stretch and repeating until you get a deeper stretch without forcing, gradually increasing the length of time you are holding the stretch with each repetition. You may also be able to target the plantar fascia specifically by pinning the plantar fascia with one hand at the calcaneus and stretching What does plantar fascia work feel like? If you’ve never experienced plantar fasciitis, it can be difficult to understand the level of sensitivity that may be present. This exercise is intended to give you a sense of the effects of manual therapy to the structures involved in plantar fasciitis, and experience first-hand how sensitive the feet can be. For this exercise, you will need a hand towel and a small amount of massage cream. Sit with your feet and lower legs bare. Choose one foot and leg to work on first, and if you have any plantar fasciitis symptoms, work on that foot and leg first. Cross the foot you will be working on over the other leg, resting the outer ankle on the other leg’s knee. Apply massage cream to the sole of the foot, around the Achilles, and on the back of the lower leg. As best you can from this awkward angle, massage the sole of the foot, around the Achilles, and up the calf, working on every muscle of the calf that you can effectively reach. Pay attention to the unique experience of being on both sides
the rest with the other hand, extending the toes (bending them back slightly from the base) as part of the stretch. Remember that fascia is not as flexible as muscle, and forcing a stretch can cause damage to the tissue. Let the fascia guide you to the appropriate amount of stretch. of the therapy experience, as the giver and the receiver, and follow your instincts. Pin and stretch the sole of the foot as outlined previously in Passive Stretching, then uncross the leg you are working on, straighten it out in front of you, and use the hand towel around the ball of the foot, holding an end in each hand, to help you stretch the calf muscles. Repeat this process at least one time to the same foot and leg, giving it a through massage (as best you can on yourself). Before you work on the other foot and leg, get up and walk around the room. Do you notice a difference in how your two feet and calves feel, between the one that was massaged and the one that was not? How significant is the difference? Repeat the exercise again, this time working on the other foot and leg, then get up and walk around the room again. Were you able to create the same sensation on both feet and legs? Does one need more work than the other?
SECTION 4: SELF-CARE PRACTICES FOR PLANTAR FASCIITIS
your clients for at-home use if the client has been formally diagnosed with plantar fasciitis by a physician, and after you have done a thorough assessment of their condition. Remember that we, as manual therapists, cannot diagnose conditions or give clients any information that could be misconstrued as a diagnosis. Clients should always be referred to a medical professional for a diagnosis. beside the bed so that self-massage can be performed in the morning before the foot becomes weight bearing can help ease the plantar fascia into the activity of the day. Repeating this protocol at the end of the day before going to bed can also help to loosen and unwind the fascia before a long period without bearing weight, which is when the plantar fascia tends to tighten up. Used in conjunction with ice (see subsequently), self-massage can be very helpful in controlling inflammation and reducing the severity and duration of symptoms. Figure 5
There are some simple self-care methods that clients suffering from plantar fasciitis can use at home, either at the first sign of symptoms to keep the inflammation from getting worse, or between treatment sessions with a therapy professional to promote and accelerate the healing process. These tools can be useful if you yourself have recurring episodes of plantar fasciitis, or they can be suggested to Self-massage Teaching your clients how to use a ball to massage their own plantar fascia at home can help them greatly reduce their symptoms. Keep a tennis ball, a racquetball, and a golf ball on hand at your office to demonstrate how to use them for self-massage. Which size ball they choose will be determined by the size of their feet and how intensely they want to massage them. Softer balls, like tennis balls, may be more appropriate at times when inflammation and pain are high, and harder balls, like golf balls, may allow the user to add a little more pressure and target areas of the plantar fascia more specifically because of the smaller size. In a sitting position, they can place the ball under the affected foot and roll it along the plantar fascia to loosen the tissue in a gentle but effective way (see Figure 5), letting their comfort level be their guide as to how much pressure to use and what areas might need more attention. A study published in the Journal of Acupuncture and Meridian Studies in 2018, which examined noninvasive and complementary methods for treating plantar fasciitis, indicated that the subject of the case study, a 43-year-old woman who was a recreational runner, saw improvement in her symptoms after following a self-care regimen that included self-massage with a ball. “To massage the plantar fascia, it was suggested the patient use a tennis ball and gently roll the bottom of her foot for 1–3 minutes before bed and prior to weight-bearing in the morning” (Lee & Marx, 2018). The timing of self-massage for the plantar fascia is also important. The best time to do this is first thing in the morning and last thing at night. Keeping a ball
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Book Code: MLA1225
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