(Newswire.net — January 14, 2014) Darien, CT — If you are a serious runner or know a serious athlete they you know how debilitating the pain from Plantar Fasciitis can be. Treatment options run the gamut all with varying degrees of success. When treatment fails to make a difference the athlete really has no choice but to eliminate running from his or her training regimen.
This is not what any athlete wants to hear. I would like to point out that a real problem exists when all the focus is placed on the plantar surface of the foot. Sure the pain is there. We need to ask what can be causing the pain in the heel and bottom of the foot?
I encourage doctors to look elsewhere. It could lead to significant improvement in a patients progress. Enough so they could go back to running again without the fear of having the pain return.
If the clinician would look to the trunk flexors commonly called the psoas and iliacus muscles which help move the leg by stabilizing the hip. From there they should look at the legs and the front part of the thigh. In particular the vastus medialis and the sartorius muscles which overlap on the inside of the knee closer to the thigh. Feel around here for painful tender points. You may be finding the real trouble spots if these points turn up tender. The tender points are what we call adhesions. These tender points form when muscles become dysfunctional. They prevent the muscle from moving freely restricting motion and increasing friction. The increased friction will cause pain and the muscles get choked up as toxins and muscle by products accumulate forming ever bigger adhesions.
The adhesions prevent the muscle from moving freely and efficiently causing pain. Next the clinician should look at the fibula head and the peroneus and extensor digitorum muscles for more adhesions. Then pay close attention to the gastroc and soleus for trouble spots that run into the Achilles tendon.
Once the exhaustive search for painful tender spots is done can we look at the sole of the affected foot. This being the terminal point and it can be real painful to the touch. It can be so inflamed that the patient will not let you touch it. The clinician needs to look at the whole leg as a unit and direct treatment accordingly.
When the foot is the entire focus a lot can be left on the table and the treatment may not be helpful to the patient. When all else fails there is hope. Hope comes in the form of a stainless steel tool that is used to erase the adhesions. The method is called Graston , named after a British doctor who invented the technique. I might add that the tissue is inflamed and is highly vascular with many nerve endings amking it more sensitive. Treatment with Graston needs to go slow at first because it will hurt in most cases. The good news is that some improvement can be felt almost right away.
The adhesions must be treated from the top down to the sole of the foot. Follow this with Cold laser therapy to stimulate cellular re-growth to wrap it up. The real secret here is that the clinician must be thorough and look at the leg as a unit. Treat it as such and great results can be had. Some patients resspond to cortisone injections and orthotic inserts. That is great and these modalities should be considered when evaluating Plantar Fasciitis. But when they fail you have options.
Serious relief calls for serious action. The patient will love you when they get the okay to start running again. This treatment until now has been a last resort effort. The patient may be better served if the intake evaluation includes the whole leg and even the stomach muscles on the side of pain. Properly directed treatment will allow for better outcomes. Admit it we still love helping patients get better. I do. Any questions can be directed to Dr.McKay at the contact points listed below.