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Entries in feet (3)


Good news for plantar fasciitis

A meta-analysis of all randomized controlled trials "investigating the effects of Mt [manual therapies] in the treatment of human patients with PF [plantar fasciitis], plantar fasciosis, and heel pain published in English....was conducted. The results showed improved function and decreased pain with use of manual therapies."* "It is recommended that clinicians consider use of both joint and soft tissue mobilization techniques in conjunction with stretching and strengthening when treating patients with PF."

I use a combination of manual therapy and acupuncture then send my patients home with exercises for strengthening and neuro-sensory training--a balanced approach that gives them the tools for life-long conditioning. I have found that rebilitating the feet is imperative for maintaining stabilization of the pelvis and alleviating back, pelvis and knee pain.


* Fraser, J.J.; Corbett, R.; Donner, C.; Hertel, J.; Journal of Manual & Manipulative Therapy (2018) 26:2, pp. 55-65.


foam rolling 

My shin splints returned. In a way this was a good thing because I've been working on my breathing so I can't run like I used to and it motivated me to get into the habit of foam rolling.

Here's a YouTube video tutorial (someone else's) on rolling out the shins. It's a really good technique for injury prevention, improving short-term range of motion and mobility.

Foam rolling effects deep myo-fascial release between layers of fascia where lymph is free to flow. Powerful therapy! Rock Tape performs a lot of research on best methods. They recommend longer time spent foam rolling post-workout, when your muscles are warmed and worked, than for pre-workout, when your muscles are relatively tight. It's akin to starting superficial and getting deeper as a massage progresses.

The foam rolling was great at managing my shin splints but I discovered that I was placing my right foot wrong. I remembered that, back in the day, my dance teacher would instruct me to evert while pointing my feet, to overcome a natural over-inversion. I tried doing this while running, paying particular attention to my right foot strike. I'm still having to pay attention as I haven't completely habituated to the new practice, but my shin splints are completely resolved rather than managed. Foot strike rules again!!!


foot to core sequencing

What do feet have to do with one's core?? Turns out, everything; it all starts at the feet. The most functional movement humans do is walk. If our parts are aligned and neuro-muscularly coordinated we walk and work with ease and without pain. There is a sequence to neuro-muscular firing that is essential to this coordination.  Think of a string of fire crackers each causing the next to ignite. That's efficient. If you had to keep lighting every couple fire crackers you'd get frustrated and you wouldn't get the same effects.

So here's how it works:

We must have enough inversion of the foot in order to effect external rotation of the tibia which, in turn, causes internal rotation of the femur, activates the glutes, then initiates firing of psoas, pelvic floor and respiratory diaphragm. It's a neuro-muscular firing cascade that happens from the ground to the core by virtue of our feet impacting the ground.

We also must have enough eversion of the foot, have enough ankle dorsiflexion and be able to get over our big toe in order to effect adequate propulsion. A number of compensations reveal any inadequacies--walking with feet pointed outward, rolling the feet, twisting the leg, throwing the leg to the side or picking up the foot early. Have bunions? or flat feet? They're the result of compensations.

Neuro-muscular firing initiates while we are anticipating where to place our foot, even before the step is taken. There's an unconcious planning that takes place in walking (and running), one that either serves us well or has become a pathological habit. People who have been raised shod have more foot, ankle and leg injuries than people raised barefoot because the sensory ability of the small, intrinsic nerves of the feet have been dampened. A shod foot trying to walk is like a ear trying to hear underwater--distorted and unsure.

Getting some barefoot time in each day can re-awaken those small, instrinsic nerves, improving balance and proprioception while protecting you from injury over the long term. Many runners who change from shod to barefoot, or minimalist, get injured because they try too much too soon. It takes some time for the nerves to waken and for your body to adjust to using your muscles in new ways. Take it very slow and gradually decrease your shoe's support over time.

Check out Harvard's website on "Biomechanical Differences Between Different Foot Strikes" for more, really cool information.