Plantar Fasciitis No More
One of the challenges for my patients is foot pain. Here's a hot tip for you. Burning feet are usually caused by poor or improper fat metabolism precipitated by a congested liver and a limited intake of Vitamin B, including Choline and Inositol. Plantar Facitis, which is pain along the tissue on the very bottom of the foot and heel area, is normally caused by not enough Omega 3 flax oil consumption, lack of Vitamin B6, low thyroid and weak adrenals. Thyroid function is needed for calcium absorption which calms and relaxes tissues. The adrenals make natural cortisone.
The plantar fascia, also know as the plantar aponeu-rosis, is a tough, fibrous tissue that originates from the tuberosity of the calcaneus and inserts into the metatarsal heads. This fascia supports the longitudinal arch of the foot. This fascia is under stress when the calf muscles are tight.
A number of different conditions may cause pain in the middle of the foot. Again, acute injuries are obvious and easily recognized with appropriate X-rays. The most common serious cause of chronic foot pain in active children is a stress fracture of the metatarsals. Stress fractures are overuse injuries found in many different sports, ranging from football and soccer to dance and gymnastics, and can occur in other parts of the body as well. They are typically treated with casting and rest. Although the initial X-ray may not show the fracture, follow-up X-rays should demonstrate healing bone to confirm the diagnosis. Chronic pain in the middle of the foot is often the result of a variety of bony abnormalities. The most common of these is flat feet. Painless flat feet are most often a variation of normal and require no treatment. However, if a child with flat feet has foot pain, it requires evaluation. Often no significant abnormality is found and the pain is relieved with the use of an...
Chronic heel pain associated with increased physical activity in preteens may be Sever's disease. In this condition, the heel bone is often tender to pressure and the heel cords may be tight. Some physicians will make this diagnosis based on X-rays showing irregularity and increased density of a portion of the bone behind the heel bone (sclerosis of the calcaneal apophysis). This is incorrect, as identical changes are commonly found on X-rays of children without foot pain. Sever's disease is not associated with pain in the tendons above or below the heel. Heel pain accompanied by pain in these tendons is often a sign of a spondyloarthropathy (Chapter 7). Isolated plantar fasciitis (pain at the bottom of the heel where the tendons from the front of the foot attach) and Achilles tendonitis (pain at the back of the heel where the tendons coming down from the calf muscles attach) occur as overuse injuries in runners and other athletes. Since these findings may also be part of...
Many sports injuries are caused by repetitive overuse, which leads to soft tissue dysfunction and bone injuries such as stress fractures and bone spurs. The Chinese hurdler Liu Xiang was unable to compete in the Beijing Olympics because he injured his Achilles tendon right before the event. The world-famous Chinese basketball player, Yao Ming, suffered a stress fracture in his foot 8 months before the Beijing Games. The likelihood of such injuries can be greatly reduced if chronic and acute stress in the musculoskeletal systems are effectively managed.
Sever's disease is a traction apophysitis of the calcaneous seen in children ages 7 to 13. Some studies suggest that the etiology of Sever's disease may be more stress related as opposed to a true traction apophysitis. Insidious onset of heel pain with running is the hallmark symptom. Pain can be
Cervical spondylosis is a chronic degeneration of the vertebrae and discs of the neck. Bone spurs, or osteophytes, are bony projections that form along Aging, repetitive stress on joints, reduced flexibility of ligaments, and tissue inflammation can cause discs to degenerate and become drier and less elastic. Such degeneration may cause discs to bulge and, in some cases, rupture. To adjust to the stress of excessive physical force, the vertebrae may develop bone spurs, which are new growths of bone along the margins of existing bones. Cervical spondylosis is a common cause of spinal cord dysfunction in older adults. If the condition is not properly treated, the injury may progress and become permanent. Bone spurs and herniated discs can impinge and put pressure on the roots of one or more nerves of the cervical spinal cord.
The cervical plexus supplies innervation to the shoulder, arm, and hand. A pinched nerve, or cervical radiculitis, is inflammation or compression of one of these nerves. It occurs when a disc presses against the spinal nerves connecting to the spinal cord. The discopathy can be caused by repetitive stress from training or posture. Bone spurs or degenerating vertebrae can also impinge on a nerve. The affected nerves branch to numerous areas, and symptoms may radiate from the source along the nerves to the areas where the nerve travels or that the nerve supplies. Inflammation and pain associated with pinched nerves may continue or worsen if proper treatment is not received. The nerve may become permanently damaged through continued pressure and stress, and the condition may cause serious underlying injury to the vertebrae or spinal cord.
The repetitive and cyclic nature of running often leads to an accumulation of mechanical stress that exceeds the adaptation threshold of the musculoskeletal system and results in a variety of injuries. The structures that commonly accumulate mechanical stress and tissue injury include the knee, ankle, shin, hamstring, Achilles tendon, calf muscle, and plantar fascia. This stress can be reduced and injuries prevented if regular de-stressing treatment protocols are adopted. After examining 180 runners, James and Jones1 reported 232 injuries at the knee (34 ), posteromedial tibia (13 ), Achilles tendon (11 ), plantar fascia (7 ), stress fractures (6 ), and other sites (29 ). Most of these injuries can be prevented and reduced if de-stressing and balancing is achieved through dry needling acupuncture treatment on a regular basis.
Bone spurs, and soft tissue dysfunction, in basketball players, 239-240 in football players, 243 Heel spur, 233 Hines, Jim, 3-4 Hip of, 181-189, 181 , 182t Lower leg and foot injuries, 229-233 Achilles tendinitis, 230 ankle fracture, 232 ankle sprain, 231-232 anterior compartment syndrome, 231 in basketball players, 238-239 calf strain, 230 in cyclists, 237-238 fibular (peroneal) tendinitis, 232 foot fracture, 232 foot stress fracture, 232-233 in football players, 242-243 heel spur, 233 in hockey players, 247 medial tibial pain syndrome, 230 plantar fasciitis, 233 posterior tibial tendinitis, 231 in runners, 235-236 in soccer players, 244-245 stress fracture, 230-231 in swimmers, 248-249 tibial and fibular fractures, 229-230 in volleyball players, 252-253 Lower limb. See also Lower limb acu-reflex points Lower limb injuries major nerves of, 1111 muscle pain in, and associated myofascial trigger points, 156t musculoskeletal mechanics of, 171-189, 189t hip, 171-177, 176t knee, 177-181,...
Pain around the joint (periarticular pain) is the hallmark of spondyloarthropathies. The key to recognizing that the child is not suffering from recurrent athletic injuries is that multiple tender joints are present (for example, it's not just the left ankle that hurts the right ankle, heel, low back, and wrist may also be tender when examined). Another common finding is pain at the Achilles tendon insertion on the back of the heel or at the insertion of the plantar fascia on the bottom of the foot (see Fig. 7-1). This can be detected by percussion or deep palpation at either point. Discovering that there are similarly affected family members when taking the family history also may speed recognition of a spondyloarthropathy. FIG 7-1 Pain in enthesitis-associatedarthritis commonly occurs at the back of the heel (Achilles tendon insertion) or bottom of the heel (plantar fascia insertion). FIG 7-1 Pain in enthesitis-associatedarthritis commonly occurs at the back of the heel (Achilles...
A PT can evaluate and treat regional pain, balance issues, and discuss energy conservation to manage fatigue. Treatments employed by PTs may include rehabilitation exercise, manual therapies, neurosensory balance analyses (measuring nerve transmission information to and from peripheral extremities to the CNS), gait analyses with corrective orthotics fitting, and a multitude of management strategies for long-term self-care. They can also teach patients to use spray-and-stretch. Spray-and-stretch requires a prescription from the provider for fluo-romethasone cooling spray (a skin refrigerant). The PT can teach patients to spray the medication on selected muscles, which allows painfully tight muscles to be stretched with less discomfort. Patients can then use spray-and-stretch at home whenever needed. PTs may fit patients for prescription orthotics for foot pain and work in concert with an orthotist to ensure proper fitting. Finally, PTs may administer ultrasound therapies to reduce pain...
Next, the clinician completes a physical examination focusing primarily on the musculoskeletal and neurological system, which would include a Tender Point Survey. This survey is a notation of pain response to careful palpation of specific body locations using a light compression of 4 kg. Other non-FM peripheral pain generators such as bursitis, tendonitis, plantar fasciitis, and osteoarthri-tis would be reviewed as well. A careful review of the small joints of the hands and feet should reveal those areas to be free from the inflammation or joint degeneration that occurs in various kinds of inflammatory arthritis but not in FM. Finally, the provider would check for possible symptoms of certain other overlapping conditions that do sometimes appear alongside FM.
A great deal of equipment is available to help with pain relief, depending on the particular condition in question. For example, a telephone headset or ear set is ideal for someone with neck pain. If you have hand pain and need to use the computer, voice-activated software can be extremely helpful. For people with back pain or foot pain, custom shoe orthotics or extra-deep and extra-wide orthopedic shoes can provide relief. And if you have hip or knee pain, a cane can reduce the load borne by the affected joint, diminishing the pain. There are so many types of equipment that it is impossible to discuss them all here. But the right equipment is incredibly important when treating pain.
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