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Showing posts with label plantar fasciitis. Show all posts
Showing posts with label plantar fasciitis. Show all posts

Tuesday, May 24, 2011

More on Plantar Fasciitis

Post provided by Barbara Bergin, MD

Let me say first off, that if you’re not the kind of person who would floss their teeth to prevent tooth decay, you probably won’t be interested in this or most of what I have to tell you.

Why is the morning a time when we often experience pain and stiffness? Think about it. Name one other time when you spend several hours in basically the same position. It’s particularly so for the feet. There is not one single moment during the night when you bring your feet to a neutral position or a dorsiflexed (pointed up) position. Your foot is pointed down ALL NIGHT LONG. And honestly, it’s not just pointed down in a relaxed pose. It is POINTED down. Sometimes when people wear splints or casts to bed at night, they get numbness in their toes. Sometimes they can even get blisters. The toes want to point down and the muscles are actually pulling them down. So after 6-8 hours of that, you go and immediately stand up…well, sometimes the feet balk a little. Give them a break. Stretch them. Say “good morning” to your feet. They’re at the bottom of your body and over a lifetime they take a lot of abuse. Give them a little TLC.

I also recommend that you stretch the bottom of your feet before standing up after you’ve been sitting for awhile. Many of my patients complain of plantar foot pain in the morning when they first wake up and less so after they’ve been sitting awhile. Once again, notice where your feet go when you sit, especially if you’re sitting for an hour or more; like while you’re watching a movie, or in church. They relax and they point down. The plantar fascia begins to seek its shortened position. When you stand up, you strain it with the pressure of your body weight bearing down on that tender band. So make it a habit to wiggle your feet up and down a little. Push your feet back against the floor, as if you were trying to stretch your Achilles tendon. Cross your leg and push back your big toe, like I described for your morning stretch.

Wednesday, May 26, 2010

Adult Repetitive Strain Disorders, Part One

Post provided by Barbara Bergin, MD

Why do we get repetitive strain disorders?

- Because our bodies wear out and we do a lot of repetitive activities. As our population ages we're seeing more and more of these disorders. I see a different set of repetitive strains in younger aged individuals, mostly related to participation in sports. Of course an older person can get repetitive strain disorders from playing sports, but they can also get them from hanging up clothes in the closet and getting milk cartons off the top shelf of the refrigerator. Just because you go out and throw a ball a little, doesn't mean the milk carton wasn't the culprit. And just because your grandson can throw the ball to you all day, doesn't mean you can return it all day.

What are repetitive strain disorders?

- There are some very common disorders. They include:

- impingement syndrome: a disorder of the rotator cuff tendons. I also group shoulder bursitis and rotator cuff tears (partial and complete) with impingement syndrome.

- greater trochanteric bursitis: a disorder of the fluid filled sac that is on top of that prominent bone on the side of the hip. I see this more often in woman than in men. It's related to the shape of our pelvis and the way we move.

- plantar fasciitis: a common disorder of the foot, also seen more commonly in women. It results in pain on the bottom of the heel and is commonly called a heel spur. It's not due to an actual heel spur.

- lateral epicondylitis: Also known as tennis elow.

There are many other, less common repetitive strain disorders involving just about every tendon and muscle in the body.

What can I do about repetitive strain disorders?

- Rest: This doesn't always mean putting it in a splint, cast or brace. It usually means modifying the painful activity. As soon as you notice pain due to some repetitive activity and you can reproduce the pain by doing the activity, you should modify it. That might mean bracing the extremity involved. It could mean stopping that activity altogether. More often it means changing the way you do the activity; lessening the number of times you do it, decreasing the intensity of the activity, modifying the way you do it. For example, if I have pain in my shoulder when I get a large milk carton out of the top shelf of the refrigerator, I will start buying 1/2 quart containers and lower the shelf on which I put the larger bottles!

- Anti-inflammation: This can range from the application of ice to prescribing medications.

- Exercise: This might include some stretches or some strengthening exercises depending on the condition and the level of pain you are experiencing.