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Plantar Fascia Pain Relief

Does your heel hurt so much that the pain interferes with your daily activities? This debilitating heel pain might occur due to inflammation of the flexible band of tissue located under the foot’s sole called plantar fasciitis – a condition characterized by pain, stiffness, or burning sensation at the bottom of your foot. This tissue connects the heel bone to the bones of the toes, making the arch of the foot.

When damaged from activities like dancing or jogging, as well as wear and tear over time, plantar fasciitis can get inflamed and cause a terrible pain especially in the morning or after a period of rest.

The risk of plantar fasciitis increases if you have high arches or flat feet if you’re obese, and if you wear shoes that don’t provide proper support. Going for a long run or other similar activities that strain your feet can also cause this heel condition.

Nevertheless, some natural ways can help manage your heel pain and take care of your foot better. In case none of them proves helpful, here are few natural remedies that are sure worth a try.

Rest and Apply Ice
The first thing to do when experiencing heel pain is let your foot rest. Avoid standing for too long or walking long distances. Also, applying an ice pack on the affected area for 10-15 minutes, few times a day can further reduce the pain.

Wear the Right Shoes
Stop wearing shoes that don’t provide proper support, and choose ones with laces and low or moderate heels which support and cushion your arches and heels. Avoid flats, and remember to change your sports shoes every 500 miles when running or doing other physical activity that puts extra strain on your feet.

Another way to support your feet and improve your heel condition is wearing orthoses insoles. If the pain keeps on recurring, you might wear them longer.

Splints and Straps
Wearing night splints can speed up the heel pain recovering process. What they do is keep your toes pointed upward when sleeping, helping to stretch plantar fascia and Achilles tendons not allowing the tissue inside the heel gets squeezed. Using a sports strapping tape to strap your heel is another way to relieve pressure.

Foot Exercises
Doing the following foot exercises can improve the flexibility of your calf muscles, Achilles tendons, and ankle, thus relieve and prevent plantar fasciitis.
Stretch your heel using a towel the first thing when you wake up. Loop it around the ball of your affected foot and pull it toward you not bending your knee. Do this 3 times for each foot.
Sit in a chair, placing your feet on the floor, with your heels touched and toes faced in opposite directions. Your heels should stay on the floor while lifting your toes upward 10 times. You’ll feel your calf muscles, and Achilles tendon tighten as you do this exercise. Repeat for 5 to 6 times a day.
Using a round object such as rolling pin, tennis ball, or a can, sit down and roll the arch of your foot over the chosen object. Do this twice a day with each foot, even if you feel pain only on one foot. This exercise will improve your stability and balance.

One research investigated the plantar fasciitis treatment which involved stimulating the classical acupuncture points Sanyinjiao, Kunlun, and Taixi manually with needles for four weeks. The results showed significant heel pain relief.
The study also showed that those who didn’t get pain relief with this technique could be helped by stimulating certain trigger points in the plantar fascia and gastro-soleus.

You can also try few herbal oral and topical medications.
Researchers discovered that castor oil and ginger are very helpful in the treatment of plantar fasciitis. Take the oil, as well as the ginger as a dry powder dissolved in water orally before breakfast. They also say paste from the Ayurvedic medicine Kolakulathadi Choornam is also helpful when applied topically on the affected area and covered with castor leaves for four hours.
This was concluded in research which says 70 percent of the participants experienced heel pain and swelling relief within 15 days of the treatment including castor oil, ginger powder, Kolakulathadi Choornam, as well as a restricting diet (avoiding peas, sweets, potatoes, fried food, and curd).

This type of therapy which addresses medical problems by massaging the joints, muscles, and bones, can also help the treatment of plantar fasciitis. This refers mainly to the counterstrain technique.

The technique uses a tender point and involves placing the body in a position in which the person will feel minimal pain when the tender point is pressed. The person has to be about 90 seconds in this position. The study which proved counterstrain brings heel pain relief immediately, also suggests that the effect reduces after 2 days. So, it’s recommended to repeat the technique until complete recovering.



Physical Therapy Can Help

Relieve pain with Aquatic Exercise

You have chronic back pain. You think medication will help, but your doctor recommends physical therapy. What is it, and can it really help you? Yes, it’s a high-benefit, low-risk solution to diagnose and treat many different conditions. Physical therapy helps people of all ages who have medical conditions, illnesses or injuries that limit their regular ability to move. It helps patients return to their prior level of physical functioning.

Primary care doctors often refer patients to physical therapy at the first sign of a problem. The most conservative option is best. Physical therapy can help patients get stronger and more flexible. And once patients see the benefits, they become believers. While some reasons for physical therapy may seem physical therapy may seem obvious, others may surprise you.

Here are 10 ways physical therapy may benefit you:

  1. Reduce or eliminate pain – Hands-on therapy or treatments such as ultrasound and electrical stimulation can help relieve pain and restore muscle and joint function to reduce low back pain. Such therapies also can prevent pain from returning.
  2. Avoid surgery – If physical therapy helps you eliminate pain or heal from an injury, surgery may not be needed. And even if surgery is required, you may benefit from pre-surgery physical therapy.  It will allow you to recover from surgery faster because you’re stronger prior to it.
  3. Improve your mobility – If you’re having trouble standing, walking or moving – no matter your age – physical therapy can help. Stretching and strengthening exercises help restore your ability to move. If needed, we also help fit people for devices like wheelchairs, walkers and canes.
  4. Recover from a stroke – It’s common to lose some degree of function and movement after stroke. Physical therapy helps strengthen weakened parts of the body and improve gait and balance.
  5. Recover from or prevent a sports injury – Physical therapists understand how different sports can increase your risk for specific types of injuries (such as stress fractures for distance runners). They can design appropriate recovery or prevention exercise programs for you.
  6. Improve your balance and prevent falls – When you begin physical therapy, you will get screened for fall risk. If you’re at high risk for falls, therapists will provide exercises that mimic real-life situations. Therapists also help you with exercises to improve coordination.
  7. Manage diabetes and vascular conditions – As part of an overall diabetes management plan, exercise can help effectively control blood sugar. We can create an individual plan with the right mix of aerobic and strengthening exercises.
  8. Manage age-related issues – As you age, you may develop arthritis or osteoporosis or need a joint replacement. Physical therapy can effectively keep older patients more mobile and fit them with the appropriate walking device if needed.
  9. Manage heart and lung disease – While most patients will complete cardiac rehabilitation after a heart attack or procedure, you also may receive physical therapy if your daily functioning is affected.
  10. Help your child manage a medical condition, injury or movement problem – Physical therapy can help children with everything from improving fine motor skills to caring for neurological issues such as cerebral palsy to recovering from surgery.ALTALTALT

SOURCE: Lehigh Valley Health Network

Youth in Sports

The participation of children in organized athletic activities raises many concerns in parents’ mind:

  • At what age is my child ready to participate in organized athletics?
  • What is the risk of significant injury?
  • What sports carry the highest likelihood of injury?
  • Are there specific injuries related to specific sports?

In 2001, American Orthopaedic Society for Sports Medicine (AOSSM) prepared this information to help provide parents with some answers.


Should my child participate in organized athletics?

Yes!  Participating in sports is a fundamental part of our way of life.  When kept in the proper perspective, athletic activities can become an important part of a healthy growth and development pattern.  A child’s participation in sports should be regarded as an extension of school time, playtime or family time – coaches or parents should never view it as an end unto itself.

Participating in sports is a very healthy way, both physically and socially, for a child to channel youthful energy in a positive manner.

When is a child mature enough to begin participating in organized sports?

Understanding a child’s social development is the first step in answering this question.  Children under age six cannot compete in an adult sense.  They live in a “play world” of their own where even play with other children is often incidental.

These youngsters have minimal ability appreciate achievement in a sporting sense and are difficult, if not impossible, to organize.  The adult measurements of competition are lost on pre-schoolers.  Sports activities for children in this group are best promoted as playground opportunities.

Between ages six and ten, children come to appreciate interaction with their peer groups but, psychologically, still do not compete in the adult sense.  Play and fun are the primary goals for these youngsters, with structure, organization and scoring, at most of secondary importance.  Children in this age group generally have very short attention spans and generally cannot perform in the adult-imposed structure of most sports activities.  They are ready for group interaction but not for many restrictive rules or structure.

Between age ten and the onset of puberty, a youth develops increasing awareness of the goals, structure and discipline require for team sports.  The prime motivation of children this age is still joining in and having fun with their teammates. However, they will accept increasing amounts of structure and are becoming more goal-oriented.

During and after puberty the aspiring athlete develops an increasing sophisticated perspective of the structure and organization of team sports, the post-pubescent athlete is ready to develop sports-related discipline.

When is a child physically capable of participating in organized sports?

In terms of physical capabilities of the young athlete, participating in sports depends upon both chronological age and physiological maturation.

The positive effect of sports activity or training on the body is measurably less in the pre-pubescent (before puberty) athlete that in the post–pubescent (after puberty) athlete.  The benefits of conditioning to the cardiopulmonary system (heart and lungs) are scientifically measurable in the younger athlete, but are of a much lower magnitude than in the older child.  Training with weights also can have a positive effect in the pre-pubescent athlete, but it cannot result in the dramatic increase in muscle mass or strength that is seen in the post-pubescent athlete.

One of the major factors responsible for this lack of response to weight training is that the pre-pubescent child has not undergone the hormonal changes, which physiologically permit the muscle-bulking phenomenon to occur.

It should be noted that no matter what the form of specific training or sport activity, stretching and flexibility drills should be included in any pre-participation or warm-up program, even in the very young.

Is there anything to be gained from sports activity and training at an early age?

Given the fact that children have certain physiological and psychological limitations is there any reason for them to participate in sport before puberty?  Once again, the answer is yes!

Youngsters involved in such activities develop motor skills, proper training habits and a work ethic, which can carry over to life in general.  They will also benefit from proper training with weights, cardiovascular conditioning and from the non-parental discipline.  Involved parents, coaches and administrators should encourage such activities, while refraining from imposing adult performance standards.

How should organized youth sports programs be structured?

The phenomenon of puberty is a troublesome period in any youngsters’ life and athletic participation during this time may actually compound nature’s “built-in” problems.  A major reason is that most youth sports programs group participants according to chronological age.

Anatomic age (stage of body development), emotional age (maturity) and social age do not always coincide with calendar (chronological) age.  An ideal system would be to group athletes by more than one standard.  For example, arrange them not only by chronological age and weight, but also by emotional and physiological maturity.

The post-pubescent athlete can be thought of in near-adult terms.  This athlete will practice with competitive goals in mind and can physically benefit from strength and endurance training. A youth in this age group should also participate in an aggressive stretching and flexibility program, which is sport specific.

However, the best system is only as good as the coach or parent who understands the psychosocial and physical maturity factors involved – and who will foster athletic participation at a level appropriate for each individual child.

What type of sports should a youngster participate in?

The young athlete should participate in a variety of sports activities.  Psychologically, the sports goal for a child under ten, and perhaps even the older pre-pubescent should be fun.  Physically, the young athlete should be encouraged to acquire basic individual skills.  There is no overriding reason to recommend participation in non-contact sports over contact sports.

Sports participation by these younger athletes should be an opportunity to develop motor skills and to have fun.  These limited goals will give the child a healthy mental attitude as well as a healthy body, both of which will benefit him or her throughout life.

Above all, a pre-pubescent child-athlete must not become the focus of the personal athletic dreams of wishes of a parent or coach.  While parental and coaching guidance is of immense value, the young athlete should not be pressured to swim or play football, for example, when another sport better fits his or her emotional and/or physical make-up. The post-pubescent athlete will usually select athletic endeavors based on a personal skill or through associations with a particular role model or peer group.

What is the risk of injury in youth sports?

The question is not whether injuries accompany youth sports, but whether there is undue risk.  Many studies have documented a very low incidence of injury in the total spectrum of youth sporting endeavors.  Interestingly, the occurrence of injury in the pre-pubescent athlete has been documented as being much lower than in the post-pubescent athlete, and lower in the post-pubescent than the young adult.

This is probably due to the fact that the younger athlete has a lower ratio of kinetic energy to body mass – the more immature the physical body, the lower the speed and power.

Since the magnitude of injury is almost always directly related to energy expended in a traumatic event, the younger athlete is less likely to get injured then his older counterpart.  The athletic injuries, which do occur, are usually minor contusions and sprains.  Fractures, dislocations and major ligament injuries can happen, but are more common in older age groups.

Parents have expressed concern about the potential for injuries to the growth areas of developing bones and muscle in the pre-pubescent athlete.  This concern has proven to be more perceived than real, as several scientific studies have failed to document a significant increase in physeal injuries (damage to the growth areas of bones) in young athletes. Only in extreme cases, such as young gymnasts in intense training for long periods of time, are at some risk to growth plate injuries.

An argument against organized youth sporting activities, which is based on the potential for injury, is not realistic.  Although documentation is not available, it is probable that injuries resulting from participation in organized sports are fewer than those suffered on the playgrounds, or by falling off bicycles or skateboards.

Young people have definite physical and emotional energies.  It is probably less hazardous to release these energies in directed endeavors than through alternative means.  Any traditional organized sport is certainly safer than riding a motorcycle, for instance.

Are there specific injuries associated with specific sports?

While each of the individual and team sports has a family of injuries most common to it, listing of individual sports and injuries will be ignored her in favor of a generalized discussion based on contact versus non-contact sports.

The most notable examples of contact sports practiced in the United States are football, ice hockey, wrestling and basketball.  In each of these sports the athlete’s body is used to physically control the opponent and, thus, to influence the play of the game. Using the body in this manner creates the opportunity for injury.

Fortunately, the majority of injuries in these contact sports are bruises and scrapes.  The more significant injuries such as fractures, dislocations or major ligament damage occur in the post-pubescent athlete.  Parents should be responsive to complaints of pain and discomfort from athletes in all age groups and be aware that any athlete who is not playing up to skill level may be suffering from a significant injury.

In non-contact sports, major fractures, dislocations or ligamentous injuries are usually associated with accidental rather than intended collisions.  Minor sprains, muscle pulls, blisters and overuse syndromes are commonly seen injuries in non-contact sports.

The overuse syndrome is usually related to sports requiring repetitive, high-stress motion such as tennis, swimming, track, golf and baseball.  Injury occurs as a result of constant repetition of a particular movement.  Stress fractures, shin splints and tendonitis are examples of overuse injuries.

The treatment in each case is early recognition of the problem, followed by abstinence from competition and at least a decrease or change in training until the affected area is totally symptom free.  Training intensity and duration can then increase again. Return to the previous level of training should be gradual and well planned.  If the symptoms of overuse persist beyond a few day of rest or it they recur, a physician should evaluate the athlete.


Are youth athletics worthwhile?

Yes! While very few athletes participate on organized teams beyond high school, and even fewer beyond college, sports activity creates a physical fitness discipline and a positive learning experience which carries through to an active, healthy adult life.

Participation carries a risk of injury but, once again, the question is not whether the risk is present but whether the risk is undue.  A question of similar importance is how best to direct the naturally occurring physical energies of youth.

The American Orthopaedic Society for Sports Medicine is convinced that appropriate sports and physical training are safe and healthy applications of these energies. Physical fitness is advisable throughout an entire lifetime and is achievable only through physical activity.  The discipline, motivation and training required to remain fit should begin as a youngster.

This is general information.  It does not purport to encompass all risks associated with youth sports activities, nor is it a substitute for your own good judgment.

Expert Consultant:  Louis C. Almekinders, MD

Revised 2001.

Contrast Baths – DO Try This at Home!

Contrast baths reduce swelling and aids recovery from painful lactic acid buildup caused by excessive exercise.  At Accelerate Physical Therapy, we have developed an application of this technique that is easy to apply at home, and surprisingly effective in comparison to (an in addition to) every other modality we use clinically.  We use it extensively for ankle, foot, elbow and hand conditions to reduce edema (swelling), effusion (excessive joint fluid), pain and ecchymosis (bruising).

Try this (very inexpensive treatment) at home:

Fill up two basins or buckets – one hot and one cold – with water from your faucets.  Soak the effected part in cold water (preferably first and last) for 2-3 minutes, then alternate 2-3 minutes in hot water, 2-3 minutes cold, 2-3 minutes hot water, and finally 2-3 more minutes cold – for a total of  10-15 minutes of treatment.

Two dishpans are easy to find in many stores for less than 5 dollars each. Fill one with cold water and one with hot water from your kitchen faucet.

The use of heat immediately after an injury may cause MORE bruising and swelling.  Therefore, do not use HOT water until 2-3 days after the injury.

Hot water causes vasodilation (widening) of the blood vessels.  Cold water causes vasoconstriction (active narrowing) of the blood vessels.  Alternating this response is therapeutic, and is effectively manipulated by the change of temperatures.  Opening the blood vessels when the injury is fresh will cause more blood to be spilled between tissues.  This blood causes the bruising seen (and not seen).  The less blood and protein substances that are released, the shorter the recovery time will be.  The more bleeding and therefore bruising, the more painful it can be, and the slower the recovery will be.  Use cold treatment, compression, elevation and apply Arnica Montana gel to the skin over the injury to treat the injury for the first 2-3 days.

Sprains, tendonitis, epicondylitis, contusions, and painful nerve conditions all have benefited from Contrast Baths here at Accelerate Physical Therapy, PC.  We strongly suggest that people use it to improve conditions that otherwise be slower to resolve.

Activating Muscles

By definition, strengthening of muscles takes 6 weeks or longer. Strength is defined by the extent to which muscles can exert force by contracting against resistance. Quick changes in strength can often be attributed to changes in neurological activation. Few physical therapist and patients have 6 weeks or more to reach strength goals. We have to reach functional goals quickly to be reimbursed by the insurance companies and serve our patient needs.

Patients are like children and water. They always take the path of least resistance. In many cases our body will create compensatory movement patterns due to imbalances or injury. For our body to move efficiently we need all muscles to be active and work with appropriate force. You can’t strengthen a muscle that isn’t activated. The compensatory muscles are happy to kick in and perform the task, but perhaps with pain or decreased range of motion. A muscle that is inactive needs to be neurologically activated before it can become physiologically stronger.

Activation is neuromuscular education and movement training. Physical therapists are not personal trainers, we are neuromuscular experts. Finding imbalances or muscles that have become lazy and correcting muscles timing and coordination will improve specific joint function and often eliminate pain and improve function.

A common situation for muscle activation is following knee trauma. Our body protects our joint from injury by filling the knee with synovial fluid which in turn shuts down our medial thigh muscles to limit activity. We use exercise, as well as neuromuscular educational stimulation to reactivate the muscle group and restore function to the knee.

Following proper muscle activation exercises can be performed and over longer periods strength and power gains as well as muscle growth can be achieved.

Target Tissue Training – Part One: Articular Cartilage

When treating cartilage injuries, stress-loading techniques are valuable as Physical Therapists encourage tissue healing. Lack of stress leads to poorly organized tissue growth. Progressing too fast, or too heavy can slow healing. Only when articular tissues begin the proliferative phase of healing should stress-loading techniques begin.

Cartilage distributes body weight in the joint. In joint (articular) cartilage, stress or misuse can create synovitis, and effusion (increased synovial fluid in the joint). Prolonged fluid in the joint may might:

  • decrease the nutrition to internal joint structures due to harmful proteolytic enzmes
  • cause thinning of the articular carti-lage
  • decrease joint range of motion from the abnormally high joint pressure.

Beginning with ROM exercise, and slowing the rate of synovial fluid production in the joint with the use of ice is very effective. Progressing from Passive range of motion, to Active range of motion exercises, with help from thermal modalities (cold) will decrease joint effusion and helps internal joint structures to heal.

Begin stress loading the joint slowly and then increase the stress as the tissue moves to the final healing phases to facilitate appropriate growth. Research has shown that stiffness of cartilage tissue can be improved. By using a daily protocol of 1000-1500 repetitions of a functional activity (without fatigue), for a period of 3-6 weeks for compression and decompression stimulus.

It has been suggested that the intensity level be 30 % or less of maximal non-painful levels. Stress levels can be increased as maximal non-painful levels increase. By testing the patient in a functional closed kinetic chain test at Accelerate Physical Therapy, we determine how to stress the tissue. In our Load Tolerance Test, repetitions for both testing and training should be consistent in speed, and have solid control of the movement. Otherwise, compression forces can spike with high-speed loading, or gradually increase with cyclic loading. Either could retard healing.

Traditional therapy programs account for joint health with passive range of motion progressing to active assistive and active range of motion and modality use. Load Tolerance Testing followed by articular cartilage compression training allows us to objectively assess and progress cartilage tolerance for weight bearing activities.

Tennis Elbow

Tennis elbow is pain at the outside of the elbow (also called lateral epicondylitis), caused by stress on the tendons attaching muscles that extend the wrist and fingers.

When tears occur, they inflame.  Pain can radiate down the forearm.  Pain increases with contraction of muscles used when shaking hands, turning doorknobs, picking up objects with the palm down, or hitting a backhand in tennis.

Pain with pressure on outside of the elbow, or in activity that requires wrist and elbow movement describes this condition.

Rest does not cure the problem. Stretching and strengthening exercises are helpful.  Contract the muscles of the forearm by moving the wrist upward.  Stretch them downward. Repeat with the palm facing up, ten times slowly.  Use elastic bands or a 1-2 pound weight to provide resistance, and to increase circulation.  Contact us at Accelerate Physical Therapy to learn about eccentric exercise techniques.

A snug strap around the top of the forearm, or an elboe sleeve decreases the stress of the muscles on the lateral epicondyle.  These lessen pain during waking hours, but don’t sleep with them on.

Physical therapists provide ultrasound or electrical stimulation to increase circulation to the area.  We also suggest you read our article about Contrast Baths (alternating between hot and cold water every 2-3 minutes).

NSAIDS, like ibuprofen may decrease the irritation of inflammation.  Icing the joint may decrease the inflammation and relieve the pain.

Warm up well before, and keep the muscles warm as you play. Racquet handles must fit properly.  String tension and head size may increase tissue stress. Stretch and strengthen all the muscles used in the sport.

Improper techniques may irritate the condition.  Consider tennis lessons.

Source: American Orthopaedic Society for Sports Medicine and the National Athletic Trainers Association