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PAIN; How to use it as a tool

Posted by Mike W on 3/22/00 at 00:00 (017669)

Hello PF board readers,

I do not like pain as much as the the next person. We are lucky in some ways that we have so many options to help deal with it. I feel for those who are forced to use pain pills on a regular basis and hope that the following will provide some useful ideas regarding how to use pain as a tool.

It is very easy to blame Doctors when treatments are ineffective. The problem in my opinion is that most patients go to their doctors with the belief that if they can get rid of the pain(symptoms) then the problem will be solved. Doctors are trained to get rid of the pain (symptoms)and most traditional treatments focus on this. Instead you should ask them how you can address the underlying cause and then develop a game plan of action. If they won't do this try to find one that will.

The traditional definition that pf is an inflammation (pain) of the plantar fascia is a defintion of the symptoms.

My definiton of the the underlying physiological cause is; pf is a repetitive strain condition caused by repetitive strain on any one of the 28 muscles and their related tendons at the point where they attach to or pass through/around the heel or toe bones.

Pf is a disorder that requires the patient to be active in their rehabilitation and because you are at a site like this you are doing just that.

Pain is our bodies signal that tells us exactly where the problem is.
Because there are so many muscle/tendon attachment points the areas of pain will be located differently from one person to the next.

How to use stretching and strengthening to address the underlying cause and deal with a painful area:

Most people are afraid to exercise a sore area because they think that
they will do additional damage. This is true especially if the muscle is shredded or the tendon is partially ripped or the bone is fractured.

What you can do is stretch and strengthen the opposing muscle that is not injured. This technique is called muscle facilitation/inhibition which means that if you contract the opposing (non painful)muscle/tendon you will automatically relax the painful muscle/tendon and do no harm to the painful muscle/tendon.

This may sound difficult but it is really quite easy. Determine where your pain is, for example at the base/bottom of the big toe. Therefore if you contract the opposite muscle at the top of the big toe you will automatically relax the sore muscle/tendon at the base/bottom.
My booklet shows in detail the main musle/tendons pairs.
If you want to look at some good basic LL leg anatomy pictures go to my link heelspurs.com/a/pft or if you have a question email me at (email removed)

What is friction massage and how can you use it to deal with pain;

It is my opinion that many people who have pf concentrate on dealing with it when maybe the real cause of their pain is a heelspur or bone spur in the ball of the foot or they have adhesions that have built up over time on their tendon sheaths(the cause of that popping or grinding noise). Friction massage is the one option the others are do nothing, ESWT or surgery.

Friction massage for bone spurs is very simply deep concentrated massage on a painful area that wears the bone spur down so that it no longer rubs against the tissues of the foot and causes the pain.

You can have this done by a physiotherapist or do it yourself. Friction massage can be very painful and if you use a physiotherapist like I did you probably won't go back (but you can learn exactly how it is done like I did). It is something that has to be repeated several times per day over a 5-7 day period to be effective.

The advantage of doing it yourself is that you can find where it is very easily and you can control the amount of pressure so you can start softly and gradually increrase the pressured it is free.

Because friction massage requires deep pressure your fingers are not generally strong enough and you could injure them. I use a device I made called a T-bar which is simply 2 wooden dowels attached with a rubber cap on one end. It is very effective for massaging other parts of the body as well.

I sent one to Scott to add to my link for those who want to buy one ask him to list it or if you want email me and I will send you one or describe how you can make one yourself. You could also use other things like the top of a pen.

Direction on how to perform a friction massage;
Sit in a chair with your back supported.
Cross one leg over the other knee and use one hand to massage and the other for support.
Take the rubber pad off the T-bar and probe the bottom of your foot/heel until you find the most painful spot.
Massage this spot for 2-5 minutes, starting very gently and gradually increasing the pressure. Pain is going to happen but you can control how much.
Next apply ice directly on this spot for about 5 minutes.
Relax for 5-10 minutes.
Repeat this 2 times per day for 5-7 days or until the pain is gone from this spot.

I hope this information helps.

Regards,
MIke Wilmot, Physical therapist, Principal Personal Foot Trainers, and former chronic sufferer of PF and heelspurs. Email maxhealth@nucleus.com


Re: PAIN; How to use it as a tool

BJC on 3/22/00 at 00:00 (017672)

Mike, I've been having some difficulty with some of what you've been saying over the past few months. I feel that your scope of PF is too narrow, and your explanation is too simplistic. I've been having difficulty thinking this through, so I have not responded, but you seem to have gone one step further with the device for friction massage, so I think it's time to at least throw this out for discussion.
I agree that PF is (often) caused by repetitive strain. PF, by simple definition, is inflammation of the plantar fascia. As I interpret this, this inflammation may cause pain, which in turn may cause abnormal patterns of movement which may affect the strength and stability of certain movements. Where I have trouble with your remedy, however, is that I hear you say that all 28 muscles and tendons should be strengthened equally. I don't believe that opposing muscle groups are necessarily equally strong. For example, the biceps muscle needs to carry an additional load to work against gravity than the tricep, which works with gravity. When dealing with the foot, which I will admit is not my area of expertise, I would need to know the relative strength requirements of each group, be able to accurately measure the strength/weakness of each, and be able to isolate those movements to strengthen. And once this is done, how does that resolve bone spurs, thickened fascia, etc? I'm not sure I can buy into the 'massage-away-bone-spurs' theory - we're talking calcium (bone) build-up. While your methodology may work in some instances, I think there is much more to the picture. As a licensed professional, I also have some difficulty with the prescription and exercises and modalities offered over the internet. This is getting awfully close to practicing without a dr. referral/prescription (a requirement for most PTs in the US). This board is offered for sharing experiences and opinions of the posters, and to provide a resource for treatment aids, but medicine should not be practiced here. I'm also having difficulty with the dismissal of surgery as a viable alternative. It is one of many treatment modalities that can/should be considered by a dr. and patient to meet the specific needs of the individual.

Re: PAIN; How to use it as a tool

Mike W on 3/22/00 at 00:00 (017697)

Hello BJC,

I am on my way out of town. I will respond to your post when I return next week.

Regards
MIke W


Re: PAIN; How to use it as a tool

BJC on 3/22/00 at 00:00 (017672)

Mike, I've been having some difficulty with some of what you've been saying over the past few months. I feel that your scope of PF is too narrow, and your explanation is too simplistic. I've been having difficulty thinking this through, so I have not responded, but you seem to have gone one step further with the device for friction massage, so I think it's time to at least throw this out for discussion.
I agree that PF is (often) caused by repetitive strain. PF, by simple definition, is inflammation of the plantar fascia. As I interpret this, this inflammation may cause pain, which in turn may cause abnormal patterns of movement which may affect the strength and stability of certain movements. Where I have trouble with your remedy, however, is that I hear you say that all 28 muscles and tendons should be strengthened equally. I don't believe that opposing muscle groups are necessarily equally strong. For example, the biceps muscle needs to carry an additional load to work against gravity than the tricep, which works with gravity. When dealing with the foot, which I will admit is not my area of expertise, I would need to know the relative strength requirements of each group, be able to accurately measure the strength/weakness of each, and be able to isolate those movements to strengthen. And once this is done, how does that resolve bone spurs, thickened fascia, etc? I'm not sure I can buy into the 'massage-away-bone-spurs' theory - we're talking calcium (bone) build-up. While your methodology may work in some instances, I think there is much more to the picture. As a licensed professional, I also have some difficulty with the prescription and exercises and modalities offered over the internet. This is getting awfully close to practicing without a dr. referral/prescription (a requirement for most PTs in the US). This board is offered for sharing experiences and opinions of the posters, and to provide a resource for treatment aids, but medicine should not be practiced here. I'm also having difficulty with the dismissal of surgery as a viable alternative. It is one of many treatment modalities that can/should be considered by a dr. and patient to meet the specific needs of the individual.

Re: PAIN; How to use it as a tool

Mike W on 3/22/00 at 00:00 (017697)

Hello BJC,

I am on my way out of town. I will respond to your post when I return next week.

Regards
MIke W