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Jade 168 Balm website

Posted by Dr. Chris Reynolds. on 6/07/01 at hrmin (050136)

If anyone's interested, I set up a website about Jade 168 Balm and PF last night. It's a bit rough, but I think some of the information could be helpful. I really appreciate the incredible amount of feedback, both positive and negative, I received after making just one posting. My knowledge and understanding, particularly of the effects the physical pain has on the quality of life of PF sufferers, has been greatly enhanced and I will be a better doctor for it. I hope we can at least help some of you. Heelspurs.com is a very impressive website, an act I won't even attempt to follow. Nonetheless, we're floating around somewhere in cyberspace at

http://www.wire.net.au/~jastmi/default.html

Re: Jade 168 Balm website

Julie on 6/07/01 at 09:56 (050144)

Hi Chris

Your website looks perfectly nice. What are you apologizing for? And it's interesting. I have two comments:

After I read the 'Ingredients' page and clicked on Home, I got a 'not found' message. But when I clicked on my back button, I got back to Home. You might want to check on this.

In all the 'causes' of PF which you dismiss (heel spurs, weight gain, overstretching etc) you don't mention biomechanical problems, e.g. over-pronation. I'm sure this was a factor in my case, perhaps themajor factor. It has been corrected with custom orthotics and I have improved (there have been other factors in my improvement).

I don't think biomechanical factors can be disregarded - but neither do I think their existence rules out possible improvement by Jade Balm. And I hope Jade Balm helps a lot of people. I look forward to my supply, and the trial.

All the best, Julie

Re: Jade 168 Balm website

Dr. Chris Reynolds. on 6/07/01 at hrmin (050200)

Julie, thanks for your comments and the information. I am no webmaster, but Bill Gates helps me a lot.
I don't think I'm saying I dismiss biomechanical factors in PF. I do doubt that spurs make much difference, and I think most doctors have seen X-rays of large spurs in people with foot injuries who have never had a foot problem. But to say that over-pronation or other mechanical factors are the actual CAUSE of PF is another matter that I have questioned. I think commonsense would tell us that being overweight, overusing the feet etc. would most likely exacerbate an underlying condition like PF. Perhaps I just have a different, if not new, way of looking at the problem. I also appreciate your views on the matter. Healthy debate can only improve our understanding to ultimately help others, which is what I am told doctors are supposed to do. You should have your Jade in a few days.
Kind regards,
Dr. Chris Reynolds.

Re: Jade 168 Balm website

bg cped on 6/10/01 at 00:08 (050365)

I agree spurs are not very often the source of heel pain. I also believe that pain is elicited from a traction force on the fascia. This may seem over simplified but if it is not from a functional source e.g. shoes, wt, pronation, supination, activity as you say, then why does it feel better when off wt bearing and then become very accute when returning to wt bearing?
In our office the vast majority of pf cases can recall either a change in footwear, activity, wt, job change etc.

To make a blanket claim that it is not from many traditional causes and not make an exact claim of what this balm is made of and how exactly it works is questionable. I would compare pf to tennis elbow in a way. When was the last time you had a pt with tennis elbow symptoms that cant list some change in activity that preceded the symptom?

The balm may act as an anti inflam but why does it get inflamed in the first place?

Re: Jade 168 Balm website

Dr. Chris Reynolds. on 6/10/01 at hrmin (050384)

Thanks for your comments. Of course I agree with you that traction and other forces AGGRAVATE the underlying condition, but what EXACTLY is the nature of that condition? By the same token, therapeutic interventions that relieve these exacerbating factors should of course be of benefit to the patient. The last patient I had with a tennis elbow was myself. The pain came on suddenly, was severe and I could hardly move my arm. There were NO antecedent physical strains or stresses, but it hurt like hell. I put a bit of Jade Balm on it and in about five minutes I had a functional arm again, although I could still feel a bit of pain. Another week and it had gone completely. However, I was lucky. Tennis elbow doesn't in my experience respond nearly as well to Jade as PF does, and I think we'd all agree that we'd prefer not to be confronted with too many tennis elbow sufferers in clinical practice.
I do not know how the Jade works - I wish I did, then I could rest in peace! My theory about the immunological nature of PF is based on clinical observations of the effects of Jade on thousands of patients with a multitude of ailments over about five years. In the areas of inflammation, wound healing and hemostasis, it is usually very effective, uncommonly has no effect and sometimes is downright miraculous in the speed at which it can eliminate pain. So when you observe how fast it CAN work, particularly in chronic conditions such as PF, and anal fissure (where it has never failed my patients), then you have to start thinking along different lines to traditional teaching. If the condition is chronic, how can it possibly resolve so quickly after applying a bit of cream over the affected area. I believe the compound contains one or a number of small molecules that penetrate the skin instantaneously which then precipitate a powerful immunological response in the immediate area.
I think I am a reasonably sane individual who trusts his senses. After 30 years in medicine I am not easlily swayed by new therapeutic substances. The Jade certainly did that and I use it every day in my office much to the benefit of my patients.
Why does the foot get inflamed in the first place? I don't know any more than anyone else does. Why do people develop anal fissures? The theories abound, but no-one really knows. I would think there are multiple factors bringing about these chronic conditions. What about alopecia for instance? Exactly why does such an autoimmune conditon develop in an otherwise healthy person? There are so many problems like this in medicine that are difficult to cure, but, like you, we all do our best to help our patients improve their quality of life. If Jade helps even a small percentage of PF sufferers, whether we know how it works or not, then that has to be a good thing.

Re: Jade 168 Balm website

footpro on 6/11/01 at 18:55 (050475)

Heel pain in general may have many causes. It can be plantar fasciitis, entrapment of Baxter's nerve, many arthritidies, stress fracture of the calcaneus. Each of these conditions presents with different symptomatology. It is of utmost for the practitioner to diagnose the problem correctly and not generically diagnoe all heel pain as plantar fasciitis. It is not. Most people with true plantar fasciitis complain of pain on the inferior medial aspect of the heel. The pain is usually greatest after taking the 1st step in the morning. The reason why is that the achilles tendon is a major deforming force which acts upon the plantar fascia. As the tendoachilles inserts on the posterior aspect of the calcaneus, fibers run inferior to the heel and become invested in the plantar fascia. As one rests (sitting or lying down) the tendoachilles keeps the foot plantarflexed and the plantar fascia is relaxed. Once the person takes their initial step, the tendoachilles goes onstretch as well as the plantar fascia. This is when the patient develops pain. As the person walks the pain tends to get better. This is why stretching prior to activity works so well. Some patients complain that they have pain in the heels and that it burns 'all the time'. Nothing helps. They may or may not have a spur. There may not be any pain on palpation of the inferior medial calcaneal tubercle. There is usually pain on side to side compression of the heel that may radiate into the toes or up the leg. This is more diagnostic of an entrapment of the Baxter's Nerve. These may or may not respond to conservative care. Operatively what is typically seen is a abundance of scar tissue in the subcutaneous tissues. The nerve is hardly visualized due to it's small size. Once release of the adhesions is performed a small section of the plantar fascia is incised. These patients tend to very well postoperatively. I've only discussed two of the more common heel pain presentations. Hopefully this will shed more light on the situation.

Re: achilles tendon / plantar fascia connection

Scott R on 6/11/01 at 20:39 (050484)

Both footpro and Dr. Reid have said today that there is tissue that connects the achille's tendon and plantar fascia and that this is the primary reason lack of ankle dorsiflexion in the achillies leads to plantar fascia problems. I would like to disagree, even (actually, especially) if this is what is being taught in DPM schools. The calcaneous, acting as a rigid body connecting and transferring forces from the Achille's tendon to the plantar fascia, is all there needs to be in order for tension in the Achilles to be transferred to tension in the plantar fascia (and vice versa dependon on your point of view). If one were to stand on the edge of a step with the balls of their feet and lower their heels and then flex their calf muscles, the tensions would be FatxDat=FpfxDpf where F is the force in the achille's tendon or plantar fascia and D is the closest distance from the ankle pivot point to the center of force in the achille's tendon and plantar fascia. Since D is greater to the PF than to the AT (about 2 or 3 times greater by my estimate), Fpf can be 2 to 3 times smaller than Fat (it's a basic torque problem, t=FxD). The 'longus' tendons that travel to the mid and forefoot from the other calf muscles (non-achille's tendon muscles) that also transfer tension do not affect the equation, but reduce Fpf and Fat. How much or little they reduce those forces I can only estimate by comparing the relative size of the calf muscles.

Re: achilles tendon / plantar fascia connection

Scott R on 6/11/01 at 20:40 (050485)

My equations in my last post didn't show up very well, so here's a repost:

Both footpro and Dr. Reid have said today that there is tissue that connects the achille's tendon and plantar fascia and that this is the primary reason lack of ankle dorsiflexion in the achillies leads to plantar fascia problems. I would like to disagree, even (actually, especially) if this is what is being taught in DPM schools. The calcaneous, acting as a rigid body connecting and transferring forces from the Achille's tendon to the plantar fascia, is all there needs to be in order for tension in the Achilles to be transferred to tension in the plantar fascia (and vice versa dependon on your point of view). If one were to stand on the edge of a step with the balls of their feet and lower their heels and then flex their calf muscles, the tensions would be FatxDat=FpfxDpf where F is the force in the achille's tendon or plantar fascia and D is the closest distance from the ankle pivot point to the center of force in the achille's tendon and plantar fascia. Since D is greater to the PF than to the AT (about 2 or 3 times greater by my estimate), Fpf can be 2 to 3 times smaller than Fat (it's a basic torque problem, t=FxD). The 'longus' tendons that travel to the mid and forefoot from the other calf muscles (non-achille's tendon muscles) that also transfer tension do not affect the equation, but reduce Fpf and Fat. How much or little they reduce those forces I can only estimate by comparing the relative size of the calf muscles.

Re: achilles tendon / plantar fascia connection

josh s on 6/12/01 at hrmin (050494)

Scott, did you see the link for http://www.chiroweb.com/archives/17/23/11.html I left some weeks ago. I also read recently of pf connections as far back on the heel as just below the achilles insertion, in addition to the more commonly visualized ones in front of the calcaneal tubercles.

But you're right, it really does'nt matter, they are still connected through the heel bone. At the end of your post you mention the plantarflexors of the leg that do not attach to the calcaneous. The peroneus longus and tibialis posterior whose tendons form a 'sling' beneath the midfoot both can act as plantarflexors but pull from the foot rather than the heel. This may offer an interesting, safer method of stretching the calves.

I recently purchased an e'book called 'How To Use The Foot Arch Correctly' by Dennis Dennlinger. Not suprisingly it's pretty silly. The author describes the method whereby learning to conciously contract and build up the peroneous longus muscle he was able to turn his flat foot into a functional foot with an arch. Though I doubt pt's or podiatrists would find the conscious hypercontraction of the peroneous longus to plantarflex the first ray as a 'cure' for a forefoot varus, or a sound long term rehabilitation strategy, his idea may provide for safer stretching.

During gait it is known that the peroneous longus and the posterior tiabial muscles are both active from foot flat to toe off. They work to support the arches and with the windlass mechanism of the plantar fascia to supinate the oblique axis of the midtarsal joints during the resupination phase of gait. They are thus active during the period the leg dorsiflexes over the planted foot.

This supination of the oblique axis of the midtarsal joints can be simulated nonweightbearing by contracting both of these musccles. The effect is a shortened foot. This shortened foot can also be created by engaging the windlass mechanism by grasping the toes and dorsiflexing them. If thus shortened, the foot can be further shortened by then contracting these muscles.

I noticed in your book that you use the proprioceptive neuromuscular fascilitation method to stretch your calves in the hang the heel off the edge setup. I've played with this method, but it has alway felt very risky for my pf and other plantar ligaments. By contracting these 'sling' muscles, it may be possible to more safely stretch the calves.

If anyone wants to give this a try, here's how to do it. Stand with heels hanging off the edge of a book or step. Holding something may be nice. lift the heel slightly above horizontal so that your weight is on the balls of your feet. Roll your weight so that it rests almost entirely on the big toe part of your balls, or the heads of the first metatarsals. Contract your peroneous longus muscles so that you push the heads of the first metatarsals hard into the floor. Your feet will now be somewhat everted. To bring your foot into neutral, you can use your ankle invertors, especially the tibialis posterior to invert your feet so that the heel is in line with the toes, and the whole foot is slightly supinated. With the heel this close to horizontal, the weight is probably fairly well distributed across the ball of the foot. Your foot is now shortened by the contraction of the 'sling muscles'. You can then lengthen and shorten your foot again by relaxing and contracting these muscles.

You'll notice that when you shorten the foot the heel rises slightly. This is because you are plantarflexing the midfoot, and when you relax these muscles the heel drops down because you are allowing the midfoot to dorsiflex.

With the muscles contracted begin to very, very slowly lower the heels to the ground, or off the step. When you start to feel uncomfortable or feel a stretch, stop, and very slowly rise again about a quarter of an inch. Pause there a couple of seconds, all the while maintaining the shortened foot. Very slowly resume your descent, 'sling' contracted until you feel shaky or a stretching sensation in your calves. At this point you can either stretch your calves using the method described in Scott's book or you can back off slightly and then resume in increments, the latter method is called pandiculation and was developed by Thomas Hanna Phd.

The theory is that by maintaining a plantarflexed (or supinated about the oblique axis) midfoot, there should be minimal tension on the plantar ligaments and plantar fascia. This should allow the calf muscles to be stretched without the use of tape and without reinjury to these structures even though with the weightbearing method there is significant force upon the heel. I surmise that since the 'sling' muscles are active and eccentricly contracting while the calf muscles are eccentically contracting during the dorsiflexion phase of gait, this technique should be most natural.

Some possible problems: 1) Since the 'sling' muscle contractions usually initiate contraction by the intrinsic muscles of the foot. The tension placed upon these muscles may lead to undue stress upon them in this position. As Mike W. notes in his post, in people with PF, these intrinsic muscles and their tendons are frequently injured and inflamed from the stress of trying to oppose the forces of excessive pronation. Mike W. would probably advise against this exercise. Then again, essentially this technique is repeated very quickly each time we push off while walking.

2) I'm not an expert so I don't know if this method could cause injury to sling muscles themselves. Since in walking they are all active together in a similar situation, perhaps not, but under these conditions, the forces are probably greater.

Scott, I noticed in your book that you have an equation which demonstrates that the position of least pf stress is with the pf parallel to surface. Would you be interested in passing this on for those with shaky math backgrounds?

The above technique could be

Re: achilles tendon / plantar fascia connection

josh s on 6/12/01 at hrmin (050495)

Scott, did you see the link for http://www.chiroweb.com/archives/17/23/11.html I left some weeks ago. I also read recently of pf connections as far back on the heel as just below the achilles insertion, in addition to the more commonly visualized ones in front of the calcaneal tubercles.

But you're right, it really does'nt matter, they are still connected through the heel bone. At the end of your post you mention the plantarflexors of the leg that do not attach to the calcaneous. The peroneus longus and tibialis posterior whose tendons form a 'sling' beneath the midfoot both can act as plantarflexors but pull from the foot rather than the heel. This may offer an interesting, safer method of stretching the calves.

I recently purchased an e'book called 'How To Use The Foot Arch Correctly' by Dennis Dennlinger. Not suprisingly it's pretty silly. The author describes the method whereby learning to conciously contract and build up the peroneous longus muscle he was able to turn his flat foot into a functional foot with an arch. Though I doubt pt's or podiatrists would find the conscious hypercontraction of the peroneous longus to plantarflex the first ray as a 'cure' for a forefoot varus, or a sound long term rehabilitation strategy, his idea may provide for safer stretching.

During gait it is known that the peroneous longus and the posterior tiabial muscles are both active from foot flat to toe off. They work to support the arches and with the windlass mechanism of the plantar fascia to supinate the oblique axis of the midtarsal joints during the resupination phase of gait. They are thus active during the period the leg dorsiflexes over the planted foot.

This supination of the oblique axis of the midtarsal joints can be simulated nonweightbearing by contracting both of these musccles. The effect is a shortened foot. This shortened foot can also be created by engaging the windlass mechanism by grasping the toes and dorsiflexing them. If thus shortened, the foot can be further shortened by then contracting these muscles.

I noticed in your book that you use the proprioceptive neuromuscular fascilitation method to stretch your calves in the hang the heel off the edge setup. I've played with this method, but it has alway felt very risky for my pf and other plantar ligaments. By contracting these 'sling' muscles, it may be possible to more safely stretch the calves.

If anyone wants to give this a try, here's how to do it. Stand with heels hanging off the edge of a book or step. Holding something may be nice. lift the heel slightly above horizontal so that your weight is on the balls of your feet. Roll your weight so that it rests almost entirely on the big toe part of your balls, or the heads of the first metatarsals. Contract your peroneous longus muscles so that you push the heads of the first metatarsals hard into the floor. Your feet will now be somewhat everted. To bring your foot into neutral, you can use your ankle invertors, especially the tibialis posterior to invert your feet so that the heel is in line with the toes, and the whole foot is slightly supinated. With the heel this close to horizontal, the weight is probably fairly well distributed across the ball of the foot. Your foot is now shortened by the contraction of the 'sling muscles'. You can then lengthen and shorten your foot again by relaxing and contracting these muscles.

You'll notice that when you shorten the foot the heel rises slightly. This is because you are plantarflexing the midfoot, and when you relax these muscles the heel drops down because you are allowing the midfoot to dorsiflex.

With the muscles contracted begin to very, very slowly lower the heels to the ground, or off the step. When you start to feel uncomfortable or feel a stretch, stop, and very slowly rise again about a quarter of an inch. Pause there a couple of seconds, all the while maintaining the shortened foot. Very slowly resume your descent, 'sling' contracted until you feel shaky or a stretching sensation in your calves. At this point you can either stretch your calves using the method described in Scott's book or you can back off slightly and then resume in increments, the latter method is called pandiculation and was developed by Thomas Hanna, Phd.

The theory is that by maintaining a plantarflexed (or supinated about the oblique axis) midfoot, there should be minimal tension on the plantar ligaments and plantar fascia. This should allow the calf muscles to be stretched without the use of tape and without reinjury to these structures even though with the weightbearing method there is significant force upon the heel. I surmise that since the 'sling' muscles are active and eccentricly contracting while the calf muscles are eccentically contracting during the dorsiflexion phase of gait, this technique should be most natural. If anyone tries it, let me know if it works for you.

Some possible problems: 1) Since the 'sling' muscle contractions usually initiate contraction by the intrinsic muscles of the foot. The tension placed upon these muscles may lead to undue stress upon them in this position. As Mike W. notes in his post, in people with PF, these intrinsic muscles and their tendons are frequently injured and inflamed from the stress of trying to oppose the forces of excessive pronation. Mike W. would probably advise against this exercise. Then again, essentially this technique is repeated very quickly each time we push off while walking.

2) I'm not an expert so I don't know if this method could cause injury to sling muscles themselves. Since in walking they are all active together in a similar situation, perhaps not, but under these conditions, the forces are probably greater. I'm not an expert, these observations and the above approach are concocted from my research and could be nonsense.

Scott, I noticed in your book that you have an equation which demonstrates that the position of least pf stress is with the pf parallel to surface. Would you be interested in passing this on for those with shaky math backgrounds?

The above technique could more safely be done sitting, using a belt or something to apply a lesser force than standing. Ideally, since this is a kind of simulation of walking dorsiflexion moments, this stretch would be carried out with the sole of the foot planted and the pf parallel to surface. I have'nt figured out how to do this with the sole horizontal, as the pnf stretch requires calf contraction.

A device similar to the Pro Stretch called the masterstretch but without the toe dorsiflexion and with a different shape to the rocker may work as it may allow gravity to apply dorsiflexion force to the ankle but allow a foot flat position from which the calves could oppose this force. The trick would be in getting the shape of the rocker just right.

Re: whoops

josh s on 6/12/01 at hrmin (050496)

Whoops, doubled up.

Re: achilles tendon / plantar fascia connection

Scott R on 6/12/01 at 06:57 (050498)

Sorry, but I've run out of time to read and understand your post. To answer your question, I wasn't able to simply the equation enough to present it. I was very reluctant to even mention it because I think it was complex enough to increase the possibility that it is wrong-headed.

Re: achilles tendon / plantar fascia connection

Scott R on 6/12/01 at 11:45 (050519)

I just realized the torque equation shows that if the fascia is closer to the ground (as it would be if it is parallel to the ground) then it's DPF is larger and therefore FPF can be smaller (i.e., the 'lever arm' action of the fascia is longer) to equal the pull from the Achille's.

Re: achilles tendon / plantar fascia connection

foot pro on 6/12/01 at 20:33 (050555)

Scott
There are many factors that go into the biomechanics of the rearfoot complex. How the subtalar joint pronates and supinates to adapt to the ground. How the forefoot and leg function in the overall position of the subtalar joint. The tendo-achilles is only one force involved in plantar fasciitis and heel spur syndrome. There aer several patients who suffer from this condition who have adequate dorsiflexion of the tendoachilles. It is commonly accepted that the foot should dorsiflex 10 degrees past the ankle on the sagittal plane. If an individual say for instance has a fully compensated partially compensated or uncompensated forefoot varus deformity, the subtalar joint has to pronate to its end range of motion to bring the forefoot to the ground. This in effect flattens the foot and what you will see clinically is an everted position of the calcaneus. This, in effect puts the plantar fascia on stretch which may predispose one to plantar fasciitis. In addition, the tibialis posterior muscle which as a plantarflexor primarily and then an invertor of the foot may become involved and the individual develops a syndrome known as Posterior Tibial Dysfunction. This can elicit heel pain as well. Once again, irregardless of the biomechanics involved in 'Heel Pain', the clinician must ascertain the correct diagnosis and then initiate treatment accordingly. Haphazardly diagnosing every individual with heel pain as having PF is 'bad medicine'.

Re: achilles tendon / plantar fascia connection

footpro on 6/12/01 at 20:41 (050556)

The calf muscle (Gastrosoleus) which originates on the posterior inferior aspect of the femur and the the posterior superior aspect of the tibia. The gastrosoleus (Gastroc / Soleus) inserts on the posterior aspect of the calcaneus. It's function is to plantarflex the foot. The tibialis posterior plantarflex and invert. The peroneus longus function is to plantarflex and evert the foot as well as plantarflex the 1st ray during the gait cycle. The reason the peroneus longus muscle and posterior tibial muscle do not transfer tension to the heel and subsequently to the plantar fascia is due to the insertions on the foot.

Re: achilles tendon / plantar fascia connection

Dr. Marlene Reid on 6/13/01 at 00:04 (050575)

I did not say that the relationship with dorsiflexion causes plantar fasciitis. I said that the lack of dorsiflexion causes pronation and vice versa. My second statment mentioned the physical connection of the fibers of the PF and the achilles tendon. The comments I made about the causes for fasciitis were unrelated to the above comments.

Re: Jade 168 Balm website

Dr. Chris Reynolds. on 6/13/01 at hrmin (050581)

Of course the correct diagnosis is essential in the treatment of any condition, not just in plantar fasciitis. Nonetheless I think some people are missing the point of what I am trying to say. If there is, as I have observed using Jade Balm on LONG TERM sufferers of PF, complete recovery of pain symptoms IN A SHORT PERIOD OF TIME (notwithstanding the underlying fasciitis, chronic inflammation etc. - we know there is chronic inflammation from the patient's symptoms), then the CAUSE of PF cannot be due JUST to mechanical factors. Aggravated yes, but not caused. I believe there has to be another element that INITIATES the inflammation.
I have witnessed very rapid pain resolution in a day or two in a number of patients. This is not a placebo effect, it is a phenomenon the like of which I have never seen in 30 years of clinical medicine. I am anything BUT a natural therapist and, had I not seen these outcomes myself, I would still believe the biomechanical theory I was taught in med school. The exact mechanism I do NOT understand, but, as I have said elsewhere, because the Jade appears to be a powerful immunomodulator, I am convinced that it exerts a similar influence on the inflamed tissue(s) of PF thus sometimes bringing rapid relief of symptoms. Let me exemplify what I am saying by giving you a testimonial I received today from a woman in her 60's from New South Wales, (not a patient of mine, but someone told her about the Jade and, under pressure from her husband, decided to try it):-

'In 1978 I first suffered severe pain from plantar fasciitis at a period when I was engaged in fun runs. I was treated by a sports injury specialist with cortisone injections,strapping and orthotics,which was not effective.
I have continued with treatment by sports specialists, orthopaedic
surgeons and physiotherapists for 21 years with only temporary
marginal improvement.
In December 2000 I treated my most painful left heel with Jade 168 Balm
before going to bed one evening. The next morning there was minimal
tenderness and I was able to walk freely. I applied Jade the following day and the slight discomfort totally eased .
I now dance with the Hillbillies Cloggers at least 9 hours a week.
My heels are painfree and there has been no recurrence.'
A. B. New South Wales. Australia. 8 June 2001

Explanation anyone?

Re: achilles tendon / plantar fascia connection

Scott R on 6/13/01 at 11:56 (050614)

Dr. Reid, I was objecting to the statement:
'The reason PF occurs with equinous is because the fibers of the achilles tendon are connected loosely with those of the plantar fascia.'
My view is that equinus causes an increase in forces that are transferred from the Achilles through the calcaneous to the plantar fascia. I believe Achille's tendonitis and/or plantar fasciitis may result from the equinus. I just noticed I didn't include achilles tendonitis in our survey of 5,000 sufferers, so I don't know what percentage of our visitors have AT.

Re: achilles tendon / plantar fascia connection

josh s on 6/14/01 at hrmin (050691)

Scott, I noticed Dr. Reid talked of the equinus forces- pronation causes- plantar fascia strain scenario that is commonly experienced by we that are tending toward flat feet. For those that have high arch/cavus type feet the manner in which the achilles tension is transmitted to the plantar fascia may be different as these feet generally underpronate and thus are not subject to the mechanics of excessive pronation. I'm sure I've read in biomechanics books that this is so, every foot is different so the specific way in which equinus causes problems with the plantar fascia is probably a little bit different for everyone. Though there definately seems to be several major distinctions.

Re: achilles tendon / plantar fascia connection

Ed Davis, DPM on 7/25/01 at hrmin (054311)

Patients compensate for heel pain several ways. The two most common manners are: 1)walking inverted (walking on the outside of the foot) and 2)avoiding full heel strike by contracting the gastrosoleus-achilles tendon complex. The second form of compensation often leads to achilles tendinitis.
Ed

Re: Jade 168 Balm website

Julie on 6/07/01 at 09:56 (050144)

Hi Chris

Your website looks perfectly nice. What are you apologizing for? And it's interesting. I have two comments:

After I read the 'Ingredients' page and clicked on Home, I got a 'not found' message. But when I clicked on my back button, I got back to Home. You might want to check on this.

In all the 'causes' of PF which you dismiss (heel spurs, weight gain, overstretching etc) you don't mention biomechanical problems, e.g. over-pronation. I'm sure this was a factor in my case, perhaps themajor factor. It has been corrected with custom orthotics and I have improved (there have been other factors in my improvement).

I don't think biomechanical factors can be disregarded - but neither do I think their existence rules out possible improvement by Jade Balm. And I hope Jade Balm helps a lot of people. I look forward to my supply, and the trial.

All the best, Julie

Re: Jade 168 Balm website

Dr. Chris Reynolds. on 6/07/01 at hrmin (050200)

Julie, thanks for your comments and the information. I am no webmaster, but Bill Gates helps me a lot.
I don't think I'm saying I dismiss biomechanical factors in PF. I do doubt that spurs make much difference, and I think most doctors have seen X-rays of large spurs in people with foot injuries who have never had a foot problem. But to say that over-pronation or other mechanical factors are the actual CAUSE of PF is another matter that I have questioned. I think commonsense would tell us that being overweight, overusing the feet etc. would most likely exacerbate an underlying condition like PF. Perhaps I just have a different, if not new, way of looking at the problem. I also appreciate your views on the matter. Healthy debate can only improve our understanding to ultimately help others, which is what I am told doctors are supposed to do. You should have your Jade in a few days.
Kind regards,
Dr. Chris Reynolds.

Re: Jade 168 Balm website

bg cped on 6/10/01 at 00:08 (050365)

I agree spurs are not very often the source of heel pain. I also believe that pain is elicited from a traction force on the fascia. This may seem over simplified but if it is not from a functional source e.g. shoes, wt, pronation, supination, activity as you say, then why does it feel better when off wt bearing and then become very accute when returning to wt bearing?
In our office the vast majority of pf cases can recall either a change in footwear, activity, wt, job change etc.

To make a blanket claim that it is not from many traditional causes and not make an exact claim of what this balm is made of and how exactly it works is questionable. I would compare pf to tennis elbow in a way. When was the last time you had a pt with tennis elbow symptoms that cant list some change in activity that preceded the symptom?

The balm may act as an anti inflam but why does it get inflamed in the first place?

Re: Jade 168 Balm website

Dr. Chris Reynolds. on 6/10/01 at hrmin (050384)

Thanks for your comments. Of course I agree with you that traction and other forces AGGRAVATE the underlying condition, but what EXACTLY is the nature of that condition? By the same token, therapeutic interventions that relieve these exacerbating factors should of course be of benefit to the patient. The last patient I had with a tennis elbow was myself. The pain came on suddenly, was severe and I could hardly move my arm. There were NO antecedent physical strains or stresses, but it hurt like hell. I put a bit of Jade Balm on it and in about five minutes I had a functional arm again, although I could still feel a bit of pain. Another week and it had gone completely. However, I was lucky. Tennis elbow doesn't in my experience respond nearly as well to Jade as PF does, and I think we'd all agree that we'd prefer not to be confronted with too many tennis elbow sufferers in clinical practice.
I do not know how the Jade works - I wish I did, then I could rest in peace! My theory about the immunological nature of PF is based on clinical observations of the effects of Jade on thousands of patients with a multitude of ailments over about five years. In the areas of inflammation, wound healing and hemostasis, it is usually very effective, uncommonly has no effect and sometimes is downright miraculous in the speed at which it can eliminate pain. So when you observe how fast it CAN work, particularly in chronic conditions such as PF, and anal fissure (where it has never failed my patients), then you have to start thinking along different lines to traditional teaching. If the condition is chronic, how can it possibly resolve so quickly after applying a bit of cream over the affected area. I believe the compound contains one or a number of small molecules that penetrate the skin instantaneously which then precipitate a powerful immunological response in the immediate area.
I think I am a reasonably sane individual who trusts his senses. After 30 years in medicine I am not easlily swayed by new therapeutic substances. The Jade certainly did that and I use it every day in my office much to the benefit of my patients.
Why does the foot get inflamed in the first place? I don't know any more than anyone else does. Why do people develop anal fissures? The theories abound, but no-one really knows. I would think there are multiple factors bringing about these chronic conditions. What about alopecia for instance? Exactly why does such an autoimmune conditon develop in an otherwise healthy person? There are so many problems like this in medicine that are difficult to cure, but, like you, we all do our best to help our patients improve their quality of life. If Jade helps even a small percentage of PF sufferers, whether we know how it works or not, then that has to be a good thing.

Re: Jade 168 Balm website

footpro on 6/11/01 at 18:55 (050475)

Heel pain in general may have many causes. It can be plantar fasciitis, entrapment of Baxter's nerve, many arthritidies, stress fracture of the calcaneus. Each of these conditions presents with different symptomatology. It is of utmost for the practitioner to diagnose the problem correctly and not generically diagnoe all heel pain as plantar fasciitis. It is not. Most people with true plantar fasciitis complain of pain on the inferior medial aspect of the heel. The pain is usually greatest after taking the 1st step in the morning. The reason why is that the achilles tendon is a major deforming force which acts upon the plantar fascia. As the tendoachilles inserts on the posterior aspect of the calcaneus, fibers run inferior to the heel and become invested in the plantar fascia. As one rests (sitting or lying down) the tendoachilles keeps the foot plantarflexed and the plantar fascia is relaxed. Once the person takes their initial step, the tendoachilles goes onstretch as well as the plantar fascia. This is when the patient develops pain. As the person walks the pain tends to get better. This is why stretching prior to activity works so well. Some patients complain that they have pain in the heels and that it burns 'all the time'. Nothing helps. They may or may not have a spur. There may not be any pain on palpation of the inferior medial calcaneal tubercle. There is usually pain on side to side compression of the heel that may radiate into the toes or up the leg. This is more diagnostic of an entrapment of the Baxter's Nerve. These may or may not respond to conservative care. Operatively what is typically seen is a abundance of scar tissue in the subcutaneous tissues. The nerve is hardly visualized due to it's small size. Once release of the adhesions is performed a small section of the plantar fascia is incised. These patients tend to very well postoperatively. I've only discussed two of the more common heel pain presentations. Hopefully this will shed more light on the situation.

Re: achilles tendon / plantar fascia connection

Scott R on 6/11/01 at 20:39 (050484)

Both footpro and Dr. Reid have said today that there is tissue that connects the achille's tendon and plantar fascia and that this is the primary reason lack of ankle dorsiflexion in the achillies leads to plantar fascia problems. I would like to disagree, even (actually, especially) if this is what is being taught in DPM schools. The calcaneous, acting as a rigid body connecting and transferring forces from the Achille's tendon to the plantar fascia, is all there needs to be in order for tension in the Achilles to be transferred to tension in the plantar fascia (and vice versa dependon on your point of view). If one were to stand on the edge of a step with the balls of their feet and lower their heels and then flex their calf muscles, the tensions would be FatxDat=FpfxDpf where F is the force in the achille's tendon or plantar fascia and D is the closest distance from the ankle pivot point to the center of force in the achille's tendon and plantar fascia. Since D is greater to the PF than to the AT (about 2 or 3 times greater by my estimate), Fpf can be 2 to 3 times smaller than Fat (it's a basic torque problem, t=FxD). The 'longus' tendons that travel to the mid and forefoot from the other calf muscles (non-achille's tendon muscles) that also transfer tension do not affect the equation, but reduce Fpf and Fat. How much or little they reduce those forces I can only estimate by comparing the relative size of the calf muscles.

Re: achilles tendon / plantar fascia connection

Scott R on 6/11/01 at 20:40 (050485)

My equations in my last post didn't show up very well, so here's a repost:

Both footpro and Dr. Reid have said today that there is tissue that connects the achille's tendon and plantar fascia and that this is the primary reason lack of ankle dorsiflexion in the achillies leads to plantar fascia problems. I would like to disagree, even (actually, especially) if this is what is being taught in DPM schools. The calcaneous, acting as a rigid body connecting and transferring forces from the Achille's tendon to the plantar fascia, is all there needs to be in order for tension in the Achilles to be transferred to tension in the plantar fascia (and vice versa dependon on your point of view). If one were to stand on the edge of a step with the balls of their feet and lower their heels and then flex their calf muscles, the tensions would be FatxDat=FpfxDpf where F is the force in the achille's tendon or plantar fascia and D is the closest distance from the ankle pivot point to the center of force in the achille's tendon and plantar fascia. Since D is greater to the PF than to the AT (about 2 or 3 times greater by my estimate), Fpf can be 2 to 3 times smaller than Fat (it's a basic torque problem, t=FxD). The 'longus' tendons that travel to the mid and forefoot from the other calf muscles (non-achille's tendon muscles) that also transfer tension do not affect the equation, but reduce Fpf and Fat. How much or little they reduce those forces I can only estimate by comparing the relative size of the calf muscles.

Re: achilles tendon / plantar fascia connection

josh s on 6/12/01 at hrmin (050494)

Scott, did you see the link for http://www.chiroweb.com/archives/17/23/11.html I left some weeks ago. I also read recently of pf connections as far back on the heel as just below the achilles insertion, in addition to the more commonly visualized ones in front of the calcaneal tubercles.

But you're right, it really does'nt matter, they are still connected through the heel bone. At the end of your post you mention the plantarflexors of the leg that do not attach to the calcaneous. The peroneus longus and tibialis posterior whose tendons form a 'sling' beneath the midfoot both can act as plantarflexors but pull from the foot rather than the heel. This may offer an interesting, safer method of stretching the calves.

I recently purchased an e'book called 'How To Use The Foot Arch Correctly' by Dennis Dennlinger. Not suprisingly it's pretty silly. The author describes the method whereby learning to conciously contract and build up the peroneous longus muscle he was able to turn his flat foot into a functional foot with an arch. Though I doubt pt's or podiatrists would find the conscious hypercontraction of the peroneous longus to plantarflex the first ray as a 'cure' for a forefoot varus, or a sound long term rehabilitation strategy, his idea may provide for safer stretching.

During gait it is known that the peroneous longus and the posterior tiabial muscles are both active from foot flat to toe off. They work to support the arches and with the windlass mechanism of the plantar fascia to supinate the oblique axis of the midtarsal joints during the resupination phase of gait. They are thus active during the period the leg dorsiflexes over the planted foot.

This supination of the oblique axis of the midtarsal joints can be simulated nonweightbearing by contracting both of these musccles. The effect is a shortened foot. This shortened foot can also be created by engaging the windlass mechanism by grasping the toes and dorsiflexing them. If thus shortened, the foot can be further shortened by then contracting these muscles.

I noticed in your book that you use the proprioceptive neuromuscular fascilitation method to stretch your calves in the hang the heel off the edge setup. I've played with this method, but it has alway felt very risky for my pf and other plantar ligaments. By contracting these 'sling' muscles, it may be possible to more safely stretch the calves.

If anyone wants to give this a try, here's how to do it. Stand with heels hanging off the edge of a book or step. Holding something may be nice. lift the heel slightly above horizontal so that your weight is on the balls of your feet. Roll your weight so that it rests almost entirely on the big toe part of your balls, or the heads of the first metatarsals. Contract your peroneous longus muscles so that you push the heads of the first metatarsals hard into the floor. Your feet will now be somewhat everted. To bring your foot into neutral, you can use your ankle invertors, especially the tibialis posterior to invert your feet so that the heel is in line with the toes, and the whole foot is slightly supinated. With the heel this close to horizontal, the weight is probably fairly well distributed across the ball of the foot. Your foot is now shortened by the contraction of the 'sling muscles'. You can then lengthen and shorten your foot again by relaxing and contracting these muscles.

You'll notice that when you shorten the foot the heel rises slightly. This is because you are plantarflexing the midfoot, and when you relax these muscles the heel drops down because you are allowing the midfoot to dorsiflex.

With the muscles contracted begin to very, very slowly lower the heels to the ground, or off the step. When you start to feel uncomfortable or feel a stretch, stop, and very slowly rise again about a quarter of an inch. Pause there a couple of seconds, all the while maintaining the shortened foot. Very slowly resume your descent, 'sling' contracted until you feel shaky or a stretching sensation in your calves. At this point you can either stretch your calves using the method described in Scott's book or you can back off slightly and then resume in increments, the latter method is called pandiculation and was developed by Thomas Hanna Phd.

The theory is that by maintaining a plantarflexed (or supinated about the oblique axis) midfoot, there should be minimal tension on the plantar ligaments and plantar fascia. This should allow the calf muscles to be stretched without the use of tape and without reinjury to these structures even though with the weightbearing method there is significant force upon the heel. I surmise that since the 'sling' muscles are active and eccentricly contracting while the calf muscles are eccentically contracting during the dorsiflexion phase of gait, this technique should be most natural.

Some possible problems: 1) Since the 'sling' muscle contractions usually initiate contraction by the intrinsic muscles of the foot. The tension placed upon these muscles may lead to undue stress upon them in this position. As Mike W. notes in his post, in people with PF, these intrinsic muscles and their tendons are frequently injured and inflamed from the stress of trying to oppose the forces of excessive pronation. Mike W. would probably advise against this exercise. Then again, essentially this technique is repeated very quickly each time we push off while walking.

2) I'm not an expert so I don't know if this method could cause injury to sling muscles themselves. Since in walking they are all active together in a similar situation, perhaps not, but under these conditions, the forces are probably greater.

Scott, I noticed in your book that you have an equation which demonstrates that the position of least pf stress is with the pf parallel to surface. Would you be interested in passing this on for those with shaky math backgrounds?

The above technique could be

Re: achilles tendon / plantar fascia connection

josh s on 6/12/01 at hrmin (050495)

Scott, did you see the link for http://www.chiroweb.com/archives/17/23/11.html I left some weeks ago. I also read recently of pf connections as far back on the heel as just below the achilles insertion, in addition to the more commonly visualized ones in front of the calcaneal tubercles.

But you're right, it really does'nt matter, they are still connected through the heel bone. At the end of your post you mention the plantarflexors of the leg that do not attach to the calcaneous. The peroneus longus and tibialis posterior whose tendons form a 'sling' beneath the midfoot both can act as plantarflexors but pull from the foot rather than the heel. This may offer an interesting, safer method of stretching the calves.

I recently purchased an e'book called 'How To Use The Foot Arch Correctly' by Dennis Dennlinger. Not suprisingly it's pretty silly. The author describes the method whereby learning to conciously contract and build up the peroneous longus muscle he was able to turn his flat foot into a functional foot with an arch. Though I doubt pt's or podiatrists would find the conscious hypercontraction of the peroneous longus to plantarflex the first ray as a 'cure' for a forefoot varus, or a sound long term rehabilitation strategy, his idea may provide for safer stretching.

During gait it is known that the peroneous longus and the posterior tiabial muscles are both active from foot flat to toe off. They work to support the arches and with the windlass mechanism of the plantar fascia to supinate the oblique axis of the midtarsal joints during the resupination phase of gait. They are thus active during the period the leg dorsiflexes over the planted foot.

This supination of the oblique axis of the midtarsal joints can be simulated nonweightbearing by contracting both of these musccles. The effect is a shortened foot. This shortened foot can also be created by engaging the windlass mechanism by grasping the toes and dorsiflexing them. If thus shortened, the foot can be further shortened by then contracting these muscles.

I noticed in your book that you use the proprioceptive neuromuscular fascilitation method to stretch your calves in the hang the heel off the edge setup. I've played with this method, but it has alway felt very risky for my pf and other plantar ligaments. By contracting these 'sling' muscles, it may be possible to more safely stretch the calves.

If anyone wants to give this a try, here's how to do it. Stand with heels hanging off the edge of a book or step. Holding something may be nice. lift the heel slightly above horizontal so that your weight is on the balls of your feet. Roll your weight so that it rests almost entirely on the big toe part of your balls, or the heads of the first metatarsals. Contract your peroneous longus muscles so that you push the heads of the first metatarsals hard into the floor. Your feet will now be somewhat everted. To bring your foot into neutral, you can use your ankle invertors, especially the tibialis posterior to invert your feet so that the heel is in line with the toes, and the whole foot is slightly supinated. With the heel this close to horizontal, the weight is probably fairly well distributed across the ball of the foot. Your foot is now shortened by the contraction of the 'sling muscles'. You can then lengthen and shorten your foot again by relaxing and contracting these muscles.

You'll notice that when you shorten the foot the heel rises slightly. This is because you are plantarflexing the midfoot, and when you relax these muscles the heel drops down because you are allowing the midfoot to dorsiflex.

With the muscles contracted begin to very, very slowly lower the heels to the ground, or off the step. When you start to feel uncomfortable or feel a stretch, stop, and very slowly rise again about a quarter of an inch. Pause there a couple of seconds, all the while maintaining the shortened foot. Very slowly resume your descent, 'sling' contracted until you feel shaky or a stretching sensation in your calves. At this point you can either stretch your calves using the method described in Scott's book or you can back off slightly and then resume in increments, the latter method is called pandiculation and was developed by Thomas Hanna, Phd.

The theory is that by maintaining a plantarflexed (or supinated about the oblique axis) midfoot, there should be minimal tension on the plantar ligaments and plantar fascia. This should allow the calf muscles to be stretched without the use of tape and without reinjury to these structures even though with the weightbearing method there is significant force upon the heel. I surmise that since the 'sling' muscles are active and eccentricly contracting while the calf muscles are eccentically contracting during the dorsiflexion phase of gait, this technique should be most natural. If anyone tries it, let me know if it works for you.

Some possible problems: 1) Since the 'sling' muscle contractions usually initiate contraction by the intrinsic muscles of the foot. The tension placed upon these muscles may lead to undue stress upon them in this position. As Mike W. notes in his post, in people with PF, these intrinsic muscles and their tendons are frequently injured and inflamed from the stress of trying to oppose the forces of excessive pronation. Mike W. would probably advise against this exercise. Then again, essentially this technique is repeated very quickly each time we push off while walking.

2) I'm not an expert so I don't know if this method could cause injury to sling muscles themselves. Since in walking they are all active together in a similar situation, perhaps not, but under these conditions, the forces are probably greater. I'm not an expert, these observations and the above approach are concocted from my research and could be nonsense.

Scott, I noticed in your book that you have an equation which demonstrates that the position of least pf stress is with the pf parallel to surface. Would you be interested in passing this on for those with shaky math backgrounds?

The above technique could more safely be done sitting, using a belt or something to apply a lesser force than standing. Ideally, since this is a kind of simulation of walking dorsiflexion moments, this stretch would be carried out with the sole of the foot planted and the pf parallel to surface. I have'nt figured out how to do this with the sole horizontal, as the pnf stretch requires calf contraction.

A device similar to the Pro Stretch called the masterstretch but without the toe dorsiflexion and with a different shape to the rocker may work as it may allow gravity to apply dorsiflexion force to the ankle but allow a foot flat position from which the calves could oppose this force. The trick would be in getting the shape of the rocker just right.

Re: whoops

josh s on 6/12/01 at hrmin (050496)

Whoops, doubled up.

Re: achilles tendon / plantar fascia connection

Scott R on 6/12/01 at 06:57 (050498)

Sorry, but I've run out of time to read and understand your post. To answer your question, I wasn't able to simply the equation enough to present it. I was very reluctant to even mention it because I think it was complex enough to increase the possibility that it is wrong-headed.

Re: achilles tendon / plantar fascia connection

Scott R on 6/12/01 at 11:45 (050519)

I just realized the torque equation shows that if the fascia is closer to the ground (as it would be if it is parallel to the ground) then it's DPF is larger and therefore FPF can be smaller (i.e., the 'lever arm' action of the fascia is longer) to equal the pull from the Achille's.

Re: achilles tendon / plantar fascia connection

foot pro on 6/12/01 at 20:33 (050555)

Scott
There are many factors that go into the biomechanics of the rearfoot complex. How the subtalar joint pronates and supinates to adapt to the ground. How the forefoot and leg function in the overall position of the subtalar joint. The tendo-achilles is only one force involved in plantar fasciitis and heel spur syndrome. There aer several patients who suffer from this condition who have adequate dorsiflexion of the tendoachilles. It is commonly accepted that the foot should dorsiflex 10 degrees past the ankle on the sagittal plane. If an individual say for instance has a fully compensated partially compensated or uncompensated forefoot varus deformity, the subtalar joint has to pronate to its end range of motion to bring the forefoot to the ground. This in effect flattens the foot and what you will see clinically is an everted position of the calcaneus. This, in effect puts the plantar fascia on stretch which may predispose one to plantar fasciitis. In addition, the tibialis posterior muscle which as a plantarflexor primarily and then an invertor of the foot may become involved and the individual develops a syndrome known as Posterior Tibial Dysfunction. This can elicit heel pain as well. Once again, irregardless of the biomechanics involved in 'Heel Pain', the clinician must ascertain the correct diagnosis and then initiate treatment accordingly. Haphazardly diagnosing every individual with heel pain as having PF is 'bad medicine'.

Re: achilles tendon / plantar fascia connection

footpro on 6/12/01 at 20:41 (050556)

The calf muscle (Gastrosoleus) which originates on the posterior inferior aspect of the femur and the the posterior superior aspect of the tibia. The gastrosoleus (Gastroc / Soleus) inserts on the posterior aspect of the calcaneus. It's function is to plantarflex the foot. The tibialis posterior plantarflex and invert. The peroneus longus function is to plantarflex and evert the foot as well as plantarflex the 1st ray during the gait cycle. The reason the peroneus longus muscle and posterior tibial muscle do not transfer tension to the heel and subsequently to the plantar fascia is due to the insertions on the foot.

Re: achilles tendon / plantar fascia connection

Dr. Marlene Reid on 6/13/01 at 00:04 (050575)

I did not say that the relationship with dorsiflexion causes plantar fasciitis. I said that the lack of dorsiflexion causes pronation and vice versa. My second statment mentioned the physical connection of the fibers of the PF and the achilles tendon. The comments I made about the causes for fasciitis were unrelated to the above comments.

Re: Jade 168 Balm website

Dr. Chris Reynolds. on 6/13/01 at hrmin (050581)

Of course the correct diagnosis is essential in the treatment of any condition, not just in plantar fasciitis. Nonetheless I think some people are missing the point of what I am trying to say. If there is, as I have observed using Jade Balm on LONG TERM sufferers of PF, complete recovery of pain symptoms IN A SHORT PERIOD OF TIME (notwithstanding the underlying fasciitis, chronic inflammation etc. - we know there is chronic inflammation from the patient's symptoms), then the CAUSE of PF cannot be due JUST to mechanical factors. Aggravated yes, but not caused. I believe there has to be another element that INITIATES the inflammation.
I have witnessed very rapid pain resolution in a day or two in a number of patients. This is not a placebo effect, it is a phenomenon the like of which I have never seen in 30 years of clinical medicine. I am anything BUT a natural therapist and, had I not seen these outcomes myself, I would still believe the biomechanical theory I was taught in med school. The exact mechanism I do NOT understand, but, as I have said elsewhere, because the Jade appears to be a powerful immunomodulator, I am convinced that it exerts a similar influence on the inflamed tissue(s) of PF thus sometimes bringing rapid relief of symptoms. Let me exemplify what I am saying by giving you a testimonial I received today from a woman in her 60's from New South Wales, (not a patient of mine, but someone told her about the Jade and, under pressure from her husband, decided to try it):-

'In 1978 I first suffered severe pain from plantar fasciitis at a period when I was engaged in fun runs. I was treated by a sports injury specialist with cortisone injections,strapping and orthotics,which was not effective.
I have continued with treatment by sports specialists, orthopaedic
surgeons and physiotherapists for 21 years with only temporary
marginal improvement.
In December 2000 I treated my most painful left heel with Jade 168 Balm
before going to bed one evening. The next morning there was minimal
tenderness and I was able to walk freely. I applied Jade the following day and the slight discomfort totally eased .
I now dance with the Hillbillies Cloggers at least 9 hours a week.
My heels are painfree and there has been no recurrence.'
A. B. New South Wales. Australia. 8 June 2001

Explanation anyone?

Re: achilles tendon / plantar fascia connection

Scott R on 6/13/01 at 11:56 (050614)

Dr. Reid, I was objecting to the statement:
'The reason PF occurs with equinous is because the fibers of the achilles tendon are connected loosely with those of the plantar fascia.'
My view is that equinus causes an increase in forces that are transferred from the Achilles through the calcaneous to the plantar fascia. I believe Achille's tendonitis and/or plantar fasciitis may result from the equinus. I just noticed I didn't include achilles tendonitis in our survey of 5,000 sufferers, so I don't know what percentage of our visitors have AT.

Re: achilles tendon / plantar fascia connection

josh s on 6/14/01 at hrmin (050691)

Scott, I noticed Dr. Reid talked of the equinus forces- pronation causes- plantar fascia strain scenario that is commonly experienced by we that are tending toward flat feet. For those that have high arch/cavus type feet the manner in which the achilles tension is transmitted to the plantar fascia may be different as these feet generally underpronate and thus are not subject to the mechanics of excessive pronation. I'm sure I've read in biomechanics books that this is so, every foot is different so the specific way in which equinus causes problems with the plantar fascia is probably a little bit different for everyone. Though there definately seems to be several major distinctions.

Re: achilles tendon / plantar fascia connection

Ed Davis, DPM on 7/25/01 at hrmin (054311)

Patients compensate for heel pain several ways. The two most common manners are: 1)walking inverted (walking on the outside of the foot) and 2)avoiding full heel strike by contracting the gastrosoleus-achilles tendon complex. The second form of compensation often leads to achilles tendinitis.
Ed