Plantar fasciitis, reflexology and foot mobilisation

Plantar fasciitis: "Rather than being the result of inflammation, the condition more closely resembles long-standing degeneration of the plantar fascia near its attachment.” 

Statement by James Speck¹ who has a master’s degree in physical therapy and a special interest in understanding injuries

Possible causes of the condition

• Repeated strain on the fascia may cause small tears that lead to pain
• Heel spurs, with new evidence, are unlikely to be a cause of fasciitis and seem to develop due to compression
• Excessive pronation leads to extra weight on the fascia
• Tissue degeneration in areas that receive poor blood supply 

Risk factors

• Decreased ankle dorsiflexion with a normal flexibility range being 20 degrees.
• Increased body weight (BMI) in non-athletes

The above risks lead to increased strain on the arch and increased pressure/compression on the heel. Muscles and ligaments in the arch are then unable to balance body weight.

Shoes

• Limit the natural movement of the foot
• Prevent/limit muscle activity
• Hold the plantar fascia in a stretched position
• Reduce circulation to the bottom of the feet

Shoes are generally too rigid with a toe box too high above the ground. This restricts the activity of intricate muscles in the toes. The foot forced into this rigid ‘container’ leads to

• Strong reduction of the gripping action of smaller toe muscles
• Prevention of the shock absorption capacity of muscles and the plantar fascia
• Prevention of muscle contractions to support the arch
• Possible reduction of circulation

As toes are not working as intended, it is possible that their restricted movement may lead to degeneration of either the plantar fascia or the tendons.

Walking barefoot allows all muscles to grip and stabilize the arch. When all these muscles are strong, the plantar fascia is more flexible and lengthens with the complex movements of the foot when walking and/or running.

The arch of the foot is naturally elevated to create space for the nerves and blood vessels that pass through. Arch supports found in shoes more often than not put undue pressure on this area reducing blood flow and inhibiting free muscle movement.

Conclusion one

James Speck reports that plantar fasciitis is not caused by

• Inflammation
• Wearing shoes that don’t have enough support
• A tight plantar fascia
• Running or standing a lot

It is rather caused by a combination of:

• Heel compression where body weight is carried by the heel instead of the whole foot when standing
• Excessive stress put on the foot due to decreased ankle flexibility, pronation and carrying too much weight
• Rigid shoes reducing muscle activity which in turn reduce the plantar fascia’s ability to absorb shock
• Weak foot muscles

Treatment

The aim of a treatment is to

• Reduce compression of the heel by changing the standing position
• Take weight off heels and spread this evenly from heel to toe
• Wear more flexible shoes with a low heel
• Exercise
• Increase barefoot activity
• Increase ankle flexibility
• Strengthen muscles in the foot and leg
• Stretch and massage legs and feet

In my 15 years of clinical experience²,  the following treatment techniques have proven to be successful

• Foot mobilisation uses gentle techniques to increase flexibility in the ankle and foot and stretches muscles and tendons
• Reflexology massages the muscles at the base of the feet loosening them up so they can stretch better. Blood flow and nerves are stimulated
• Massage loosens and stretches muscles and tendons

Exercises to strengthen the feet

Here are a few examples of how to strengthen the complex muscles in the feet

• Picking up small items with the toes
• Walk on soft (beach) sand and make the feet work
• Standing on toes, raise heels as high as possible, hold and lower slowly, repeat several times
• Stand on the toes and walk a few steps
• Stretch toes out like a fan, sideways and forward
• Roll arch of the foot gently over tennis ball or golf ball, this loosens up the muscles in the arch of the foot

This video shows a great quick routine that can be performed daily: 

Conclusion twoPlantar fasciitis is the result of the wrong kind of pressure on the heel and treatment needs to concentrate on the entire foot to evenly carry body weight and to encourage a healthier function of the whole foot.

References

1. Speck, J. (2013). The real cause of plantar fasciitis. Retrieved from

     http://www.somastruct.com/cause-of-plantar-fasciitis/
2. Hilarius-Ford, A. Orthopractic foot mobilisation. Retrieved from
    http://annehilariusford.com.au/services/footmobilisation

PMS and the debilitating PMDD

The Age, 2 February 2014

“It can leave sufferers bedridden, unable to work and suicidal. But should extreme premenstrual syndrome be categorised as a mental disorder? By Amy Molloy.

"WHEN THAT TIME COMES AROUND, I CAN'T CONTROL MY BEHAVIOUR OR MY EMOTIONS."

This is the opening of an article in The Age about how PMS, in this case better described as premenstrual dysphoric disorder (PMDD), can seriously affect women every month to the point where they cannot function. The faculty of medicine, nursing and health sciences at Monash University reports that 90% of women experience at least one symptom during their menstrual cycle, from feeling uncomfortable to gaining weight. A small percentage, 3 to 9%, experience debilitating symptoms where they cannot control their lives. This brings about a host of symptoms such as not being able to control behaviour, feeling worthless, useless and a terrible person. Last year PMDD was recognized in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.1

Research conducted in India concluded in 2009 that 54% of women with suicidal tendencies were menstruating at the time against 6.75% in the control group.1

The danger of having PMDD classified as a mental disorder is over-prescription and the use of antidepressants. The other danger is that lifestyle is overlooked such as diet and the use of beauty products.

Diet and lifestyle
As with any hormonal imbalance such as fertility issues, conception, it is recommended to look at one’s diet. It is advisable to reduce the intake of sugar, caffeine and alcohol and drink enough water. It is recommended to include healthy fats, such as avocado, coconut oil and olive oil (not heated), in the diet as hormones are made from fats and proteins and they need fuel1.

Beauty products
Moisturizers and other products applied to our skin penetrate the skin and enter into the muscle tissue and blood stream. Some of the components effect the functioning of our body and as Fertility specialist Nat Kringoudis mentions, they may contain toxins that mimic oestrogen and cause a hormone imbalance1. Check out the ingredients in your beauty products, soaps and shampoos; the skin is our largest organ and is permeable. Today there are many brands available that use natural ingredients.

The role of reflexology
Stress needs to be reduced and this is where Reflexology excels. It is also a great tool to balance hormones in the body. I don’t personally know anyone who suffers from PMDD so have not worked with anyone presenting with these symptoms. I have however worked with women with strong PMS symptoms as well as with menopausal women. My experience shows that reflexology lightens symptoms to the point where women no longer have extreme symptoms experienced before having reflexology. One menopausal woman was changing her bedding at least once every night if not twice due to extreme sweating. After a couple of treatments, this was no longer the case. She also felt better during the day with lasting improvement.

Conclusion
Research done by Dr Terry Oleson, Psychobiologist, and Bill Flocco, Reflexologist, supports that reflexology is effective in the treatment of PMS2 and I would suggest that, together with medical treatment, reflexology could offer support to those women who have been diagnosed with PMDD.


References
1. Molloy, A. (2014). Women’s trouble: Should extreme premenstrual syndrome be categorised as a mental disorder? The Age. Retrieved from http://www.theage.com.au/lifestyle/womens-trouble-20140128-31knc.html
2. Oleson, T & Flocco, B. (1993). Randomized Controlled Study of Premenstrual Symptoms Treated with Ear, Hand, and Foot Reflexology. Obstetrics and Gynecology, 1993;82(6): 906-11. Retrieved from http://www.reflexology-research.com/index.php/what-is-reflexology/reflexology-information/reflexology-research/a-z-list-reflexology-research-abstracts-update/pre-menstrual-syndrome

DISCLAIMER: Please note this article does not replace medical advice. Please consult with your medical doctor, naturopath and/or Chinese doctor if there are any health concerns.

Reflexology and Foot Mobilisation Technique: great combination for all ages

Reflexology and Foot Mobilisation Technique (FMT) benefit all, including athletes and the elderly

Besides reducing stress and having all round physical and mental benefits, Reflexology stimulates nerves, blood flow, muscles and tendons in the feet. FMT creates space within joints in the feet, increases foot mobility and flexibility, and improves weight bearing and posture.

The foot

Each foot has 26 bones, 33 joints (of which 20 are actively articulated) and approximately 7,800 nerves. Tendons and muscles are attached to the bones. It is said we take an average of 10,000 steps a day.

Physical activity

Human beings are meant to be active and the body copes very well with pressures put on feet and joints. Exercise slows and/or prevents injuries as it helps to maintain balance, strength and flexibility. In today’s world however, many life styles are more sedentary resulting in poorer recovery from the occasional exercise routine. Landing hard on their feet, athletes have bodies that are conditioned to absorb this shock and the resulting vibrations working themselves up the body. The elderly, due to loss of general flexibility, may be restricted in their activity as gradual stiffening of the joints limits their range of movement. Gait changes and increased joint stiffness often lead to decreased confidence, which may cause injury.

Injury

When strained, a muscle may be contracted long enough to pull on the bones within a joint. The body adjusts itself by contracting other muscles to accommodate for the change in alignment. Nerves pass on information that something is not quite right; for example, the pain in a sprained ankle will prompt us to realign our body to avoid the pain. This puts undue tension on muscles and tendons in the direct and wider area of the injury.

Reflexology and FMT

Reflexology and FMT combined in a treatment are great tools to help the body function better and within its own limits. Nerves are stimulated, and muscles are warmed and stretched.

Reflexology through specific techniques

• ·       Warms and loosens up muscles in the feet
• ·       Allows the body to deal with inflammation
• ·       Loosens up tight muscles in the body
• ·       Brings nutrients to all muscle tissue

FMT through painless and gentle mobilisation:

• ·       Breaks down fibres around stiff joints restoring range of movement
• ·       Creates space within joints effectively increasing mobility, flexibility and strength
• ·       Muscles and tendons realign
• ·       The body benefits giving:
• o   Everyone better weight bearing and posture
• o   Athletes a more effective use of energy for performance, working from a stronger base
• o   The elderly higher confidence whilst in motion

Conclusion

Both techniques are very useful, Reflexology balances the body’s functioning and FMT creates space and improved mobility within the 33 foot joints. The increased range of movement is very useful for anyone as the foot is more agile, fluid and responsive. Athletes are able respond to quick changes in direction and intensive loads on the feet are better tolerated, overall performance is improved. The elderly are more confident on their feet and thus can go for longer walks, which improves mental and physical health as well as independence.

References

Jedynak, T. (2012). An introduction to the principles of Foot Mobilisation Techniques. Podiatry Now

Jedynak, T. (2007). Foot mobilisation techniques (FMT) for reflexologists. Course material

Johnson, L. Learn orthopractics. ANZ College of Orthopractics. Course material.

Ticklish feet? Reflexology's different approaches

Many people are hesitant to have Reflexology as they have very ticklish feet. In my 14 years as a practitioner and a few years of student supervision, I have only ever seen two people who found it difficult. One made me chuckle as she had trouble suppressing her laughs during the treatment. Who says you cannot have fun whilst working!

Each part of the body is a microcosm of the whole, this means that when someone’s feet are too ticklish Reflexologists have a few options.

Over time, the hands, the face and the ears have all been mapped out and are very effective in their own way.

Hand Reflexology 

Each hand, as per the attached picture, represents half the body. The right side of the body is to be found in the right hand and the left in the left hand. Many Reflexologists use the hands for ‘homework’. The client goes home having been shown which parts of the hands to work in between appointments.

Auricular therapy

As the attached photo shows, the whole body is represented in the ears with the head ‘in’ the earlobe and all the internal organs located in the hollow of the ear. Are you suffering from back pain? Work the cartilage ridge on the ear lobe, find the tender spots and work them several times a day.

Facial Reflexology 

When it comes to the face there are many projections of the body on it. The attached diagram shows but one-way of looking at it. Again, a sore back can be worked by massage the top of the nose from the tip to in between the eyebrows.

Of course, all of the above methods or a combination of these can be used during a treatment. It will vary from practitioner to practitioner and from client to client.

So, do you have ticklish feet? Have a go at experiencing Reflexology, as you can see there is more than one way to experience this amazing treatment.

Reflexology and prevention

Reflexology by its nature is a wonderful tool for health prevention as it works from the inside out. It

has been demonstrated over the last few decades that the body’s natural healing resources are stimulated¹ during a Reflexology treatment resulting in all functions of the body to become more balanced, including hormonal function. Reflexology helps lift one's mood which encourages us to be more proactive in our well-being.

The following statement though struck a chord:

''There's a waiting list for treatment, but there's no waiting list for prevention'' says Melbourne University's Professor Rob Moodie².

After a heart attack, about 40% of patients do not follow their doctor’s advice to change their lifestyle². We have become complacent in the face of Western medicine, and believe that medical science will take care of all our ills and can fix us quickly without too much hassle.

The media is partly to blame as it reports the unusual and the extreme such as an IVF Mum at 50 and some research that led to a major breakthrough. Along the way the heart broken couples that gave up on a family and the serious affects of disease are not mentioned.

Asked what caused their illness, most people mention stress, it is an outside contributor so there is no need to take responsibility as stress ‘cannot’ be controlled and let’s face it, not only do most of us have stress at some stage in our lives but it is also invisible, so, easy to blame.

Lifestyle is a huge contributor to our ills. Advertising promises delicious foods and drinks that will enhance our lives. Our taste buds have been conditioned, and to be honest we have become addicted to the added ingredients, such as salt and sugar, to make the food taste good.

Taking responsibility for our own health

Are we ready – and encouraged – to look at prevention? Change the way we eat and exercise? Are we ready to put the effort in? It is said that it takes 21 days to change a habit.

We can be ‘pro-active in prevention’ by eating healthy, simple foods and by exercising. These steps do not need to take hours in the kitchen or in the gym. Simple, healthy meals do not take long to prepare and walking can be pleasurable by adding a sense of fun, ask a friend to join you and/or chose an interesting walk.

Feeling better

The production of the ‘feel good’ hormones such as endorphins, serotonin and dopamine are released after exercise and eating a healthy diet. These hormones make us feel happier and they reduce anxiety and stress. The body also feels more energetic. It is worth trying for at least 21 days, the time needed to change a habit!

Support

Last but not least, have regular treatments that will enhance your well-being, Being a Reflexologist, I certainly advocate receiving these treatments regularly as it supports body and mind which lift the spirit which in turn can motivate to implement healthy changes. Other treatments that are very beneficial are, to name just a very few: Reiki, massage, acupuncture and a nutritionist advises on a healthy, balanced diet. 

Conclusion

If prevention were well done, you would never know if a specific problem would have appeared¹.

References:

1.     Kruchik, M. Maternity Reflexology. Retrieved from http://www.maternityreflexology.net/?categoryId=4337

2.     Dunn, A. (2013). The Age. Retrieved from http://www.theage.com.au/comment/taking-note-of-the-me-in-medicine-20130802-2r4zc.html