Plantar Fasciitis

I have recently had plantar fasciitis – the second time I’ve experienced it. The first time, the acupuncturist managed to get rid of it in 3 weeks, and the current version seems to be taking longer, but now seems to be disappearing very slowly after about 6 weeks.

This time was a bit worse, but I’ve found the unpleasant experience to be a good learning curve, and I’ve gleaned some good ways of dealing with the problem.

Plantar Fasciitis seems to be very common, so if you have it, perhaps this longer-than-usual blog will help.

The Anatomy

There should be a gap between the bone and the fascia of the foot:

When the arch drops, it stretches the fascia causing more pressure to be placed on the plantar fascia ligament.

This isn’t necessarily the reason that you personally have it, or have had it, but is possibly one of the reasons that it happens.

Why does it happen?

No one is 100% sure what triggers plantar fasciitis; there are a number of suggestions such as:

1) overuse, or

2) hitting a hard surface too hard with the heel when walking, or

3) dropping something on the top arch of the foot which causes the fascia to overstretch suddenly and tear, or

4) it can also be a collapse (perhaps slight, or maybe more) of the main or transverse arches of the foot.

5) grinding the foot into the ground when simultaneously turning it, or

6) water retention in the leg and foot, which increases the pressure in the sole of the foot, not allowing it to 'breathe'.

Runners and athletes seem to be particularly susceptible to it.

Where does it hurt?

This can vary from the front of the heel (as in the picture at the top), but can also be on the ball of the foot. In both cases, the pain can refer towards the arch, and up into the ankle and back of the calf.

Things that make it worse:

1. Walking – any pressure on it… this includes teaching tai chi & qigong, i.e. being on your feet for extended periods.

2. Keeping the foot still for too long, e.g. sitting down, and in particular, getting out of bed first thing in the morning.

Inflammation

Plantar fasciitis is usually an acute inflammation of the plantar fascia, usually (but not always) on or close to the heel.

It manifests as pain when walking and putting any pressure on the foot, in particular the heel.

We need inflammation

We tend to think of inflammation as being a bad thing, but you need inflammation, it isn’t only something annoying. When you damage cells, or something irritates the body, or you are attacked by pathogens (an organism or agent that produces disease), the body produces inflammation as part of the healing process, and without it, the body might not be able to heal itself, or at least, not as quickly…

We’ve all had inflammation; the symptoms can be heat, pain, redness, swelling, and/or loss of function.  

In the case of plantar fasciitis, you might feel a burning/sharp sensation, particularly when walking on it; it may or may not be red externally; there is an internal swelling; walking is difficult.

In order to heal itself, the body retains water in the affected area to cool the area; this causes the tissues of the foot to swell slightly and puts more pressure on the fascia so that, when walking, you are compressing & squeezing that area more than usual.

Energetically

There is another aspect to this though.

By producing heat and discomfort in the area, the body diverts more energy for repair to that area – in the same way that, when you hit e.g. your elbow, you rub it, therefore increasing both the blood flow and energy to that area.

Hot weather and plantar fasciitis

My acupuncturist tells me that, with the hot weather, she has had an influx of patients with plantar fasciitis and that the majority of them have water retention in the ankles and lower legs (see ‘legs up the wall’ below).

This creates more pressure in the feet, and can lead to inflammation of the facia.  

Possible coping mechanisms to alleviate the problem:

The information below is what I’ve discovered during appointments with my acupuncturist and cranial osteopath, as well as having reflexology almost every day.

By themselves, the methods below might or might not help. Most of them are not ‘cures’ in themselves but are contributory factors which hopefully will ease the situation, and help to alter it and move it along. I have spoken with many people who have had the 'condition', and it seems that there wasn't ONE particular treatment that solved the issue for them, and many people said that it simply 'went away'.

• Bend the arch back into shape. Take hold of the foot (on your lap), and use your thumbs to re-educate the muscles – with caution…

There is a problem with this:

In order to do it, most people will put the foot on top of the other thigh close to the knee. If you have very flexible hip joints, this is okay, but, if you don’t have hip flexibility, when ‘reshaping’ the foot, you can inadvertently bend the ankle inwards, causing compression on one side of the ankle, and over-extension on the other side. The ankle can therefore become misaligned.

This destabilises the foot, and ultimately it will take the foot longer to recover because the pressures rising up the leg, when you put your weight on the foot, are altered.

A better way to reshape your foot is to use the floor. The 1st picture is a little extreme!

• Soaking your foot or feet to increase the blood flow:

Put 2 x tablespoons of sea salt, 3 x tablespoons of cheap red vinegar, and grate some raw ginger into a bucket.  Soak your feet in the bucket – as hot as you can handle, and wait until the water cools whilst you watch TV/emails/book etc.

• Moxibustion on the afflicted area (if you happen to have any moxa!)

and then…

• Ice-pack: After soaking the foot/feet, ice-pack the foot for as long as you can bear; this is to squeeze/contract the tissues/cells so the lymph is forced to move. You can do this with your feet up the wall, balancing the icepack on the heel/sole (see below).

• Legs up the wall: Put your legs up the wall so that the lymph can drain more efficiently (15 minutes or whatever you can manage); every now and again, hit your legs with a loose fist (or both) moving in the direction of the ankle towards the body (see below).

• Strike the kidney channel: Whilst your legs are up the wall, strike the inside of the leg between the calf muscle (gastrocnemius) and the tibia (main calf bone) with the tips of the fingers bunched together.
  

  

  
  

Start in the area approx. 2″ above the ankle bone, and strike up the leg towards the thigh, for a further 3″.

This can help to move and reduce the water retention.

Follow the orange dots where it says KD7, 8 & 9.

Reflexology

This has been a very interesting experience. I don’t know if it’s because I have been having this almost every day, but for me it has been extremely beneficial.

Aside from just massaging and stretching the inflamed fascia of the foot, my reflexologist used what is called a ‘linking technique’ in order to cause tension in the fascia to be released. Two apparently unconnected points are touched very lightly for a while (e.g. it might be the tip of the big toe and the heel or ankle of the same foot).

This has had a very positive effect on the fascia, and whilst the ‘linking’ was taking place, I experienced a shuddering/tremor along various pathways in the foot and leg, in my case up to my hip, although I suspect that this could even rise to the neck.

I do it in this order:

1. Hot soak

2. Feet up the wall simultaneously with ice-pack occasionally striking the Kidney channel.

3. Occasional moxa.

4. Reflexology.

Other things that alleviate it are:

Stretching the foot from the ball, e.g. when you’re going upstairs, or you can put your hands on the wall, leave the problem foot at the back, and bend your back knee.

What definitely helps to ease it is sitting on a chair where I can put my right leg (the painful one) slightly behind me, resting only on the toes.

A hard ball under the foot:

Tubigrip

Cut off a length of elasticated Tubigrip, rolling it into as many layers as you like to increase its strength and elasticity, and then wrap it around the transverse arch of the foot, i.e. from the ‘knuckle’ of the big toe, to the ‘knuckle’ of the little toe.

In other words, re-shape the transverse arch of the foot – if you like, do it overnight.

As an additional tool it helps, but like everything else, there’s no single answer.

Acupressure

In acupuncture/acupressure, because of the way in which some of the fascial ‘trains’ cross the body diagonally, you can use the hand to relieve the foot on the opposite side.

The ‘heel’ of the hand relates to the heel of the foot.

In the attached picture, this is my left hand, and the area circled is where you hit hard with the fingers bunched together to relieve the right foot.

For me, this works sometimes, but not all of the time.

Homeopathy

There are various remedies that might help with the condition. Remedies in homeopathy are very specific, and largely depend upon the symptoms; there is not really a cure all in homeopathy.

The remedy that is mainly mentioned (and fits with my particular condition) is Rhus Tox, but there are many others. Like all homeopathic remedies, it's best to consult a homeopath before moving on to what is referred to as 'higher potencies', and the length of time that you continue to take the remedy can also be important - you can actually create the symptoms if you go on taking it for too long (called 'proving' a remedy). Some of these, usually in low potencies (6c, or possibly 30c) can be bought at a local chemist. If you would like advice, both Helios and Ainsworths will usually be able to help out.

Some of the remedies are:-

Rhus Toxicodendron (Rhus Tox) - this is what I am currently using

Ruta Graveolens

Calcaria Fluorica

Ledum Palustre

Pulsatilla (Nigricans)

Berberis Vulgaris

Bryonia Alba

Valeriana Officialis

Ibuprofen gel

I’m a bit anti this one, but I have experimented with it.

It involves putting the Ibuleve gel on the affected and painful area before going to bed, wrapping it up with a couple of circuits of clingfilm, putting a sock on, and going to sleep with all that in place. Very attractive!!!

It helped a little, but I’m not keen on doing it too much, mainly because inflammation is there to heal you, so why get rid of the inflammation? The gel is not going to do any repair work as such, although it might alleviate the pain (see ‘Pain’ below).

Shoes

The market for shoes has developed a variety of trainers and other types of shoe to help with plantar fasciitis. I have just bought a new pair of trainers both for teaching tai chi and qigong and for everyday use outside.

The ones that I have bought have much more cushioned heels, and a slight arch support (but see immediately below also). The cushioning undoubtedly makes walking better compared to my usual shoes. You can also get gel heels, which might help (see right).

Things to watch out for when buying trainers: 1) Running trainers are not flat-soled, such as barefoot shoes. This means that, if you move the weight towards the ball of the foot, you 'tip' forwards (which would be useful if you were running); this is not helpful with either tai chi or qigong! 2) The height of the heel and the ball of the foot are often not the same. Again, this is good for runners and athletes, but not so good if you are going to either stand still, or do tai chi and qigong.

Insoles in the shoes

I mentioned to the osteopath about insoles in the shoes.

He’s very against them. 

His view is that they work for a while, but, as you can see in the first picture at the top of the blog, there should be a gap between the fascia and the bone; you need that gap, and if you get the habit of wearing insoles, the fascia eventually becomes overstretched.

If you then stop using the insoles, the fascia is overstretched and is too long, and the arch of the foot no longer has anything to keep it arching. It can therefore collapse.

This is not what podiatrists are taught…

Pain

You can read about this in lots of books, but I’ve found it very helpful to ‘go with’ or ’embrace’ the pain. Sounds a bit hard line, I know!

In other words, instead of fighting it when it’s uncomfortable, it is interesting to allow the pain to be, accepting it as part of the healing process.

It’s an interesting experience; it seems to diminish, and becomes part of the new ‘you’. It’s to do with not trying to stay as you were, and allowing things to change; any fighting of pain being a form of tension or resistance to change.

It embodies the expression “what you resist, persists”.

Magnets

Sometimes described as a ‘pseudoscientific’ therapy, I personally have found that a strong magnet, placed on the point of pain, helps.

No one seems to be sure why it might help; some say that it influences the natural magnetic and electrical fields of the body, others that the magnet will draw the blood to the problem area because of the iron in the blood.

Whatever the reason, it works for me. You just attach the magnet with some micropore plaster.

If you think it’s ‘just a placebo’, but it helps – why not use it?!…. Unless you have a pacemaker, insulin pump, or are pregnant.

Finally

A very interesting phenomena took place whilst sorting out my Plantar Fasciitis.

I know that for some this will be a fairly revolting thought (I'll spare you a photograph!), but the heel of the affected foot, and only that one, developed a very thick layer of protective skin – the other heel was completely unaltered.

The skin was like leather, went a yellowish colour, was extremely smooth like an eggshell, and gradually cracked slightly but without any discomfort. It formed this skin layer ONLY where there was pain, and nowhere else.

When the foot began to recover, this thick layer of skin immediately began to fall off.

Extraordinary how the body looks after itself!

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James Drewe teaches Tai Chi and Qigong in both London and in Kent and online.Details of weekly classes both live and online can be found on the website, and there are classes for 2-person Tai Chi on one Saturday a month.There is also learn both tai chi & qigong through a monthly subscription, and there are many free videos on YouTube.

CONTACT:

http://www.taiji.co.uk

https://www.qigonghealth.co.uk

Email: taijiandqigong@gmail.com

Phone: 07836-710281

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