Another Plantar Fasciitis update.
But what exactly are we talking about?
It seems my heel is much more popular than anything actually useful I talk about. I’ve been getting 2-3 emails a week from people who have plantar fasciitis or have had it and want to share their experiences with me. Thank you for the attention. I appreciate the support.
With that in mind I want to share more knowledge with you. Part of this is specific to the Plantar but part of it is how to diagnose injuries as well.
I went to see my massage therapist Jill this weekend to have her poke around in my heel. I haven’t run in over a month and nothing has really changed with the injury. It’s not swollen, but it is still achy.
I like to use massage therapy in a broader context. When people think of massage, they think of some 3rd party rubbing. I like to think of it differently. I think of massage as diagnosis and healing. I think that if you just go lie on a table and get rubbed you are missing out on the real value of massage.
When I work with Jill, who I have known personally for over 20 years, it is a much more advanced interaction. First, she knows who I am and what I do with my body. This means she can ask the right questions. Our starting point is a collaboration on what I feel, think and want out of the session.
We aren’t starting from scratch and I don’t expect her to be able to magically tell where it hurts. It is a partnership. She becomes an extension of my perception. Her knowledge of the body and my senses work together to diagnose, isolate and treat.
Her fingers know what different tissues feel like. She can tell me where there is scar tissue or adhesions. She can manipulate those specific points where I direct her in a way that bring blood and, yes, human healing energy. Call me a mystic if you want but the touch of another human has healing powers.
I had Jill dig into my foot to see if she could isolate what it was that was giving me trouble.
The broader diagnostic lesson here is that you need to get specific. Most injuries may have a technical medical term that sounds specific, but are actually quite generic. Any of the ‘itis’ type injuries, tendonitis, fasciitis etc are just telling you that something is inflamed. They aren’t telling you specifically what is inflamed. In order to heal, you should know what is tweaked.
The foot is a great example of this. If you’ve got a pain in your foot it could be a number of things. There is a lot going on in there.
There is a layer of tissue that exists throughout your entire body called fascia. The fascia is thin layer of stretchy stuff that holds things in place and takes some punishment. Think of it as a compression shirt – but in this case it is a full-body compression suit. There’s a great article about the fascia by Christopher McDougal, (yes that Christopher McDougal) you can Google.
http://www.menshealth.com/fitness/understanding-your-muscles
Underneath and intertwined with the fascia are muscles. Muscles are made up of fibers that contract. When they contract they create power, for things like swimming, biking and running. There are several bunches of muscles along the bottom of your foot. Each of these is made up of millions of muscle fibers.
When you get fasciitis this is just saying that somewhere in this wrapping sheath there is an injury or inflammation. On the bottom of your foot there is a big piece of fascia wrapping the Plantar muscles. Hence Plantar Fasciitis.
Those muscles underneath the Plantar Fascia are connected to your bones via ligaments and tendons. Ligaments and tendons are the gristly, rubber-band type tissues.
The whole mess works as a system. The individual muscle fibers get fired by nerve impulses and contract. The individual muscle bunches contract together, interacting with the toe and heel bones. They tug on the connecting ligaments, are constrained by the controlling tendons and slide back and forth within the Fascia.
You have problems when one of these many individual parts gets injured. That’s when you get an ‘itis’ or an ‘osis’. My point is that your specific injury could be in any part of that system. You should find out which part it is.
Jill was able to push through the fascia and found a small bundle of fiber, like the size of a toothpick or grain of rice, where my injury is. My injury is where a specific muscle, the Abductor Halucis attaches to the heel. She could feel the injury and after our session I could feel it too.
She was able to loosen the muscles and fascia surrounding the injury and that really helped the heel feel relaxed and normal, at least for a little while.
Knowing exactly where and what the injury is helps not only in the treatment but also helps your peace of mind. The more specific you can be helps you treat the injury specifically and also helps you feel more in control of the situation.
How does this help me? First I now know that there is value to working that specific area on the heel to break up the tissue and help blood get in there for healing. I know which stretches to focus on. If it comes to it, I’ll know where to inject the cortisone.
The two things I want you to take away from this is first, to learn to use massage as true therapy. To use it as diagnostic, and treatment. Sit down with your therapist, open up the books and look at the pictures of what exactly you are dealing with.
Secondly, don’t settle for a generic diagnosis. Do the work to understand what all the moving pieces are and isolate the injury as specifically as possible.
There is a lot going on in your body. It is an amazingly complex and beautiful system. Learn how to work with it. It’s your machine and you should know how to work with it.
To be specific I have a small tear in the ligament that attaches the plantar abductor halucis to the heel – and I’m going to heal it.