♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the Internet ♪
- Hi folks I'm Bob Schrupp physical therapist.
- Brad Heineck physical therapist
- Together we are the most famous physical therapists
on the Internet. - In our opinion
of course, Bob. - This video's part
of a series on plantar fasciitis.
You can find it on bobandbrad.com
This one's called the plantar fascia dirty dozen.
It's stopping your healing.
This is a list of 12 things that can prevent your
plantar fascia from healing or getting better.
They can also cause plantar fascia.
- Sure.
- Plantar fasciitis.
- It's got nothing to do with the movie.
- Nothing to do with the movie.
What movie?
- The Dirty Dozen! - Oh, the Dirty Dozen.
- Charles Bronson!
- Nope, nope, nope.
- If you're over 50 years old,
you've probably watched it. - Yeah you know what it is,
that's right.
You probably cry even during it.
Okay number one, standing or walking on hard surfaces
for a long period of time.
That's just something you wanna keep in mind,
maybe you work that way
and that's where you're gonna wanna make sure you have
the correct footwear.
- Right, the arch support, some cushion there.
- This is one that actually,
anything that overextends the plantar fascia.
So as you recall, the plantar fascia starts in the heel here
and goes up into the toes.
So if you do anything like this,
and this just happened to a friend of mine.
He was working on a roof,
and he was sitting like this.
And like Brad mentioned when we were talking earlier,
if you lean back even more like this,
now you're putting a lot of stress,
you probably can see this can't you Mike?
- You can't sit on your heels, Bob?
- I can't go any further than that.
- Oh, I don't know if I can or not.
Like if I go like this, yeah.
It depends on how flexible you are.
I'm really stretching that right now when I push,
and if you're like this for a sustained period of time
that is really gonna stress it.
- That's killer.
And also like if gardening,
anytime you're on your knees like this,
if you're working on carpet or whatever,
it's gonna give you problems. - So if you could flatten
your foot out and plantar fascia.
- Yeah, this would even be better, absolutely.
- If you tolerate that.
- Yep, if you tolerate it, especially if you have a shoe on
it might feel a lot better.
- Right. - A lunge.
So if I do a lunge Brad and I go forward like this,
that would be good--
- Kind of give you, I was gonna use it for a pointer.
- Oh I was gonna use it - Oh go ahead!
- to help!
So if I do a lunge, as you can see I'm really stretching
that back toe and foot again. - Right here, yep.
- Another one would be heel raises.
Obviously you're gonna put a lot of stress on it too.
Not that, I mean I think you could do that,
but I wouldn't do it while you have plantar fasciitis.
- Sure, yeah that's one of the least stressful ones
of those. - Right, right.
- Next one, acute trauma.
You don't want to be jumping from things off of the back
of a truck or you know off the stairs
when you have plantar fasciitis,
you can rip it right back open.
- Well younger people will do that, we don't jump off--
- Old people can't do that, no.
Next one, number four, tight calves or hamstrings.
We talked about that on another video.
If your calves or hamstrings are tight,
the motion's gotta come from somewhere,
so there's gonna be more motion in the foot then
and it's gonna cause more stress on the plantar fasciitis.
- So that calf muscle goes to the heel,
connected to the heel, it's really one.
- One unit, almost. - One unit, we look at it as.
- All right the next thing is,
I've seen this in patients before,
so let's say they've injured their other foot,
maybe they've fractured it.
- No weight bearing.
- Yeah no weight bearing, so it would be more like this.
And so they have extra stress on this foot.
And sometimes you have them hop a little bit.
I have seen more times than not
where a person develops plantar fasciitis
because they're doing all that hopping.
- You know and we're using the walker here,
but a lot of people with crutches,
and you're really moving on the crutches,
trying to cover a lot of distance.
You're still at school or at work
and you're trying to keep up with your old self.
- You're jamming that foot.
Number six, doing too much, too fast.
Now this is really important as you start to heal.
And you say hey, it's doing better,
I wanna get back to running, so what do you do,
you go back and run five miles the first day
because it feels good,
and all of a sudden it comes roaring back again.
- And you may not feel it while you're running,
it may not be until the next morning when you wake up
and you stand on the ground again
and you say oh I'm back to where I was.
- Yeah you're gonna really wanna take things slow
and really incrementally take on more and more.
10% at the most.
- Right, a run walk program. - Right, exactly.
On number seven dirty dozen, weight gain.
Now this could be fat, it could also be muscle,
if you're putting on more muscle.
More weight on the body, more weight on the extremities.
- It could be you're gonna go hiking with a backpack.
- Right, very good point Brad.
That's an excellent point.
If you're doing too much carrying of weight.
- Right. - It's gonna put more stress.
- If that's the case,
you gotta make sure you have good shoes with arch support.
- Yeah, I just have a patient right now
that they're gonna be doing some tree cutting,
and I go you shouldn't be doing that.
He's gonna be lifting up logs.
So number eight, poorly fitting shoes.
We're gonna have a whole segment
on this on how to look at your shoes.
But they definitely can contribute to plantar fasciitis
and keep it going, especially if you have shoes
that are wore out and they're causing you to pronate.
- I've had people just change their shoes
and have significant improvement.
- I'm a runner, and when I start to feel plantar fasciitis,
I start to feel pain on the bottom of my feet,
I make sure I change my shoes and it always helps.
- Sure, yep.
- Number nine is running, jogging, aerobics, dancing,
anything like that obviously is gonna make things worse,
so you've gotta stop that I'm afraid.
You're gonna have to find an alternative.
Biking, swimming, something like that.
- Try to get that impact off of there.
- Number 10 is poor running technique or walking technique,
and yet again we're gonna have a video on this
on how to walk correctly.
If you walk to the point where you hit your heel first,
you're gonna put a lot more stress
on that plantar fasciitis.
We want you to hit the heel and the forefoot
at the same time, or very close to the same time.
And we'll have a whole video on that,
so if you look at our series.
Number 11, if you actually have one leg that's longer
than the other, and--
- Which there's a lot of people that do
and aren't even aware of it.
- Right.
- Maybe not until you get older.
Your body's typically adjusted to it,
but things change as you get older.
- I've seen a half inch up to an inch and a half,
sometimes when you have arthritis or a knee replacement
then it really accelerates it.
So if you know that you have one or someone's told you
you have one, you put a wedge
or a cup underneath the shorter side,
so that you make up for that discrepancy.
Number 12, the one that we've already mentioned
in a previous video is no walking with bare feet
or stocking feet.
So you're gonna wanna always make sure you got shoes
with good arch support or slippers with good arch support.
- Right, yep. - Always.
These are three additional things
that you can't control really.
If you're diabetic,
there's gonna be less blood flow to the area.
The plantar fascia already is something
that doesn't have a lot of blood flow anyway.
- Exactly.
- So you're gonna be more at risk.
As you get older, Brad, as we get older,
the fascia gets older and brittle, just like we.
(chuckles)
- Yep, the gravity takes over, the things change,
your discs, everything that's when I think diet does
have impact on your overall, but that's another topic.
- And then the final thing that you probably can't control
to some extent or maybe didn't want to control is pregnancy.
When you are pregnant, you actually have the hormone relaxin
that helps relax the ligaments,
obviously gonna make the delivery of the baby easier,
but it's also gonna relax the ligaments of your foot
and you're gonna actually tend to pronate more
or have your flat feet more.
- All those little ligaments holding the bones,
because you have so many little bones in your feet,
when they relax it's gonna collapse and stress that fascia.
- One more thing with pregnancy,
huh isn't there a lot of them, things that go on?
- Well yeah you're making a baby, there's sacrifice.
- All right. - What would we know
about that, we're men. - That's right.
All right, watch the rest of our program at bobandbrad.com
- Thank you. - Thanks.