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ERS today I'm going to be showing you how to treat somebody with plantar fasciitis he has had pain on
the heel by the heel of his foot this is usually at the base where they feel the pain it originates
right here from the calcaneus all the way to the base of the of the of the toes so it's pretty long
it's three flat thick bands and sometimes you get micro tears so it's very painful usually happens
with people that stand for for long periods of time or runners or joggers or people that work
standing up all day or climb Hills or have a little bit of pronation too which I think that
might be the case and flat feet so he's having some pain so I'm going to show you some things
that you can do and I also want to tell you that I treat it prone in supine so you want to treat
it from both sides and you also want to treat the Achilles tendon because the the plantar fasciitis
connects right here to the calcaneus and then the calcaneus the calcaneal tendon also known
as the Achilles tendon you know comes down here and it attaches you know at the calcaneus bone
so it may be tight here then it starts pulling on the Achilles and the calves and the gastrocnemias
the Soleus the tibialis posterior so you want to make sure and treat the back of the leg too
so what I like to do and you want to start really without any oil so you might just want to do some
spreading already just do some light spreading at the top of the foot at the dorsal part
just to kind of spread the metatarsals remember the metatarsals are in the toes
in the feet metatarsals metatarsals are in the feet so you want to do some work at the top
to begin with do some spreading here and if their feet are really dry then
you can use a little bit of lotion but I I try not to put too much lubrication okay
so you want to start just by doing some gentle squeezes depending on how much
pressure they can tolerate so just do some warm-up introduce your hands to their feet
and then you can do some with the heel of your hand just go down some nice stretches here to feel
you know see what you feel see if you feel any tension
and also with a soft fist remember this is a soft fist so you want to
do also with your soft fist going down just gliding down which is gliding down for now
and you can do this up to you know to 10 times 7 to 10 times another thing to remember is that if
it hurts too much you want to make sure and stay within the range of six and seven on a scale from
one to ten you don't want to go above you know to a eight or nine or a ten because you'll irritate
it more so now one of the things you can do is all I'm doing is spreading with my thumbs
I'm spreading out like a fan spreading the bottom of the foot just spreading it out with my thumbs
spreading the tissues that plantar fascia all the way down to the heel you know
and you can also use your your your fist and just spread with the bottom of with your knuckles a
little bit spread the fascia and like I said the pain usually happens is worse right at the base
of the heel so you want to be careful with that area so again I'm spreading like a fan
just with my Knuckles if I need to go a little bit deeper then my thumbs so I spread it out
you can also do some figure eights with your knuckles
and some stretches there I can tell that he kind of hesitates a little bit when I
start stretching it out too much so I still need to be careful so I'm going
to do I'm going to hold at the Achilles tendon or the calcaneal tendon which is
the same thing and do some flexing and then gentle extension and see how that feels for
him this might be something good that you can do up to about you know like 10 times
and I'm pushing with my fist to get more traction
okay so now I'm going to start doing a little bit more specific work you can do
it with a brace thumb a brace thumb is where you're supporting your thumb so what I'm going
to do is just go in circular motion some static pressure all along you know the base by the toes
I'm gonna I'm gonna speed it up a little bit just for the sake of the video but you can do
the static pressure all the way across underneath the base of the toes you can also do it piggyback
where you put one finger over the other and you know for to support the finger so that your thumbs
don't get too tired you can do this move right here all the way down with a piggyback fingers or
you can do it with a knuckle if it's easier to do with a knuckle you can also do it with a knuckle
and when you get to the base here where it hurts a lot you know just make sure that you do it
gently you don't want to dig in there too much but that's so those are that's one of the techniques
that you can do another one is cross friction where you're going across the plantar fascia
that's all I'm doing is cross friction here
and then again you can do some spreading let's see if it's if it lightened up a
little bit if it's not as tense you can do with the knuckles gliding down
and I also like to do some figure eights here holding the Achilles tendon putting just a little
bit of pressure maybe do it it starts getting that part loose so once you've moved and done some work
here on the planner part with them supine then you're ready and you can do hand over hand some
hand over hand petrissage here to it top of the foot and do some spreading and also you another
move is like you put your hands on top and then with the fingers you're separating some of that
tissue there's lots of muscles underneath that plantar fascia the plantar fascia doesn't have too
much blood flow it's so it's difficult for it to heal so what I'm doing is I'm just separating the
tissue and like I said with a heel of your hand or with a soft fist you can go ahead and do some
um some effleurage here and now we're ready to turn him prone
so now he is supine and I can you know hold his foot and again do some elongating Strokes
here with a flat fist soft fist just to get more stretching on here from this position
so remember that more than likely this is where it hurts at the base of the heel
so I like to work the calcaneus here
and just kind of like if you're praying put your finger like put your fingers together lace your
fingers and just go over the calcaneal and the calcaneus or the Achilles tendon
urisa
almost like as if you're praying
you want to do some stretching
and again you can start doing just some cross fiber friction here all the way with your thumbs
so you basically do all the same techniques but just while they are you know while they're prone
another one is the separating the separating of the tissue
and I want to show you how to do some stripping of the uh Achilles
flossing because that really helps and again if you want to do the knuckle
right along where it hurts you can do that too again from the prone side you have more axes here
to the bottom of the foot you can also do the piggyback all the way down the plantar
fascia and also with your knuckle if you know if uh if you're ready to go deeper
then you can do more of the knuckle here another one that is important to do is to flex and extend
that the hallux remember this the big toe is the Helix the thumb is the Pollux so that you you
extend and flex the toe ex extend and flex the toe gently you don't want to do this difficult I mean
too hard because this one also pulls all the way you know the plantar fascia so flexing the big toe
and then extending it this is also good to relieve some of that pressure there okay but I want to
show you how to do the um flossing of the Achilles because remember working the gastrocnemius and the
Soleus is going to be important so one of the things that you want to do let me move over here
okay so I want to show you how to do the flossing of the uh the muscles and the Achilles tendon so
you want to bend their leg and you're going to pinch lightly right here by the Achilles you don't
want to pinch too hard because you don't want to cause a lot of pain but you're going to pinch here
and then flex and extend the foot flex and extend their foot flex and you do this several times and
I'm you know I'm in an awkward position because I'm trying to show in the camera but I actually
do it with my forearm you know or you can do it with a palm of your hand if you're strong enough
but you want to get some of this flossing here and a lot of times the Achilles tendon is very painful
so once you're done with that and you can also work on the planner part you know standing up
I prefer standing up because then I get to use all my my my weight you know and
spreading of the toes and spreading of the um of the plantar fascia here the fibers
and then you can do the soft fist you can do the circular
and like I said just be very careful around this area if it's very painful and don't forget you've
got to work the calf muscles especially oh his calf muscles are like really tight
from all the walking that he does so um you want to make sure and work the gastrocnemius
and the Achilles tendon you can do again the praying hands you know after gastrocnemius
putting a little bit of squeezing pressure on the Achilles tendon
the Achilles tendon is the strongest and longest tendon in the body so right here at the bottom
by the heel I'm working on the Achilles tendon so you want to make sure and massage this really well
and then you can do some spreading of the gastrocnemius
and of the Soleus
and some lifting some lifting of the um tibialis posterior the gastrocnemius the Soleus
all these muscles here and again at the Achilles you want to make sure and treat the Achilles
tendon so make sure you work on them supine uh prone and don't forget to work the cups so I hope
that this you know that you're able to help a lot of people with a with plantar fasciitis and make
sure you tell them one of the best things to do is to get a frozen bottle of water a 12 ounce bottle
of water put it in the freezer and then have them roll their foot over it because the eyes will numb
it and give you a little bit more of a stretch and it will also take bring down the inflammation
so it's good to do that in the morning at night and do some stretches you want to you know Flex
you know and extend flex and extend the foot so until the next time create a great day foreign