♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Howdy, folks.
I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We're the most famous physical therapists
on the internet.
- In our opinion of course, Bob.
- Today we're gonna talk about plantar fasciitis
that's not improving.
Very common scenario,
by the way. - Sure.
- Here's how we got an 88% improvement
with just one self-treatment method.
- We're gonna show you,
plus we're gonna show you three additional pearls
that'll help accelerate it as well.
- By the way,
if you're new to our channel,
please take a second to subscribe to us.
We provide videos on staying healthy, fit, pain free,
and we upload every day.
Also go to bobandbrad.com.
We're always doing a giveaway.
It's just not starting today.
You gotta go tomorrow.
Tomorrow, yes. - It's only 24 hours.
- Yeah.
You go there,
you'll go to the giveaway section.
You can also find the giveaway at Facebook.
It'll be pinned to the top of the page.
- That's right.
- Got to Twitter, Instagram, or TikTok
for a 60 second version of our program.
Let's go to work, Brad.
- Nice work, Bob.
Thank you so much.
Bob, I was, you know,
looking about this plantar fasciitis.
Like you said, we know,
they see the therapist after they've had it
for a long time. - Right.
- It's not getting any better.
And then they, you know, come to us for help.
So what is really working out there?
So I went to the studies
and I found this study and it was very interesting.
They took 37 patients.
- Gotcha.
- And a number of them had both feet had plantar fascia.
- So that's why it's 52 feet.
- Yeah, 52 feet. - The math didn't really work,
but now I understand. - Right.
37 patients.
- 52 feet.
- And the average length of time
that they were experiencing foot pain
was 33, almost 33 and a half months.
- Think about that.
- So it's chronic.
- Almost three years of pain.
- Yeah, yeah. - Wow.
- It was going on for a long time, so-
- And that's the average?
- Right. - Okay.
- And that's the average.
So what they did is they just wanted the one treatment
that both you and I think, well,
this is a really good idea.
It makes sense.
We've had success with it with patients.
And your wife
had success with it. - My wife had success with it.
- And it happens to be a night splint.
- Yes. - Wearing it at night.
Now what they did is they had all of these people
wear night splints for four weeks
and they cut all other treatments out.
Nothing, no stretching, no exercises, no ibuprofen.
It was a very comprehensive study.
By the way- - It's well done.
- Yeah, well done study.
I got the name of it on there somewhere...
By Ankle and Foot International,
January 1st, 1998,
it's a older study,
and it was called the "Effective treatment
of chronic plantar fasciitis
with dorsiflexion night splint."
- Very good.
- Okay.
So four weeks, nothing else but the night splint.
They had to wear it every night, all night long.
After the four weeks, 88% improvement.
- Wow.
- And the 80% of it was subjective.
80% of them said, "Yeah, it feels better
as a result of wearing this."
And there was also two objective measurements that they did.
And both of those showed significant improvement.
One was, you know, where you had gone to school-
- The Mayo Clinic old scoring system.
- Right, exactly.
- Not familiar with it,
but I'm sure it's a standardized scoring
so they can figure out whether it really got better.
- Right, it wasn't just a psychological effect of it.
- Right. - So-
- In my wife's case, by the way,
she had two bouts of plantar fasciitis.
And the first time, the massage seemed to help.
The second time, we're doing massage,
we're doing all of the things.
It's just not getting better.
We do the splint.
Boom, it got better.
- In one night?
- Well, it got better rapidly,
like within one week. - Sure.
- I mean, so I was surprised at that.
But that's one person, again.
- Now we both have prescribed this to patients.
First of all,
you have to, you know, get a night splint
or figure out some way to use one.
But the common complaint,
between Bob and I, both experiences,
it's not comfortable and you take it off,
or you don't wear it daily, or nightly.
- You don't wear it consistently.
- Right, you have to wear it.
Obviously the study went for four weeks, 28 days.
That's a long time.
But once you figure out a way
to wear the night splint comfortably
and you can wear it every night
and you get used to it,
you're gonna have success.
- One of the problems is there's so many different types
and sizes and body types.
- Right.
- What you'll see is the number one complaint
is that it doesn't fit well.
- Right.
- The one my wife had, it was really pretty decent
and they're no longer making it.
- Oh.
- And now you've got one that you kinda like, right?
- Right.
I got this from a patient.
He wasn't a patient of mine,
but a person who had it, he said this one.
It's called, and we're now...
This is just something, we're not-
- We're not endorsing this by any means 'cause...
Look at the reviews yourself. - Right, exactly.
- And figure out which one you think might work for you.
- Another complaint is getting up
in the middle of the night if you have to use the restroom,
difficult to walk on, where to the point where some of them-
- Almost would fall, I bet.
- Right, now this is not an AFO made for sleeping,
but the concept is that some of them will have
a firm, rigid back
which goes around on the bottom,
and that can make it very difficult to walk on,
especially if you don't have rubber grippies on the bottom.
One thing I do wanna make clear is,
in the study,
the dorsiflexion that they did for the person...
You might have to move, Bob.
- Show us what this dorsiflexion is, Brad, by the way.
- Yeah, so the reason you wear a night splint, by the way,
'cause you might be wondering, "What's the big deal?"
The tissue of the plantar fascia
and the bottom of the foot to the heel,
and it actually, not directly,
but indirectly is connected to the calf muscle.
And when you sleep with your foot pointed down,
which I think everybody does. - Right.
- Those tissues start to heal
and they tighten up a little bit over the night.
And then when you get up and you put weight on it,
it stretches that partially healed tissues
and it rips them apart again.
- [Bob] Yeah, re-tears it.
- And that painful,
if you get those symptoms,
when you get up and say, "Oh, it hurts,"
and then it improves after you walk for a while,
you're a really good candidate
for one of these nights splints.
- You're going through this cycle of every night, basically.
- Right.
- You're healing, tearing,
healing, tearing, so.
- So what we're gonna do is put a night splint,
and at 90 degrees is where your foot,
or neutral is where your foot is at 90 degrees.
Like here,
this would be plantar flexed.
Dorsiflexion is pulling it up.
Now they went, they said five degrees,
which isn't too much into dorsiflexion.
So if you're getting close to the 90 degrees,
I would say, you're gonna get good benefits.
- You gotta go by comfort. - Exactly.
- Because you won't be able to sleep if it's...
I mean, you might have to start here, even, Brad.
- Exactly.
- And work your way up to that
because, you know, you gotta sleep,
and you won't be compliant
if it is not comfortable.
- Right.
So with that in mind, let's go back to this,
and you'll see,
I thought this really has,
it looks like a good idea
because it also pulls the great toe up,
which we know from recent studies and experience-
- That seems to help too.
- That's a critical part of having progress.
So actually, I don't have plantar fasciitis,
but I said, "I'm gonna sleep with this thing."
So I did. - Sure.
- I put it on, it fits nice.
The other thing about it,
it has a compression type stocking
and you can easily walk around on this.
I don't have any problem at all walking on it.
- [Bob] Sure.
- So that part was good.
The compression stocking,
if there happens to be swelling in the foot
from the problem,
it's gonna help with circulation a little bit.
Just a minor thing.
So you put it on,
it's all Velcro, it works out nice.
There's a strap that goes around just below the knee
in that area right there
where a lot of braces do use for a support area.
And you put this on,
and there's a little thing in here, a support.
It's a little rigid plate.
- [Bob] Oh, yeah.
- [Brad] The reason for that
is to help get that toe extension,
that could be real critical.
And you could adjust it.
You know, if you're gonna get up to that 90 degrees,
which for me, it's like, "Oh, that's a little tight."
So I went to bed, I slept with it for a little bit.
I woke up, it's a little tight.
If I just do that-
- [Bob] What's nice about this one,
it's pretty easy to adjust.
- [Brad] It is.
- [Bob] But again, I'm gonna guarantee you
that there is people that aren't gonna like this.
It's just there's always something about each one.
- Right, and that-
- [Bob] This is a ProStretch Night Sock.
- Yep. - Yeah.
- So I'm not saying this is the one,
but I'm just pointing out the good points about it.
- Right.
- With me, about four o'clock in the morning,
everything was very comfortable.
I forgot I was wearing it,
with the exception of my toe,
is right where my toenails touch the skin of my foot
because this was pushing into it.
- Oh, sure.
- It was irritating right at that point of the skin,
and I couldn't sleep anymore so I had to take it off.
But I think if I hadn't cut my toenails, you know,
cut them really short, like some people do that,
I have a tendency to cut them too short,
I don't think I would have had that problem.
The point is, is you're gonna need to get a night brace
that fits and works well.
And you may have to adjust it and work with it
for a few nights in a row to find out,
or just get used to it so that you can sleep good.
- You may have to build up to it too
to make it through all the whole night.
Maybe you do what you do.
Go so far, take it off.
Next night, see if you can go longer.
- Right, right.
Again, we're talking about a chronic problem
that's been with you for months.
And, you know, you don't wanna have the laser surgery
or, you know, you can't afford it.
You're working on getting it better conservatively.
I think it's a good option.
Now also, before you even get out of bed,
you can do some exercises.
- Yeah, I'll show you right here.
- And Bob's gonna show those exercises.
- So these are the ones that you all should be doing anyway.
So you can actually see the plantar fascia on me here.
So I'm gonna grab my toes.
I'm grabbing all the toes
and I'm dorsiflexing the ankle,
so I'm bringing the ankle like this.
- [Brad] There you go.
- [Bob] Like that.
And I'm grabbing the toes.
So I'm stretching everything at the same time
before I even get out of bed.
- [Brad] You're not gonna get real aggressive on this
if it hurts.
You're gonna be gentle with it and just stretch it
as tolerated.
- You can do a good 30 second stretch,
and maybe a couple of times.
But then also in addition to that,
you can go ahead and do some massage on this area.
- [Brad] Right.
- [Bob] And so you can take your two fingers,
thumbs, I should say,
and just do circular massages.
This is often the painful spot.
- [Brad] Yep, exactly.
- [Bob] I often work around that.
You probably maybe can't massage it on that spot.
It's too painful.
But massage like this and get the band,
that plantar fasciitis band,
ready for the day. - Right.
- [Bob] You know, before you even get on it.
Then you can also do splaying
where you actually pull your thumbs apart like this.
Oh my god, really feel that one. (chuckles)
- [Brad] I think it feels pretty good.
- [Bob] Yeah, it feels good.
It hurts so good. - Yeah, yeah.
- [Bob] So circular and pulling the thumbs apart like this.
- [Brad] And you'll do that, your thumbs will get tired
within a minute or two and then you're done.
- And then the final thing you do, what, Brad,
you actually put your shoe on before you get out of bed.
Don't walk.
Or if you have good slippers with good arch support,
throw those on before you get out of bed
or go to the bathroom.
- Yeah, so you're gonna show-
- Avoid that barefoot walking.
- You're gonna show a cold roller too, Brad?
- Yeah, let's say you've been working all day
and you've irritated your foot a little bit
and you wanna cool it down.
If you just take,
like this, we got a bottle water.
Fill it up, or empty it, whatever,
so you've got a air gap
about 3/4 full or a little bit more.
Throw it in your freezer, turn it into an ice bottle, okay?
You have to have the air gap
so it doesn't pop off with the expansion of the ice.
So you got your frozen water bottle there,
and then you can just work it back and forth like that,
and that gives you a massage.
The mechanical benefits and the cold, the cryotherapy,
is gonna help with that,
that foot that's been working so hard all day.
So after you've worked at it for five minutes or so,
and it's starting to feel cold and numb and better,
then take that and then drink the water.
(Bob laughs)
No, don't drink the water.
Put it back in the freezer,
prepare for another day where it may be needed.
- It's nice you can even do at work.
You know, you can keep it under your desk.
- There you go, Bob.
That's a good point. - Because a lot of times,
anytime you sit for a while, it tightens back up.
- Right, right, exactly.
- So you wanna loosen it before you get out of,
even off the desk. - Right.
So, you know, I know we got the 80%, 88% improvement,
but you do have to stick with the plan.
It's not always simple,
but it's proven to be quite effective.
It's just a matter of deciding you're gonna do it.
- Thanks, everybody, for watching.
- Good luck.
(gentle electronic music)