposure. This post won’t be about sunscreen products, although I’ve provided a link for more info on sunscreen below. Rather, it will be about skin cancer awareness and what to look for on our skin. Massage therapists are in a great position to aid people in keeping an eye on the skin as we see quite a lot of it. I have asked clients on several occasions about a spot I noticed or encouraged them to get something checked out if it looked suspicious.

So, what do we look for when we scan the body for skin cancer? Here are some pointers:

Sores on the skin that do not heal. This is very important. Sores that don’t heal are a big indicator of precancerous lesions, basal cell carcinoma and squamous cell carcinoma. Often a crust or scab forms, flakes off and forms again. But the sore never fully heals. This is a very important warming sign that should be brought to the attention of a doctor immediately. While basal cell carcinoma does not metastasize, squamous cell carcinoma does. The longer it is undiagnosed, the greater chance the cancer has of penetrating to deeper layers of the skin and reaching the lymphatic system where it can travel to other parts of the body. Don’t mess around with this!

Another type of skin cancer is malignant melanoma. It is the least common of skin cancers, but is responsible for 75% of the deaths associated with skin cancer. It can metastasize and can do so quickly. Here are some things to look for:

A = Asymmetry: the mole or spot is not symmetrical.

B = Border irregularity: the mole or spot has an irregularly shaped border or an indistinct border, blending in with the skin.

C = Color: the mole or spot has more than one shade or color. Colors can be black, brown, tan white, red, purple or even blue.

D = Diameter: the mole or spot is larger than the size of a pencil eraser.

E = Elevated: the mole or spot is elevated or partially elevated compared to the surrounding skin.

There’s another guideline called “the ugly duckling,” meaning that some melanomas don’t follow the standard ABCDE categorization but are different compared to the person’s other moles. My husband chimed in that these could be labeled F for Freaky! These “ugly ducklings” should also be examined by a doctor.

There is much more to skin cancer awareness. But these are some basic things to look for. Scanning yourself and other family members regularly is a great way to keep an eye on things that can be further investigated by a dermatologist. When in doubt, get it checked out by the doctor. As with other cancers, early detection and treatment is very important. Exposure to the sun has a cumulative effect, with lots of exposure occurring when we are kids. Kids should play outside. Let’s make sure they are protected. One resource I read for this post stated that melanomas rarely occur in young people, so any large moles that develop after adolescence are highly suspect.

Here are some resources for further information:

http://www.cityofhope.org/patient_care/treatments/skin-cancer/Pages/default.aspx/?utm_source=Google&utm_medium=SEM&utm_term=melanoma&utm_content=SEA_2935217375&utm_campaign=TPG-COH-PSG

http://www.skincancer.org/

http://www.nlm.nih.gov/medlineplus/skincancer.html

Here’s an interesting website I found with an article on sunscreen products:

http://www.ewg.org/whichsunscreensarebest/2009report

So, with that, please enjoy the sun responsibly. Happy spring!

Note: Information offered in this blog should not be construed as individual medical advice. Please see your doctor with any questions you have about skin cancer and all other medical/health issues. Cancer is a huge topic; this post offers basic, introductory information and should not be seen as a definitive treatment of the topic. I referred to the following text for some of the information presented here: Werner, Ruth, A Massage Therapist’s Guide to Pathology, Lippincott Williams and Wilkins, 1998.