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foot-pain

Plantar Fasciitis: Heel to Toe Pain

Overly stretched, tiny tears can lead to inflammation and pain in the arch of the foot. This condition, called plantar fasciitis, accounts for nearly one million doctor visits per year. Our foot has a thick band of tissue called fascia that runs from our heel to our toe. This troublesome foot issue is actually more common in women than men. We need to spend time on our feet moving, so this foot problem, if left untreated, can cause excessive pain and greatly limit our mobility.

Contributing Factors

Plantar fasciitis is more common as we age (specifically between ages 40 and 60), but is also more likely to occur in someone who is overweight or constantly on their feet. It is very common in runners. Activities that are known for high rates of plantar fasciitis include ballet, dance, long-distance running, and ballistic jumping. There are a few other contributing factors which include wearing shoes that are worn out and have thin soles or wearing high-heels. The mechanics of how you walk (your stride) involves your foot position. If you have flat feet or a tight Achilles, the body will compensate for these dysfunctions which can lead to injury of the fascia.

Pain

Pain starts to occur near the heel towards the bottom of the foot. Most people feel the pain in the morning right when they get out of bed. This is known as “first-step pain”. This can also occur if you have been sitting for a long period of time and then stand up. The plantar fascia acts like an absorbing shock spring in our foot. Repetitive stretching and tearing of this area results in a stabbing pain.

Treatment

If pain persists, seeing a doctor can help detect this condition. He or she will check the tender areas of the foot. The good news is that plantar fasciitis does normally go away on its own. There are several treatment options. A doctor might prescribe anti-inflammatory medication or a steroid injection. Physical therapy and massage can help as well as shock wave therapy to stimulate blood flow. A Tenex procedure can remove scar tissue in the area or surgery can be done to remove the plantar fascia off of the heel bone. Wearing the right shoes or using shoe inserts oftentimes does the trick, so be sure to try these simple fixes first. Ice and soaking the heel can also help alleviate pain .

A good home remedy is freezing a foam cup of water then rubbing the top of the cup on the heel for 10 or so minutes. Stretching the calves and Achilles tendon can help over time and there are ways to tape the area of the foot to position the heel correctly with each step. Night splints worn to hold the foot at a 90 degree angle help when stretching the fascia.

There’s no doubt that we use and abuse our feet, bearing vast amounts of weight on them while performing all of our daily functions. As we walk from point A to point B, getting those 10,000 steps in, we must practice self-care from head to toe to heel. Sometimes foregoing that cute pair of shoes even at the gym is worth the fashion sacrifice to walk without pain.


Megan Johnson McCullough, owner of Every BODY’s Fit in Oceanside CA, is a NASM Master Trainer, AFAA group exercise instructor, and specializes in Fitness Nutrition, Weight Management, Senior Fitness, Corrective Exercise, and Drug and Alcohol Recovery. She’s also a Wellness Coach, holds an M.A. Physical Education & Health, and is a current doctoral candidate in Health and Human Performance. She is a professional natural bodybuilder, fitness model, and published author.

 

References

https://journals.lww.com/jaapa/Fulltext/2018/01000/Plantar_fasciitis__A_review_of_treatments.4.aspx
https://journals.sagepub.com/doi/full/10.1177/2473011419896763
https://academic.oup.com/occmed/article/65/2/97/1488760

back-pain-at-gym

Back to Basics

As health and fitness professionals we like to think of ourselves invincible.  After all, we help people feel better, and accordingly, we should never do anything to appear less than indomitable.  We also all know this is simply not true.  

Seniors-on-bikes

Why is a Bike So Good for your Knees?

Why is a bike so good for your knees?

When it comes to knee pain, it is hard to know what activities will help them feel better

While…

It is pretty easy to know what makes your knees feel worse:  jumping, running, quick changes in direction, even going up or down stairs.

Why some activities make your knees feel worse

Let’s explore the WHY of knee pain before we get in to how to make your knees feel better.

WEIGHT BEARING

If you have knee pain, it could be caused by an injury (typically torn ligaments, cartilage, bursitis, dislocation) or maybe you are suffering from something like osteoarthritis where there is inflammation and bony changes inside the joint.

When you are on your feet, your knees are weight-bearing joints.  That means your body weight is going through them.  If you have knee pain and you are overweight, those extra pounds will likely make your knees hurt worse.

Your knee is especially vulnerable because of its wide range of motion.  There are many positions in which your knee can be damaged.  Note: For cardio activity, where you are doing a many-times repeated motion, you may want to exclude weight-bearing exercises.  This, of course, is not the rule for strength training since weight-bearing is actually GOOD to strengthen your bones.

IMPACT FORCES

“Impact” refers to the force that goes through the knee joint caused by your foot striking the ground.  As you walk, run, or jump, the forces transmitted are multiplied by your body weight:

  • Walking 2-3 X Body Weight [1]
  • Running 4-14 X body weight [2]
  • Jumping 9+ X body weight

There are also sheer forces through the knee caused by gravity and resistance, like when you slow down, walk down a hill, or come to a sudden stop.

If you have knee pain, you can see why walking, running, or jumping may exacerbate the pain.  Again, if you are carrying extra body weight this creates more force on every step through your knee and is a good reason that doctors want you to be a healthy weight before a knee surgery.

LATERAL MOVEMENT

For some people, moving side to side causes pain.  Think basketball shuffle or doing a carioca side line step in your athletic training class (not to be confused with Karaoke which usually involves drunken singing).   Pain here may be caused by collateral ligament issues, meniscus cartilage issues, or joint changes.

I know in my case because of my arthritic changes to the lateral (outsides) of my knees, side to side movement was excruciating.

Is moving your knee actually good for it?

Your knee is the largest joint in the body and it is made to move.  When you stop bending it so much, it may start to feel like a rusty hinge.  That may be due to the joint’s synovial fluid (think lubricant) has gotten thin.  Thin synovial fluid can be caused by many factors, including dehydration, poor diet, or lack of movement, to name a few.

The right kind of movement will stimulate your joint to produce thick and healthy synovial fluid that can do its job of reducing friction and nourishing cartilage.  Healthy synovial fluid may reduce your pain – and that is good.

If impact movement, like running, causes you pain, it’s time to find a way to reduce impact. Try these options:

  • Elliptical Machine
  • Swimming
  • Rowing
  • Biking

If weight-bearing movement, (when you are standing up) like using an elliptical machine bothers your knees, try one of these:

  • Swimming
  • Rowing
  • Biking

If Lateral movement also bothers you, you may have to eliminate swimming because if your knee joint is “loose” (like mine was), kicking during swimming may not feel so good.

So that leaves us with

  • Rowing
  • Biking

While I row on an indoor ergometer, my tool of choice is a BIKE.  You can do it indoors on your own or in a class. You can ride a bike outside for exercise, commuting, for adventure touring.  Riding a bike is simply fun.


Article originally printed on HealthyKneesCoach.com. Reprinted with permission.

Robin Robertson is the international best selling author of “Healthy Knees Cycling”, “Healthy Knees Strength”, and “Healthy Knees Total Knee Replacement”. She has owned and operated the Bellingham Training & Tennis Club since 2000. Robin is accomplished in a variety of training methods including Functional Aging Specialist, ACE-certified personal trainer, USA Cycling Coach, and founder of Healthy Knees Coach.

 

References

[1] PMC US National Library of Medicine, National Institutes of Health. (2013). Knee Joint Forces:  Prediction, Measurement, and Significance.  Retrieved on 12/6/19 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3324308

[2] Medscape.com (2015) Joint Loading in Runners Does Not Initiate Knee Osteoarthritis.  Retrieved on 12/6/19 from: http://www.azisks.com/wp-content/uploads/2017/04/Joint-Loading-in-Runners-Does-Not-Initiate-Knee-Osteoarthritis.pdf