Simple exercises to do at home for heel pain and plantar fasciitis

Here is a video of some simple exercises to do at home to help with heel pain and plantar fasciitis. Do them gently and don’t exceed 4/10 on pain when doing them. If the symptoms are not getting any better then make an appointment with for a check up or with your local physio.

 

To learn more about heel pain and plantar fasciitis go here.

Plantar fasciitis – pain in the heel and foot

 

What do runners and couch potatoes have in common? They can both get pain in the heel and arch of the foot from problems with ligaments there. These ligaments are called the Plantar Fascia and the problem is known as Plantar Fasciitis and it can cause sharp pain in the heel, arch and foot especially in the morning.

 

What is Plantar Fasciitis?

Your Plantar Fascia is a tight band of connective tissue that runs from the heel of your foot and fans out into five bands to the base of your toes. Plantar Fasciitis (PF) is the most commonly reported cause of heel pain (1).  It is characterized by pain at the calcaneal origin (heel bone) of the plantar fascia and increased thickness of the plantar fascia (2).  

Although this stubborn condition is prevalent in people who sit a lot it is also extremely common in the active people too and is the third most common injury amongst runners (3).  Like most runners I’ve had a few battles with PF pain myself, so here’s some useful information and a few handy tips on how you can avoid, manage and treat this stubborn condition.

 

What causes Plantar Fasciitis?

The condition itself is thought to be caused by overload of the long arch underneath the foot.  In active people this is often caused by a rapid increase in exercise for example, an increase in hill running or the classic too much too soon.  In the sedentary people PF pain is often caused by joints and muscle not working correctly, that is, poor biomechanics or weight gain. The exact cause of this condition is still poorly understood and recent findings suggest that the name Plantar Fasciitis may be misleading as it doesn’t usually involve an inflammatory phase (-itis means inflammation).  The term Plantar Heel Pain, Plantar fasciopathy or fasciosis is probably more accurate. Below is a list of some of the common causes of PF pain that I see in clinic.

  • Pes Cavus (high foot arch) and Pes Planus (flat feet) deformities
  • Inappropriate footwear
  • Overweight – high BMI
  • Diabetes
  • Poor ankle range of movement
  • Increase in weight bearing activity e.g. hill running, speed training, high intensity work out classes
  • Excessive dynamic foot pronation
  • Poor balance and lower limb control

 

What are the signs and symptoms of Plantar Fasciitis?

A common presentation for a patient with PF symptoms is pain and tension on the sole of the foot, pain is often worse with the first steps in the morning but eases with time and movement.  Runners will often say that the pain is present before their warm up or at the start of the run but eases once activity increases, however the pain comes back with vengeance after activity or the next morning.  

 

How can a physiotherapist help?

A physiotherapist will be able to diagnose your symptoms by taking a taking a careful history of your complaint.  During the assessment stage we will look at your biomechanics, functional ability and carry out various tests to diagnose Plantar Fascia pain and rule out any other conditions which may be causing your symptoms.  From here we can formulate a treatment plan which may consist of soft tissue release, joint mobilization, taping techniques, electrotherapy and an exercise rehab programme. We can also provide you with advice on orthotics, appropriate footwear and help gradually get you back to full pain free activity in the shortest possible time.

 

How can I avoid plantar fascia pain when running or training?

Here at Sundial we work with several of the local running club in Brighton and Hove and we provide support for the Brighton Half Marathon. This is the programme we recommend:

  • Have a gait analysis with us here at Sundial
  • Purchase appropriate footwear
  • Grade yourself into running slowly, have a training plan and avoid the dreaded too much too soon
  • Don’t just run, mix up your training with other forms of exercise for example, swimming, cycling, strength training
  • Give your feet a break, have a rest day, try some foam rolling or low impact exercise such as yoga or Pilates
  • Remember, if in doubt, get it checked out and don’t let a niggle become a pain.

Sundial, at our two clinics here in Brighton, offers a free 20 minute physiotherapy assessment to anyone who would like advice about an injury, this session is a great way to get some useful tips on how best to manage your injury and to see if physiotherapy is right for you.  Why not call the clinic today to arrange a free informal consultation and stop that niggle turning into a pain!

 

James

Sundial physiotherapist, Brighton and Hove

 

References

  1. Singh et al, 1997 and Buchbinder, 2004
  2. Buchbinder, 2004
  3. Ribeiro, 2011

 

Back pain in pregnancy and chiropractic

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During pregnancy your body changes to adapt to your growing baby. These changes happen fast and you can experience pain and discomfort in your pelvic and lower back area.

Hannah’s story

Hannah came to me here at Sundial during her 4th month of pregnancy because she was experiencing pelvic pain for few weeks and the intensity of pain was increasing with time. She was also suffering with pubic pain for the last few days.

She would feel more pain turning in bed, walking and going up or down stairs. Being a nurse Hannah needed to be on her feet most of the day and she desperately needed relief.

After an examination I explained to Hannah that she was experiencing pain because of a sacroiliac dysfunction, a lack of movement in the joint of the pelvis.

These types of pain are very common during pregnancy. In fact 20% of pregnant women suffer with pelvic pain and 50 to 85% with low back pain. This is mainly due to the hormonal changes during pregnancy as your body starts to produce relaxin, the hormone that relaxes your ligaments in order to increase the space for your baby and birth. Also mechanical changes occur as the pregnancy goes along. As your tummy gets bigger the curve of your lower back increases and creates pressure on your back joints and muscles too.

We started working on this sacroiliac dysfunction using very gentle techniques to free up the joints and also working on the ligaments and muscles of the pelvis with gentle pressure. I also gave Hannah stretches and exercises to stabilise her core muscles and pelvis at home.

I saw Hannah regularly throughout her pregnancy in order to maintain the right sort of movement in her pelvis and, fortunately, she didn’t experience pelvic pain anymore!

Can arthritis of the spine cause back pain?

Does arthritis, specifically osteoarthritis, cause low back pain? In this video Brighton chiropractor and back pain expert, Matthew Bennett, reveals the answer and explains what osteoarthritis of the spine actually looks like.

Headaches – the hidden cause

Neck exercise to relieve headacheAnyone who has suffered from regular headaches knows how unpleasant and disrupting they can be. Many headache sufferers find it difficult to concentrate, to work or even carry out simple activities without feeling grumpy.

Jamie’s story

Jamie came to me here at Sundial because of six years of headaches that were affecting his work and his life with his partner. And things were getting worse. A recent increase of the frequency of the episodes made him realise he had to do something.

Headaches can be bad enough but Jamie’s symptoms started a journey all of their own. His pain was travelling from his neck to the top of his head on one side and travelling down to the shoulders and to between his  shoulder blades. He would always have the headaches during the week and only found respite at the weekends. A stressful day at work or being on a computer for long period of time was increasing the pain to unbearable levels so even painkillers were ineffective

Jamie has a job with a lot of responsibilities in a big company and needs to manage a team. He spends a lot of time sitting in meetings and even more staring at  a computer screen. Stress is a constant feature in his work.

When Jamie came to see he was keen to end this agony. After an examination I found that some of the joints in his neck were stiff and not moving correctly. The surrounding muscles were in spasm and were very sore to the touch. It was clear that Jamie was suffering from headaches caused by referred pain from the neck – so called cervicogenic headaches.

In Jamie’s case the dysfunction has been triggered by his repetitive poor posture, especially sitting at the computer for long periods of time.

Successful treatment begins

I started to treat Jamie for cervicogenic headaches, by addressing the cause. As a chiropractor I worked on the muscles of Jamie’s neck and shoulders applying gentle pressure to relax the muscle tension. I also used my hands to increase the mobility of his neck joints using gentle pressure.

But Jamie had to bring some change in his life as well. Here are the tips I gave him and it could help you too to deal with your cervicogenic headaches.

Jamie has now far fewer  episodes of pain and during a really stressful day at work, if the pain starts, he can decrease the intensity and the duration of the episode by himself using these tips

If you would like a free check up to see if chiropractic can help you then call to make an appointment or use our online booking above.

New study slams medical treatment for back pain

backsA new study on back pain in the prestigious medical journal, the Lancet, roundly criticises medical treat of low back pain. Researchers from all over the world took part and looked at how back pain is treated and they concluded that there is “inappropriately high use of imaging, rest, opioids, spinal injections, and surgery.”  They go on to say that “Doing more of the same will not reduce back-related disability or its long-term consequences.”

Back pain is now the number one cause of disability globally and rates have continued to rise in spite of increased spending on treatment. The authors make a plea for more sense and evidence based treatment. They call for a new direction which encompasses emerging treatments alongside effective solutions that exist already.

Effective treatment for back pain

Guidelines exist for doctors to follow on the most effective sorts of treatment but often these are ignored or not implemented properly. Here in the UK, NICE has issued guidelines and these are mentioned in this study as being helpful and they echo the findings in this paper.  The evidence points to a biopsychosocial model of care which looks at the behavioural, psychological, and social factors as well as the anatomical structures which play a role in the persistence of pain and disability. What does this mean for you if you have back pain?

It means that there is greater emphasis on self-management, physical and psychological therapies, and some forms of complementary medicine, and less emphasis on pharmacological and surgical treatments. So staying active, doing gentle exercises, getting some manual therapy as well dealing with stress, anxiety and depression, especially negative feelings around pain and disability, are very helpful. Some guidelines also recommend massage and acupuncture. One thing the guidelines in the US Denmark and UK agree on is that spinal manipulation is helpful. Which is good news because that’s what we do here at Sundial.

The report goes on to highlight the differences in standards of care throughout the world and it is clear that there is huge variance in practise and approach. For instance in the USA only half of back sufferers are prescribed exercises and in Sweden, USA and Australia electrical modalities like ultrasound are routinely used in spite of being ineffective.

Back pain is not one condition

This review is an excellent summary of the worldwide management of low back pain but has its limitations. Back pain is not one condition but several conditions causing a similar group of symptoms. A muscle spasm, disc derangement and a spinal joint dysfunction all cause low back that can refer pain down to the buttock and leg and a skilled clinician can tell which problem it is likely to be. Whilst several conditions can co-exist it is clear that an accurate diagnosis is important because the treatment is different for all three. Here at Sundial we make sure we make an accurate diagnosis and agree a treatment plan that is the most likely to get the best results.

If you would like a free check up to see if we can help your back pain please give us a call or book online above

 

Reference:

Prevention and treatment of low back pain: evidence, challenges, and promising directions

Foster, Nadine EBuchbinder, Rachelle et al.
The Lancet , Volume 0 , Issue 0 ,

21 March 2018

Free physio exercise routine (worth £42) with free spinal check-up

Low back stretchMost people think that having a healthy back is matter of luck, a matter of avoiding accidental injury and bending a lifting properly. Whilst these things certainly help there are three things that research has shown to be the most effective way of treating and preventing back pain.

Firstly, and most importantly, keeping fit and active has the biggest impact on preventing back problems. Initially, a few days rest may help a bad back but getting active early on is key to a full recovery. Once your back is better it is important to maintain levels of activity and there are certain simple exercises that you can do at home. These exercises can also prevent back pain coming on in the first place.

The second thing that will help keep your back in tip top condition is getting treatment sooner rather than later. If back problems are not clearing up or keep coming and going it may be a sign that that the condition is slowly worsening and this can lead to chronic, ongoing pain.

The third solution to keep your back healthy is regular preventative check-ups. Back problems come on because the spinal joints gradually stiffen over time, causing reduced movement, inflammation and pain. We can check for the early signs of spinal stiffness and our treatment can unlock the stiff joints and prevent the pain from coming on in the first place.

For January, we are offering a free spinal check-up with a chiropractor combined with free 30-minute physio assessment and personalised exercise routine (worth £42) for everyone seeing a Sundial chiropractor. To book in online – www.sundialclinics.co.uk or call Sundial Queens Road, 01273 774114

 

Terms and conditions: One free spinal check up and one free physiotherapy exercise session is available on request. To be eligible to claim you must receive a session with a Sundial chiropractor between 2nd – 3rd February 2018. Only one free chiropractic check-up and one free physiotherapy session is allowed per person and it must be taken by 31st March 2018. The free sessions are not transferable and cannot be exchanged for the cash equivalent.