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Golf ball for PF

Posted by Cary S on 8/09/02 at 14:39 (092067)

To any Docs out there: What is your opinion concerning using a golf ball to overcome PF. Someone suggested to me that I put a golf ball on a rug, and work the problem area to help loosen and break up the PF. Is this a good idea, and are there any specifics which I should know??

Re: Golf ball for PF

Dr. Zuckerman on 8/09/02 at 17:18 (092079)

Hi

I would never use a golf ball due to the chance of injury to an already damaged tissue. I know that some physical therapist recommend this and so do some doctors.

Re: Golf ball for PF

Julie on 8/10/02 at 16:34 (092137)

Seems to me there's a misapprehension going on here. PF is an injury, not a bunch of scar tissue. What is there to 'break up'?

Re: Golf ball for PF

tcp on 8/11/02 at 07:52 (092176)

If you go to bath and body, or any other bath store they typically carry small massage balls that are softer than a golf ball...possibly reduce any further injury to the area? I have done this and it feels nice, try not to press to hard...can be painful!

Re: PF -- scar tissue -- DOCS???

Mar on 8/11/02 at 08:28 (092178)

Hmmmm -- I thought PF was a series of little microtears throughout the years that builds up a lot of scar tissue and makes the fascia tight and it pulls on the heel. The initial onset of pain can be brought on by an injury. Is this not true???? Docs -- enlighten me please! Thanks Mar

Re: PF -- scar tissue -- DOCS???

Dr. Zuckerman on 8/11/02 at 11:04 (092185)

Hi

Chronic insertional plantar fasciitis is causes by micro-tears of the pf fibers. It is a repetitive motion injury or a traction degeneration. The fibers fail to heal much like a broken bone what has poor blood supply.
It is soft tissue mal-union

Yes an injury can bring this on but so long as there is poor or no healing of the micro trears then you are going to have some level of pain. What ESWT does is re-injury the already injuried area so that the body can again attempt to repair the damged and or torn insertional plantar fascia fibers

Re: PF -- scar tissue -- DOCS???

Cary S on 8/11/02 at 11:17 (092186)

If the ESWT procedure reinjures the area so the body can then re-heal soft tissue connections, then why would a golf ball massaged into the area strongly, not do the same sort of thing?? Is it true that there is a build up of tissue which causes the fascia band to remain too tight. When I put my shoes on I often fel that there is sort of a lump of soft tissue behind my arch on the inside of my foot. Massaging it strongly often gives temporary relief, so I've been wondering about being more agressive over a few day period.

Re: PF -- scar tissue -- DOCS???

Dr. Zuckerman on 8/11/02 at 11:22 (092188)

First of all the plantar fascia is never tight. It feels and looks like a piece of celery . It will never loosen up with any stretching. However the intrinsic muscles and tendons about and below is a different story.
There is just much much risk and much better ways to stretch the intrinsic muscles then a golf ball. No pain no gain is a better way to approach this pf problem.

With ESWT there is a diagnosis of poor healing. With a golf ball you can do too much damage. IS is possible for a golf ball to work yes. Is it possible to cause too muach damage yes.

Re: Golf ball for PF

JudyS on 8/11/02 at 17:20 (092243)

Julie, I'm under the impression that chronic re-tearing of the fascia (by people like me who refuse to take care of the problem properly from the start) creates scar tissue and that that scarring contributes to the lack of healing blood-flow to the fascia. When I was having deep-tissue massage about two years ago, the PT and my Pod kept telling me they could 'feel' layers of scar tissue and that they were trying to break it up. I'll admit, I could pretty much feel some tight lumps also - especially when they were being massaged!
But unlike that sissy John h, I let the PT keep on with the painful massage and I think it was my first serious step towards healing.

Now, though, I'm confused, have I been under the wrong impression about scarring all this time?

Re: PF -- stretching

Mar on 8/11/02 at 19:22 (092249)

OK -- now if the fascia isn;t loosening up with stretching, what exactly are we stretching when we do exercises? Somehow I think I might heal if I fully understood this whole thing! I go for round 2 of ESWT on Wednesday and would really like to know as much as possible to make it work for me. Thanks -- Mar

Re: PF -- stretching

Julie on 8/12/02 at 00:12 (092267)

Mar, exercise for Plantar Fasciitis aims to stretch the gastrocnemius and soleus muscles (the calf muscle complex) and the achilles tendon, and thus increase the angle of dorsiflexion. The fascia itself doesn't stretch, and in any stretching care needs to be taken not to pull on it at its weak (insertion) point. That's why many, including me, think non-weight bearing stretching is best and most effective in the long run.

Re: Golf ball for PF

Julie on 8/12/02 at 00:15 (092268)

I don't know, Judy. I'd leave it to someone else to answer this. I do know how a golf ball would have felt to my heel, though, and shudder at the thought. Essentially, what I was saying was that I agree with Dr Z: don't risk re-injuring injured tissue (even if there is scar tissue.) But I could be wrong. It's just my opinion.

Re: PF -- stretching

Tim V on 8/12/02 at 01:16 (092271)

I still don't understand how one can do stretching (dorsiflexion) either with a towel around the ball of foot or
weight bearing without increasing tension in fascia (at insertion point). Since the calf muscle, achilles tendon,
plantar fascia to toes form chain it seems hard to avoid applying increased tension on fascia.

It must be stretching is considerd to apply less tension on fascia than walking and that with continued
stretching and strengthening of muscles, the muscle and tendon parts will become more flexible
and better able to support the fascia, thereby reducing stress on it during walking.

Re: PF -- stretching

Julie on 8/13/02 at 02:01 (092330)

Tim

Since the entire complex - gastroc/soleus/achilles/fascia - are a linked chain, it is indeed difficult to stretch the former three without increasing tension on the fascia. That's why some of us are suspicious of the usually-recommended weight-bearing stretches.

The towel-around-the-foot can also be overdone, but I don't think it has quite the same potential for damage as the weight-bearing stretches. It's easier to control, and if you're sensible and don't pull hard, but simply apply an appropriate tension (one that doesn't result in increased pain) it can be all right.

But the most effective exercise for the muscle/tendon complex is probably a gentle stretch applied consistently over an extended period, such as the night splint provides.

Re: Golf ball for PF

Dr. Zuckerman on 8/09/02 at 17:18 (092079)

Hi

I would never use a golf ball due to the chance of injury to an already damaged tissue. I know that some physical therapist recommend this and so do some doctors.

Re: Golf ball for PF

Julie on 8/10/02 at 16:34 (092137)

Seems to me there's a misapprehension going on here. PF is an injury, not a bunch of scar tissue. What is there to 'break up'?

Re: Golf ball for PF

tcp on 8/11/02 at 07:52 (092176)

If you go to bath and body, or any other bath store they typically carry small massage balls that are softer than a golf ball...possibly reduce any further injury to the area? I have done this and it feels nice, try not to press to hard...can be painful!

Re: PF -- scar tissue -- DOCS???

Mar on 8/11/02 at 08:28 (092178)

Hmmmm -- I thought PF was a series of little microtears throughout the years that builds up a lot of scar tissue and makes the fascia tight and it pulls on the heel. The initial onset of pain can be brought on by an injury. Is this not true???? Docs -- enlighten me please! Thanks Mar

Re: PF -- scar tissue -- DOCS???

Dr. Zuckerman on 8/11/02 at 11:04 (092185)

Hi

Chronic insertional plantar fasciitis is causes by micro-tears of the pf fibers. It is a repetitive motion injury or a traction degeneration. The fibers fail to heal much like a broken bone what has poor blood supply.
It is soft tissue mal-union

Yes an injury can bring this on but so long as there is poor or no healing of the micro trears then you are going to have some level of pain. What ESWT does is re-injury the already injuried area so that the body can again attempt to repair the damged and or torn insertional plantar fascia fibers

Re: PF -- scar tissue -- DOCS???

Cary S on 8/11/02 at 11:17 (092186)

If the ESWT procedure reinjures the area so the body can then re-heal soft tissue connections, then why would a golf ball massaged into the area strongly, not do the same sort of thing?? Is it true that there is a build up of tissue which causes the fascia band to remain too tight. When I put my shoes on I often fel that there is sort of a lump of soft tissue behind my arch on the inside of my foot. Massaging it strongly often gives temporary relief, so I've been wondering about being more agressive over a few day period.

Re: PF -- scar tissue -- DOCS???

Dr. Zuckerman on 8/11/02 at 11:22 (092188)

First of all the plantar fascia is never tight. It feels and looks like a piece of celery . It will never loosen up with any stretching. However the intrinsic muscles and tendons about and below is a different story.
There is just much much risk and much better ways to stretch the intrinsic muscles then a golf ball. No pain no gain is a better way to approach this pf problem.

With ESWT there is a diagnosis of poor healing. With a golf ball you can do too much damage. IS is possible for a golf ball to work yes. Is it possible to cause too muach damage yes.

Re: Golf ball for PF

JudyS on 8/11/02 at 17:20 (092243)

Julie, I'm under the impression that chronic re-tearing of the fascia (by people like me who refuse to take care of the problem properly from the start) creates scar tissue and that that scarring contributes to the lack of healing blood-flow to the fascia. When I was having deep-tissue massage about two years ago, the PT and my Pod kept telling me they could 'feel' layers of scar tissue and that they were trying to break it up. I'll admit, I could pretty much feel some tight lumps also - especially when they were being massaged!
But unlike that sissy John h, I let the PT keep on with the painful massage and I think it was my first serious step towards healing.

Now, though, I'm confused, have I been under the wrong impression about scarring all this time?

Re: PF -- stretching

Mar on 8/11/02 at 19:22 (092249)

OK -- now if the fascia isn;t loosening up with stretching, what exactly are we stretching when we do exercises? Somehow I think I might heal if I fully understood this whole thing! I go for round 2 of ESWT on Wednesday and would really like to know as much as possible to make it work for me. Thanks -- Mar

Re: PF -- stretching

Julie on 8/12/02 at 00:12 (092267)

Mar, exercise for Plantar Fasciitis aims to stretch the gastrocnemius and soleus muscles (the calf muscle complex) and the achilles tendon, and thus increase the angle of dorsiflexion. The fascia itself doesn't stretch, and in any stretching care needs to be taken not to pull on it at its weak (insertion) point. That's why many, including me, think non-weight bearing stretching is best and most effective in the long run.

Re: Golf ball for PF

Julie on 8/12/02 at 00:15 (092268)

I don't know, Judy. I'd leave it to someone else to answer this. I do know how a golf ball would have felt to my heel, though, and shudder at the thought. Essentially, what I was saying was that I agree with Dr Z: don't risk re-injuring injured tissue (even if there is scar tissue.) But I could be wrong. It's just my opinion.

Re: PF -- stretching

Tim V on 8/12/02 at 01:16 (092271)

I still don't understand how one can do stretching (dorsiflexion) either with a towel around the ball of foot or
weight bearing without increasing tension in fascia (at insertion point). Since the calf muscle, achilles tendon,
plantar fascia to toes form chain it seems hard to avoid applying increased tension on fascia.

It must be stretching is considerd to apply less tension on fascia than walking and that with continued
stretching and strengthening of muscles, the muscle and tendon parts will become more flexible
and better able to support the fascia, thereby reducing stress on it during walking.

Re: PF -- stretching

Julie on 8/13/02 at 02:01 (092330)

Tim

Since the entire complex - gastroc/soleus/achilles/fascia - are a linked chain, it is indeed difficult to stretch the former three without increasing tension on the fascia. That's why some of us are suspicious of the usually-recommended weight-bearing stretches.

The towel-around-the-foot can also be overdone, but I don't think it has quite the same potential for damage as the weight-bearing stretches. It's easier to control, and if you're sensible and don't pull hard, but simply apply an appropriate tension (one that doesn't result in increased pain) it can be all right.

But the most effective exercise for the muscle/tendon complex is probably a gentle stretch applied consistently over an extended period, such as the night splint provides.