Plantar Fasciitis

Your foot may develop thick and fibrous bands of tissue that are known as ”fascia”. These can reach from the heel to the toes. The tissues offer support to the arch of your foot and the muscles. If they get overly stretched, small tears may develop in their surface which can lead to pain and inflammation.

What Causes It?

There are numerous things that can lead to plantar fasciitis. Even though men sometimes develop the signs of plantar fasciitis, the condition is more frequently observed in women. Obese or overweight people are also highly prone to develop plantar fasciitis. Alternately, you may get affected by it if you are on your feet standing, walking or running for multiple hours a day. Elderly men and women are also prone to get affected by plantar fasciitis.

Other risk factors include:

• Having very high arch or flat feet
• Wearing worn-out footwear with thin soles
• Having “heel cords” or tight Achilles tendons
• Wearing high-heeled shoes on a frequent basis
• Having an unusual foot position or gait while walking

 Long Sitting Stretch

1. Sit on the surface of the floor with both your legs properly stretched out
2. Wrap a towel just around the top section of the affected foot
3. Now gently pull the towel close to you so that you feel a stretch across the bottom section of your foot
4. Continue holding in this position for about 30 seconds and then relax. Repeat this stretch for 10 times

Achilles Stretch

1. Stand facing the wall and keep your hands on it in a straight-out position
2. Keep your affected foot flat on the surface of the floor and step back
3. Lean towards the wall slowly as you move your other leg forward
4. Stop just as you feel a stretching sensation through the calf
5. Stay in this position for about 30 seconds and then relax. Repeat the exercise for about 10 times

Stair Stretch

1. Stand on a stair step with your weight on the balls of the feet
2. Hold on to the stair rail for balance
3. Now slowly lower your injured foot heel until you feel a stretch
4. Hold on to this position for 30 seconds and then relax. Repeat this stretch for 10 times

Can roll

1. Sit in the chair and put your injured foot over a can
2. Roll the injured foot back and forth just from tip of your toes to heel
3. Repeat this 10 times in both the directions

You can also manage the inflammation and pain that often occur with plantar fasciitis simply by practicing the call roll using an ice bottle. This specific technique is referred to as ice bottle massage.

Toe Stretch

1. Sit on floor by having your knee bent while you keep your foot flat on floor
2. Pull your toes back on injured foot as long as you feel a stretch just across the arch
3. Stay in this position for about 30 seconds and then relax; repeat he stretch for 10 times

Plantar Fascia Toe Stretch

1. Remove your shoes
2. Stand with your face towards the wall; place ball of the foot gently on the wall. Make sure that your toes are extended up on the wall
3. Press down slowly while stretching the toe backwards while elongating the plantar fascia
4. Stay in this position for about 10-15 seconds.
5. Repeat the stretch for 5 times.

Your PT can prescribe the stretches mentioned above to be performed regularly at different times of the day. However, you should stop in case any stretch leads to an increase of your pain. If you feel any serious pain, make sure that you consult your physical therapist or doctor.

Carpal tunnel Syndrome

Carpal tunnel syndrome (CTS) is a condition that developed when a person’s median nerve becomes squeezed or pressed at the wrist. The median nerve is a nerve that from forearm to the palm.  The carpal tunnel is a rigid, narrow passageway of bones and ligament around the base of hand. It houses our median nerve as well as the tendons which bend the fingers. This median nerve transmits feeling to the thumb’s palm side as well as the middle finger, index finger and a part of ring fingers (not little finger). Carpal tunnel also controls certain small muscles present around the base section of the thumb.

In some cases, thickening from lining of the irritated tendons as well as other types of swelling eventually narrows this tunnel and eventually compresses the median nerve. It can lead to weakness, numbness as well as pain in the wrist and hand or around the arm and forearm in some occasions. CTS is regarded as the most widely occurring entrapment neuropathy, where pressure is exerted in one of the peripheral nerves of the body.

Treatment

Non-surgical treatments

• Splinting.  In most cases, the initial choice of treatment is application of a splint that is worn at night.
• Avoiding any kind of daytime activities which can aggravate the symptoms.  People experiencing slight discomfort during the day may want to take breaks from tasks rather frequently to rest their hand. Cool packs can be applied if the wrist turns red, swollen and warm.
• Over-the-counter drugs.  In various special circumstances, medications and drugs can be used for easing the swelling and pain associated with the carpal tunnel syndrome. For instance, NSAIDs or Non-steroidal anti-inflammatory drugs like ibuprofen, aspirin or various other types of nonprescription pain relievers can be used for providing short term relief from the discomfort. However, these medications cannot treat the CTS condition itself.
• Prescription medicines. Corticosteroids like prednisone or lidocaine can be directly injected into the wrist area. They can also be taken orally (in case of prednisone) for easing the pressure on median nerve. This method can be applied to people having intermittent or mild symptoms. However, individuals with diabetes as well as those who are predisposed to diabetes must be aware of the fact that regular and prolonged use of the corticosteroid medications can eventually make it rather difficult to effectively regulate the insulin levels.
• Alternative therapies.  It has been found that Yoga asanas can help in reducing the pain and enhance grip strength among the patients of CTS. There are also people who report relief from acupuncture and chiropractic treatment methods but effectiveness of such therapies still remain unproved.

For all early-stage CTS cases, conservative care is recommended as the first step of treatment. Physical therapy can also work well when it comes to reducing the symptoms. Such therapies can also help a patient in getting back to regularly performing all normal activities. If you are looking to visit a physical therapist for the first time, make sure that you describe your symptoms clearly and in great details. You should also mention the specific things that make the symptoms worse.

Based on the specific causes responsible for your CTS, the therapy program may comprise the following:

• Education regarding:
  • changing wrist positions (for instance, avoiding bent wrist positions for a prolonged period of time)
  • proper upper back and neck posture (you should avoid slouching or forward head position)
  • In case sensory changes are detected, you may be asked to use sharp tools, utensils and other implements in a safe manner
  • “stretch breaks” that must be taken during your daily routine or work
• Exercises for enhancing the muscle strength especially in your fingers, hand and forearm, as well as in some cases, postural back and the trunk muscles
• Various stretching exercises for improving flexibility of the hand, wrist and the fingers
• Application of heat and cold treatments for relieving pain
• Application of a night splint for reducing discomfort
• Ergonomic principles should be followed in your work area. If you need to work on a laptop or desktop computer by sitting at a desk, it is very important that the keyboard is placed at a position so that it is properly aligned with the rest of your body. This can help in avoiding working in bent wrist position.
• Increasing size of the tools and the utensil handles simply by adding some extra material to ensure a comfortable grip
• If vibration is common in your workplace you should use anti-vibration wraps or anti-vibration gloves around the tool handles

The physical therapist is also going to consider your leisure activities as well as your home in general and may recommend you to wear gloves for keeping the wrists and hands warm. You should also avoid sports which can aggravate the symptoms of the condition, like racquet sports as long as the condition resolve.

The main aims of the physical therapy are reducing your CTS symptoms without performing a surgery, so that you can have as much an active and functional life as possible. The physical therapy is also meant to assist you in resuming your normal home, work and leisurely activities.

Physical Therapy after the Surgery

In case evaluation shows that the symptoms of your CTS are more severe or your symptoms continue to persist, the physical therapist may actually refer you to some physician for surgical consultation. Surgery can be performed if deemed necessary for releasing the band of the tissue that is leading to pressure on median nerve. Once surgery is done, physical therapy treatment becomes very important after the surgery so as to help in restoring strength to wrist as well as to modify habits which may have caused the symptoms initially. Physical therapy may include the following:

• Exercises for improving the strength of wrist and hand muscles as well as for improving function
• Stretching for improving mobility of wrist and the fingers. Improving their function is yet another important reason
• Scar management for making sure that the skin remains supple and flexible
• Medical education pertaining to appropriate posture as well as wrist position so as to avoid problems associated with carpal tunnel compression. This can often be a risk with various home and leisure activities
• A worksite visit along with simulation for optimizing the different postures and positions

If you would like help reducing your pain and want to live pain free life or restoring range of motion, then don’t hesitate to contact Health Plus Physical Therapy in Edison, NJ for an appointment today.

Our location:
2114 Oak Tree Rd, Edison, NJ 08820
Phone: 732- 494-5999
Fax: 732-494-5994
Email: info@healthpluspt.com

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