- Is your plantar fasciitis not getting any better?
- Are you asking me?
- Yeah. No, we're gonna show you what to do if it isn't.
♪ Bob and Brad, ♪
♪ the two most famous physical therapists ♪
♪ on the internet. ♪
- All right, the first reason it may not be getting better,
Brad, is because it's actually plantar fasciosis.
- Ah, another--
- And not plantar fasciitis.
- So are they two separate diagnoses?
- They're very similar, actually.
Plantar fasciitis often becomes plantar fasciosis.
- So it's fasciosis in the,
if you consider the chronic where it's--
- Right. - Just keeps on goin'
and goin',
and it seems like it's not getting better week after week?
- In both cases, we're talking about the plantar fascia.
- Sure.
- And that's a fascia that's on the bottom of the foot.
My foot's a little bit dirty.
- Don't worry about it, Bob.
We'll take care of that later.
- So quite often in both cases, the pain is right here,
right by the heel.
So in plantar fasciitis, it's actually inflamed. -Itis?
- Inflammation!
- Right?
Fasciosis is more degraded. It's become weakened.
It's become scarred up.
- So it's injured from initially being torn. It's just--
- Right.
- not getting better, but it's not all real tender
and inflamed then.
- Yeah. It heals, you break it open again.
It heals, you break it open again.
- Day after day.
- Right, so in that case,
you really don't want to put ice on it,
which you do
with plantar fasciitis. - Right.
So you wanna put heat on it. - Okay.
- So that's the first thing you're gonna try.
- Okay. So in regards to heat,
you can use a hot pack.
Put it in the microwave if you have one like that.
You can use the electric type.
FIR Infrared actually will go deeper and better.
If you don't have that, and you have a regular one,
that's fine.
You know, you can take a rice full of sock.
We have that on some videos now. Heat that up
in the microwave. - A sock full of rice.
- Oh yeah, yeah.
And that actually works quite well,
and it costs very little.
And most people can have that available.
- Yeah, it's comfy. - Yeah.
So what's the next option?
- All right. If your foot pain continues
and continues, Brad, I want you to try some massage.
- Sure. - On the bottom of the foot.
Now, if it's still plantar fasciitis, flared up.
- Yep. - You're gonna wanna h--
The painful area is right here usually.
Now, it's often too painful
to even massage in the area with plantar fasciitis.
- Yeah. I've had a number
of patients where I'll push on that spot,
work my way to it, and then they,
"Oh," they say, "Stop right there!"
- So you can work around it.
- Sure.
- But with fasciosis, you may be able to work right on it.
- And I would suggest if we start to massage,
should we get right into it here?
- Right, let's do it.
- So the fascia actually is here,
and it spreads out this way like a fan.
- In between the toes, actually.
- So I'm gonna start here, and regardless,
I'll start here on a patient or myself.
We can do circles with the thumbs, okay?
And then get closer and closer to the tender spot.
If it gets too tender, just don't go any closer.
Use good judgment on that.
Don't go on a really tender spot
and just beat it up just to put up a--
- Make it worse. - Right.
So use good judgment. Don't be too aggressive.
You can do the Splane type.
Usually would not do this with socks on.
- Right. - I'm just doing it
'cause you can have a--
- You can really see its figures.
- Better contrast.
And this is where your thumbs will get tired
if you're doing it properly.
You're gonna push in deep and pull across.
Same with the circles. You're gonna get in deep
to that fascia.
The fascia is a very tough tissue.
- Right, it's thick. - Yep.
And you really can't get too aggressive on it.
And then work that up into that point.
Now, if you can tolerate,
I like to work circles around this area as well as Splane,
but circles just seem to work better
'cause you know that's the point.
And if you do this for about 20 seconds
and it clearly feels better, it's like, "Oh wow!
That's better than when I started,"
then you keep gettin' after it until your thumbs get tired.
- But I have a concern.
- Oh, yes.
- The concern is, Brad, that you won't do it because--
- I won't do it?
- Because it's tough to do.
- So you're sayin' I could have my wife do it.
- The average person won't do it.
And the average person's wife won't do it.
So that's where this week's giveaway--
- And even my wife won't do it.
- I'm sure she won't.
This Bob and Brad Foot Massager,
this is really a great unit.
It's actually got a remote control, and it's got heat,
and it's got different settings.
- Right.
- And you can go just go to bobandbrad.com
and go to the Giveaway section and sign up for it.
- This is the giveaway.
- That's the giveaway.
- Yeah, and the nice thing about this is you get on there,
and it doesn't tire out.
You can have your feet in there.
- Right, and never says, "No."
- Yes, unless you unplug it.
Are we gonna show some other options
for massage without your fingers?
- Well, you can show. Sure, tennis ball.
- Yeah. If you got a tennis ball or a golf ball,
depends on how aggressive you want to get.
I would start with the--
- The tennis ball
- Tennis ball, yep.
And this, you can go with your socks on.
Shoes off, of course.
- What a pair of socks you have there, Brad.
- Well, yeah. Look at that!
See, those are bones. They're skeleton socks.
Yeah. I find 'em entertaining, and I sleep in 'em too.
- I bet you would. - Yeah.
Now get the golf ball, and that is when it's--
- That's aggressive - Yep.
The thing about the golf ball, it's a little slippery.
I'd have to take my socks off. See, it slips out.
But it won't do that if you take your socks off.
It actually grips 'em good.
But you're gonna work over that,
and you can, you know, watch TV,
do whatever you want and do that for a few minutes.
And, you know, more than once a day, actually.
- All right, we have one more suggestion.
- Oh, I'm sorry. I'm babblin'.
- Okay. The final thing you wanna make sure, Brad,
is that the calf is adequately stretched
because if this is tight,
it's gonna put more stretch and stress on the foot.
- That's right. 'Cause they're all connected.
It's all a chain
- A posterior chain.
- That's right.
- So, what you wanna do is a lot of ways you can do this.
Or you could just take a towel or a sheet or a pillowcase
and pull on it like that and give a good stretch.
- Yep. If you had a belt, you could use that.
Sometimes it works better if you have your shoe on
'cause your sheet or whatever you're using kind of grips
to the rubber sole. - Right.
- Or you can certainly do it without,
whatever works best for you.
- Brad, do you wanna show another option?
- Yes, I do.
Oh! Right now.
Okay, the old classic, traditional wall stretch.
It's best with shoes on.
You need something that grips to the floor,
and put your foot, so it points straight towards the wall,
not like this. - Keep your heel down.
- Yep. Heels glued to the floor.
Sometimes I'll tell my patients,
"Pretend someone's got a nail in your shoe,
and they nail the heel right down to the floor,
so it can't come up."
This is being stretched, not this one.
This is just kinda hangin' out.
I'm gonna keep the knees straight, lean forward,
and stretch and hold it 15 to 30 seconds,
or pressure on, pressure off, 10 times.
And then bend the knee, and do the same thing.
It works a different muscle.
The Gastroc versus the soleus - solus, right.
Yep. Not that you need to know that,
but some people appreciate that information.
Then it makes 'em sound like,
"We know what we're talking about."
- Right, exactly.
I can imagine being your patient,
the things you tell 'em.
- Yeah, I come up with some pretty interesting analogies,
and I have to be careful.
- All right.
Remember, Brad, I can fix about anything.
- Except for . . .
- Ah, what is it, Brad?
- The broken heart bond.
- Ah, we gotta get on it!
- That's right, Bob.
And I'm considering a new technique,
a new approach, next week.
- Surgery?
- It'll be another chapter in the book.
- Okay, gotcha!