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Physical Therapists' viewpoint

Posted by Scott R on 1/21/01 at 16:59 (037014)

I received this email recently. What do you think about this viewpoint?

Dear Scott,
The problem of heel spurs(heel pain) involves first correcting the posture of the lower extemity,which starts by aligning the pelvic joints, which in most cases is an outflare of the ilium at the sacroiliac joint on that side. Once that is achieved, then the sacrum must be balanced, the Piriformis, iliotibial fascia, Soleus and plantar fascia released and the 1st tarsometarsal, ankle and foot joints mobilized. If you have a P.T. friends share this with them and they can hopefully give you more insight.

Re: Physical Therapists' viewpoint

Dr. Zuckerman on 1/21/01 at 17:22 (037018)

I have realized over the years that there shouldn't be an isolated treatment for heel pain. Never leave out a complete history of the lower extremity and involve and think about all of the healing physicians including especially physical Therapists and Chiropractic Physician.

I don't mean to leave out any the other healing arts

Re: Physical Therapists' viewpoint

Nancy N on 1/21/01 at 17:56 (037027)

You know, this sounds a lot like the idea expressed in the book Pain Free, by Pete Egoscue. He's a PT, and says that the problem is in the alignment of the lower body. He doesn't go into as much detail as you listed above, so I can't say for sure that it's an identical theory. It's an interesting idea, though--I've been doing 3 of the 4 exercises he recommends for foot pain in the morning (I don't have the equipment to do the fourth). It certainly hasn't made me any worse, and might have helped make me better. It at least stretches out the feet well before I get out of bed--basically, it consists of two sets of foot circles (rotating from the ankle), 30 in each direction, then bringing the foot up and down from the ankle 20 times, and then two stretches--one from the ball of the foot (using a belt, rope, whatever to pull on the ball of the foot) for 30 seconds for the calves, and then from the middle of the foot for 30 seconds for the hamstrings. Then I get up, put on my Birks, and do what he calls the 'air bench,' which is done against a wall in a chair-like position, with your feet directly below your knees, for one minute. There are illustrations in the book--it's hard to really explain unless I quote the book (which I'm willing to do if anyone wants/needs to know). He says that you should work on the feet until they don't hurt anymore, and then go on to work on other parts of your body to make sure everything is aligned properly.

Re: Physical Therapists' viewpoint

Julie on 1/22/01 at 02:17 (037059)

The body is an organic whole; every part of it has a relationship to every other, and everything that happens in one part affects everything else. The first time I posted on the board I said that I, my osteopath, and my pod all considered that my pf problem stemmed from a slight back injury which caused impingement of the sciatic nerve, and I've made the point several times since that our foot problems can't really be considered in isolation.

Different practitioners will look at it differently depending on their training and experience - osteopaths and chiropracters will focus on the spine, Alexander teachers on the head-neck relationship, etc. Yogis and other healers will bring the mind, emotions and spirit into the picture. On the physical plane, the pelvis, which is the centre of balance in the body, is as good a place to start as any. But the bottom line is, as Dr Z says, that treatment for heel pain shouldn't be considered in isolation.

Julie

Re: Physical Therapists' viewpoint

Dr. Zuckerman on 1/21/01 at 17:22 (037018)

I have realized over the years that there shouldn't be an isolated treatment for heel pain. Never leave out a complete history of the lower extremity and involve and think about all of the healing physicians including especially physical Therapists and Chiropractic Physician.

I don't mean to leave out any the other healing arts

Re: Physical Therapists' viewpoint

Nancy N on 1/21/01 at 17:56 (037027)

You know, this sounds a lot like the idea expressed in the book Pain Free, by Pete Egoscue. He's a PT, and says that the problem is in the alignment of the lower body. He doesn't go into as much detail as you listed above, so I can't say for sure that it's an identical theory. It's an interesting idea, though--I've been doing 3 of the 4 exercises he recommends for foot pain in the morning (I don't have the equipment to do the fourth). It certainly hasn't made me any worse, and might have helped make me better. It at least stretches out the feet well before I get out of bed--basically, it consists of two sets of foot circles (rotating from the ankle), 30 in each direction, then bringing the foot up and down from the ankle 20 times, and then two stretches--one from the ball of the foot (using a belt, rope, whatever to pull on the ball of the foot) for 30 seconds for the calves, and then from the middle of the foot for 30 seconds for the hamstrings. Then I get up, put on my Birks, and do what he calls the 'air bench,' which is done against a wall in a chair-like position, with your feet directly below your knees, for one minute. There are illustrations in the book--it's hard to really explain unless I quote the book (which I'm willing to do if anyone wants/needs to know). He says that you should work on the feet until they don't hurt anymore, and then go on to work on other parts of your body to make sure everything is aligned properly.

Re: Physical Therapists' viewpoint

Julie on 1/22/01 at 02:17 (037059)

The body is an organic whole; every part of it has a relationship to every other, and everything that happens in one part affects everything else. The first time I posted on the board I said that I, my osteopath, and my pod all considered that my pf problem stemmed from a slight back injury which caused impingement of the sciatic nerve, and I've made the point several times since that our foot problems can't really be considered in isolation.

Different practitioners will look at it differently depending on their training and experience - osteopaths and chiropracters will focus on the spine, Alexander teachers on the head-neck relationship, etc. Yogis and other healers will bring the mind, emotions and spirit into the picture. On the physical plane, the pelvis, which is the centre of balance in the body, is as good a place to start as any. But the bottom line is, as Dr Z says, that treatment for heel pain shouldn't be considered in isolation.

Julie