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Wednesday, May 18, 2011

Plantar Fasciitis

Post provided by Barbara Bergin, MD

Stretch your feet every morning before you get out of bed.

I see at least one woman every day in my office with this problem. I have 19 partners who collectively probably see similar numbers of patients with plantar fasciitis every day. Do a little extrapolation and you can begin to imagine the amount of plantar fascial pain out there and then the cost of treating that pain. And with a couple of simple preventive measures, I really believe this pain could be eradicated. I’m looking for a Nobel prize here.

I know you were probably thinking I’d tell you about some life changing vitamin or some extract that would put cartilage back in your knees. Maybe I have a special exercise that will keep you from tearing your ACL. This foot stretching thing is so…mundane. So uncomplicated. But let me tell you that I’ve been doing it for about 10 years. I started the morning after the first morning I woke up with the dreaded heel pain. And I never experienced a second morning of waking up with heel pain. But don’t wait until you have heel pain to start stretching your feet in the morning.

I think there are a lot of preventive measures we can utilize which don’t affect the quality of our lives and may keep you from experiencing pain and some disease. It just so happens that foot stretching to prevent plantar fasciitis is a great example; a very simple example of that kind of preventive measure. It takes about two minutes to stretch your feet and there’s really no downside to it. I love that kind of prevention. Lots of potential benefit…little downside.

Let’s compare it to a mammogram. Now there’s a test with lots of potential benefit, but it comes with some downside. It’s uncomfortable. A complete stranger has to grapple with your breasts. It takes at least four years to get a little used to it. There’s a little radiation exposure. Plus it takes a couple of hours out of your day and you can’t put on deodorant that morning. You see where I’m going with this?

Let’s compare it to taking a baby aspirin every day. There’s a preventive measure with potential benefit, but in some people taking a baby aspirin can cause ulcers. If you are taking aspirin, it could be risky to take other anti-inflammatories like ibuprofen or Aleve, Celebrex or Lodine.

As you begin to realize that full wakefulness is imminent, begin to wiggle your feet up and down. Don’t be too aggressive. No need to wake anyone up. Take hold of the top of your flat sheet and gently pull it snug. Then press your toes against the firm sheet, using the sheet to assist in stretching the bottom of your foot. You’re trying to stretch the plantar fascia.

Okay, now there’s your 30 second stretch with a lot of benefits and few to no side effects or diminished quality of life. But if you want to take it one step further, and I would recommend that you do, then sit up and swing your feet around to the floor. Take one foot and pull your big toe backwards, just to tolerance. Don’t try to dislocate the joint.

While doing this you’ll be able to feel a little band on the bottom of the foot. It will feel like a bowstring. Some of that is your plantar fascia; the thing that gets so tight and causes so much misery. Massage it with your other hand. Do the same thing on the other foot. Then put your feet on the floor. If you feel pain in your heel, then start over with the stretch and massage. Repeat as needed.

What I’m really hoping for is prevention. If you already have heel pain, this might not make it go away instantly, but these stretches are an integral part of the treatment regimen for plantar fasciitis. Just keep doing that every morning before you get out of bed. If you do this before you have pain, in other words, you use it as a preventive measure, you will likely never experience the misery of heel pain.

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