physical therapy

How Physical Therapy Can Cure the "Dreaded Plantar Fasciitis"

Do You Have Plantar Fasciitis Symptoms?

  • You get out bed and feel searing pain with that first step.
  • You dread the first 10 minutes in the morning of standing and almost pee your pajama pants trying to get to the bathroom because your foot hurts so bad and you have to hobble there.
  • You’ve stretched your foot, arch, and calves endlessly with no lasting improvement.
  • You rolled a golf ball under your arch to the point of tears.
  • You bought 16 pairs of ugly shoes only to wear your tennis shoes to work every day.

If you’re familiar with any of these situations, it’s likely that your plantar fascia is in trouble, and with the arrival of summer your symptoms only get worse. For many, summer means flip flops, cute sandals, and walking barefoot on the beach.

For others it means ramping up training to prepare for a race this fall. All of these can put strain on the bottom of your feet resulting in your poor plantar fascia becoming inflamed and irritated.

Here’s a secret…the problem isn’t your plantar fascia. It’s actually your core, your hips, and your butt.

The foot is structured in the shape of an arch with the plantar fascia, a long, flat, wide ligamentous structure like a hammock, across the bottom supporting the arch. If you have weakness of your core, hips and butt or these muscle groups aren’t working properly, they can’t maintain the correct joint position in the leg, thus placing all of the stress through the bottom of the foot.

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Look at your foot when you’re standing – do you have an arch or are your feet flat like a duck? Are your ankle bones pointing inward?

When your weight is evenly distributed through the foot, the body can utilize all the muscles, joints and ligaments to support that weight. The hips and legs can then exert forces upward to hold your body upright.

When weight is unevenly distributed, the feet will rest in pronation (weight on the inside edge) or supination (weight on the outside edge).  Pronation is the most common fault and can occur for a variety of reasons; one is genetic predisposition to flat feet.  Another cause is weakness in the external rotators of the hip, which leads to abnormal rotation of the femur (thigh bone) and creates valgus (knees together) posture. If you follow this down the chain from the hips to the foot, the knees come together the ankles squint in too, resulting in strain on the plantar fascia.

By strengthening the core, hips and thighs and being aware of proper posture, the strain can be reduced and the plantar fascia can begin to heal.

Physical Therapist Approved Activities for Healing 

Finding neutral foot

Sit on a chair with feet flat on the floor, knees bent at a 90⁰ angle with toes forward, and ankles directly under your knees. Try to create an arch by lifting the ankle bones but also keeping the big toe on the floor. The goal is to make the pointy bones inside the ankle to be level with each other (not the inner one lower than the outer one).

Make it tougher

Once you can hold that position, try it while standing. Put your hands on a table or a countertop to decrease the amount of weight on the feet and help balance. Once you can hold that for 30 seconds and repeat it 5-10 times, try on one foot. Do this in front of a mirror so you can be sure your hips stay level when you lift the foot off the ground.

Now practice it – all the time

Pay attention to your arch while you’re standing. For example, while waiting in line at the grocery store, or while brushing your teeth. The more you practice holding that arch, the easier it becomes.

Strengthen with a purpose

Squatting is a great way to strengthen the lower body, if special attention is paid to maintaining proper alignment.  Imagine screwing your feet into the ground, using an outward rotation motion but not actually moving the feet. This motion lifts your arches and direct the knees ever-so-slightly outward.  As you can see in the image, this helps maintain safe alignment of the knees and feet and prevents excessive strain on the joints and ligaments of the leg.

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Orthotics, or shoe inserts, are often used to help maintain the arch temporarily. Ultimately though, correcting the mechanics of the leg and building strength will reduce the inflammation at the plantar fascia. So will maintaining a neutral foot position during daily activities thus preventing irritation in the first place.

Try the activities above for a few days to gain awareness of your foot position and note any changes in your symptoms. As with any exercise program, if you feel increased pain stop!  The activities are designed to decrease irritation so if there is pain, it’s a signal that your body doesn’t like what you are doing to it.

If you aren’t finding relief or just can’t get the hang of it, call a physical therapist (check out our blog post How to Find the Right Physical Therapist). A thorough PT will examine the lower back, core, hips, knees, ankles and feet, not just focus on the symptoms at the bottom of the foot. The therapist will work with you to develop specific physical therapy goals and a program to reach them.

Remember the process of healing and retraining takes time and it won’t happen overnight. With work and dedication, you should be able to return to what you love doing without pain.

Battle Born Health, where you can be STRONGER THAN YESTERDAY.

natural energy drinks

Are Energy Drinks a Necessary Supplement for Active Kids?

It’s summer which means our kids are doing camps and running around all day in the sun. Some are in competitive sports camps where they have games, practice and tournaments, plus it’s HOT and our kids are sweating! We NEED to replace those electrolytes; the commercial says so!  We need to get them energy drinks…or do we?

Sports drink commercials run during pretty much every break in televised sports and while they show athletes sweating, moving and looking generally worn out, they fail to actually explain the product’s alleged value. So what exactly are electrolytes and do we need what’s in that sports drink?

Electrolytes are electrically charged ions in our body including inorganic compounds such as sodium, potassium, magnesium, calcium, chloride, and bicarbonate. Their job is to help conduct electrical impulses throughout our bodies that are crucial to a whole host of functions. The three main electrolytes are sodium, chloride, and potassium.

These minerals are responsible for balancing body fluids, maintaining the body’s PH, regulating heartbeat, metabolizing carbohydrates, and are essential in the sodium/potassium pump which allows nerves to conduct messages. This is the process whereby neurons and muscles work to create an action potential. An action potential is the cascade of events that allow for nervous system to communicate, create a muscular contraction and thus movement. In plain English: Brain says run à action potentials make the legs move.

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During intense exercise the body will excrete these minerals through sweat and urine.  Now let’s define this “intense exercise” that warrants electrolyte replacement afterwards.  It is defined at 90 minutes or longer of continuous strenuous exercise. Think about when you have sweated so much your skin has a layer of salt caked on it…that is what we are talking about. Of course temperature and humidity factor into this as well, but the key here is long duration of continuous, strenuous exercise.

There are certainly times when we may need to help the body replace these important electrolytes. The energy drink companies have done a wonderful job of convincing us that they have the magic elixir, and the minute you get off the couch you NEED it.

Most energy drinks are similar, they contain high fructose corn syrup (glucose-fructose syrup), sucrose syrup, citric acid, natural flavor, salt, sodium citrate, mono-potassium phosphate, modified food starch, red 40 and glycerol ester of rosin. An 8 oz. serving of a typical sports drink contains 14 grams of sugar, which is equivalent to 3.3 teaspoons of sugar. If you drink the whole 20 oz. bottle, you’ll be getting a whopping 8 teaspoons of sugar.

Please don’t go out and buy the zero calorie sports drinks, the fake sugars are even worse for growing bodies than the corn syrup.

This isn’t to say that our kids will never need to replace electrolytes and replenish carbohydrate storage. They certainly might in the event of a doubleheader, kids playing multiple sports in a single day or during a busy tournament weekend.  At this point,  it is appropriate and important to replenish these elements in the body.  It’s important to remember that it must be in a useful form so the body can metabolize those minerals and vitamins and put them toward performance.

Our bodies react to high fructose corn syrup, sucrose syrup and chemical sweeteners with an inflammatory response; corn syrup is not natural, it requires a huge surge of insulin to process and remove from the blood stream. Instead of the body working to move leg muscles to run or kick, it’s busy removing the corn syrup from the system.

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Eight teaspoons of sugar will give them a rush and then a huge crash (aka bonking in the 3rd or 4th quarter – watch for it).  Plus, the chemicals used to give the drink it’s day glow colors (and dye all the kids’ tongues) are extremely unhealthy.  Again,  this increases the inflammatory load on the body. Sugar and processed food will further increase the amount of work for the body must do to recover, making a second or third game even more difficult and increases the chance for injury.

So now all parents are thinking, “Crap, now what do we do?  How can we help our young athletes thrive?” I have an answer for you…electrolytes that are found in FOOD! Natural, whole sources are more bio-absorbable and therefore more efficient sources for replenishing the body.

According to Emily Brown from Running Times Magazine “the usual foods we eat contain far more electrolytes than sports drinks. For example, a medium banana contains about 450 mg of potassium, whereas sports drinks provides 30 mg per 8-ounce serving. After a long run, a meal consisting of 8 ounces of yogurt and 16 oz of chicken noodle soup would adequately replace lost electrolytes (potassium and sodium)…”

Easy examples to replenish on the field are: citrus fruits (remember that standard-issue orange half we got as kids?) bananas, nuts, leafy greens, celery, tomatoes, apples, broccoli, avocados, apricots, seeds, carrots, olives and pickles. Eating these foods before and after the game will sufficiently reestablish the minerals and carbohydrates lost during the game. And even better, these foods with adequate amounts of water, will replenish without the fillers or damaging chemicals found in sports drinks.

Believe me, I understand that it’s difficult as a parent to enforce this change in behavior and you can just hear them now, “all the other kids get gatorade, why can’t we?” I encourage you to share this article with the parents on your team, vacation group, or counselors at the camp. When everyone as a group commits to avoiding the garbage, it gets easier to stick to the new plan. Collaborate with the other parents, during tournaments to encourage our kids to replenish their systems in a more favorable way.

Make a snack list prior to the event, parents can sign up to bring fruits (apples, oranges, bananas) nuts, almond butter with celery sticks, and carrots with ranch to the games.  Trader Joes and Whole Foods are usually easy to find and have these already prepared if you’re traveling for games out of town. Meals at home or on the road encourage vegetables consumption (not fried) to decrease the inflammatory processes that were produced during the exertion of the game and summer activities.

Here are a few easy recipes to sip during days out in the sun:

  1. Coconut water + a squeeze of lime, lemon or orange + 1/8 tsp. of sea salt. * for young kids, you can get a young Thai coconut (sold at many health food stores) and stick a straw (maybe with an umbrella) right inside.
  2. Fresh water + a squeeze of lime, lemon or orange with 1/8 tsp sea salt and 1 tsp of honey (to taste).
  3. Smoothies with fresh or frozen fruits and veggies (berries, banana, citrus, spinach, cucumbers, carrots and apples) blended with ice… tell them a leprechaun made it green.

For AFTER a big event, smoothies can include plain Greek yogurt (full fat) or whole milk, include veggies not just fruit to lower the sugar impact and increase the vitamin and nutrient diversity.

I have included a few websites in the references with more recipe ideas.

As a final thought, save the treats for after all of the games have been played, and keep consumption in moderation. Yes, they worked out. Yes, they have burned the caloric equivalent of a jumbo ice cream, but ingesting loads of treats does not allow for complete physical recovery. Their bodies need quality nourishment to adequately restore their muscles and be ready for the next event.  Let’s give our girls the level of support they deserve, so they can continue to amaze us with their success and incredible abilities!

For additional references and recipes please visit:

1. http://thesilverclouddiet.com/2013/02/a-sugary-drink-with-a-toxic-secret/

2. http://www.consumethisfirst.com/2010/05/10/sports-drinks-kids-and-electrolytes/

3. Emily Brown as featured in the November 2009 issue of Running Times Magazine

4. www.wellnessmomma.com

This article originally appeared in the June Issue of The Live Love and Eat Magazine.