Saturday, June 19, 2010

Plantar Fasciitis, Part 3

If you develop PF on only one heel, then you probably are imbalanced, left-to-right. Having PF on only one side doesn’t necessarily prove that you have an imbalance left-to-right, but it does look suspicious and should be checked out. This may be a contributing cause of the specific case of PF.
If pain is too debilitating, soft padding and springy arch supports may provide relief. This may be necessary in the worst stages of PF, but it should be kept in mind that orthotic remedies are very similar to cushy running shoes which lead to PF in the first place. Use shoe and orthotic remedies with caution. If your arch has failed (past-tense) then you have no choice. You must rebuild the arch. Muscle strengthening alone will not be sufficient. You must use both strengthening and structural support. There’s not just plantar and muscle change that must take place. You must also reshape the cartilage of the arch. This is not a quick process, and can take four years of therapy in the worst cases. Without therapy, it simply will never go away. If pain ever goes away, it will be after scarring and arch failure, and the patient simply gets used to the failure. This type of failure means the natural mechanical benefits of the arch are forever gone.
The first part of your strategy should be to stop aggravating the injury. This may involve complete inactivity for a period of months.
Return to the basics of proper running mechanics. Develop proper “spring” and elasticity, and strengthen the muscles of the feet and ankles. Also practice proper weight transition through your stride, making sure your arms, body and legs – your entire center of gravity – are properly positioned at all phases of your stride. Foot muscles should be strengthened for shock absorption and smooth control, but the best shock absorption of all is “free elastic energy” response from limber, healthy stretched muscles and tendons.
Never over-stride. The foot should land directly beneath the center of gravity. The foot should have very short ground time. Long strides should be achieved through air-time, rather than leg reach. Improving natural bounce is essential to remaining injury-free.

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