Warm Weather Foot Pain
The lazy days of summer are not always good for your whole body. Over the past month there has been an increase in patients referred to our clinic for arch or heel pain, or plantar fasciitis. The plantar fascia is a thick connective tissue that runs from the heel to the heads of the metatarsals, the long bones in the feet. Plantar fasciitis is an irritation or micro-tearing of the plantar fascia of the foot. Footwear changes in the warm weather of summer which can increase the incidence of this condition. A person will transition from the supportive winter boot or shoe to the freeing flip-flops for sunny days. This leads to a sudden increase in excessive stress on the plantar fascia, causes irritation, inflammation, and potential micro-tearing. So, many people will give up there flip-flops and sandals for supportive shoes, which cures the problem. But, plantar fasciitis can be very stubborn, and those are the people referred to our clinic.
There are a few other home treatments that a person can attempt. I would first start with transitioning back to more supportive footwear. People with plantar fasciitis typically have more pain in the morning, so going through a good stretching program before you get out of bed or right after a shower would work the best. This can be accomplished by using a belt wrapped around the ball of the foot and pulling on the belt moving the toes towards your shin. Long stretches are better than short quick ones, so 30-60 second holds would work well. The belt stretch can be performed with the leg straight and bent to stretch both muscles of the back leg and the attachments to the heel. A person can also try using a frozen bottle to roll the foot on, which helps control inflammation and breaks up scar tissue that may have formed from the micro-tearing. Another irritating factor is letting the foot flex down during the night, which leads to the arch shortening. People can use braces or attempt to sleep with boots to control the natural pointing motion of the foot during sleep. There are also special socks with a Velcro strap on the toe to lift the foot up that can be purchased.
If home remedies do not seem to have an effect on the condition, a physical therapist may help. Traditionally, modalities of ultrasound, electrical stimulation, and iontophoresis have been used to help control the inflammation and pain associated with the condition. Current evidence supports these traditional treatments which do not get to the root of the problem, therefore just covering up the problem temporarily. A treatment called ASTYM has been recently used with success. The treatment includes using manual pressure and soft tissue manipulation to re-organize the tissue on the bottom of the foot. The treatment technique basically promotes the natural healing process of the body by stimulating the correct inflammatory response. The ASTYM technique encourages returning normal daily activities as quickly as possible.
So, what do I do next summer? I would recommend transitioning gradually into flip flops and sandals. Avoiding long hikes or walks using only sandals early in the summer may be beneficial. Also, adding calf and arch stretching 1 to 2 times a day if you are prone to plantar fasciitis. Another question may arise, how does this fit into the concepts of the minimalist shoe revolution? This idea suggests that less supportive footwear may be beneficial to developing stronger and more injury resistant feet. As I and shoe companies have recommended start introducing this footwear 10% each week. But, again this concept is not for everyone and particularly individuals with high arches have more difficulties.
If you have questions about the ASTYM treatment please call Baker Valley Physical Therapy, and talk with one of our certified ASTYM therapists. 541-523-8888
Written by Blake Marlia, DPT
Published September 2012