Some thoughts on dealing with chronic PF:
Checking the system for misalignments....not just the foot/ankle but further up the extremity. Always check regardless if one or both feet are affected, but should be obvious if one foot it affected. Bc if you walk on two feet, why is only one foot in pain?
Standing posture and gait posture analysis should be looked at to determine if any excessive forces are put upon the feet.
Realize that the PF may be a result of the foot's COMPENSATION for something else occurring up the chain, and not necessarily the primary issue.
Simple example: Your anterior rotated pelvis on the R side is causing your center of gravity to shift forward. To compensate your posterior structures (R calf) have contracted to compensate this shift in order to keep you level. Constant contraction of the calf finally pulls enough on the PF causing pain. You can stretch, massage, Superfeet and whatever you want, and that may work a bit, but until you take the pressure off the posterior structures by balancing out the pelvis, you'll always have potential issues. Correct the imbalance and NOW all your measures to relieve PF pain will be that much more effective because now those posterior structure don't need to compensate for anything.
Custom orthotics, insoles, taping and what have you are fine for short term use to provide pain relief and some support, but realize you're just putting on a thicker tire to replace the one that keeps wearing out without aligning the car.
Mobility of joints: Forefoot, midfoot, rearfoot....all those little bones in your foot/ankle are designed to move. One or more gets chronically stuck and that can cause PF type pain. Again, looking up the chain at things like knee/hip mobility must be considered when treating symptomatically isn't working.
Lot of people do stretching for calves involving the ankle which is good and fine, but what about the other end? Great toe flexibility is equally important and stretches out the PF from the other end. While one of my favorite calf stretches is hanging off stairs, it doesn't really get the PF fully bc the toes are not extended. Separate toe stretches or the use of slant boards or Pro-stretch can be used.
Most people don't stretch long enough to make effective changes to the soft tissue. The fascia is a very tough connective tissue, esp at the foot/ankle where it must withstand constant pounding and hundreds, if not thousand pounds of force into the area. Think about the pounding your foot takes just walking daily; now think about it with all the stop and go motions, changing of directions during a tennis match. You really think 30 second stretches are going to be THAT effective?
Same goes with the soft tissue mobilizations: Again, the fascial system is designed in part to resist force...again think about the amount of pressure placed on the foot during a tennis match. The development of adhesions and restrictions to that area in chronic PF can be rather strong. If it can resist the few hundred pounds of pressure from walking or a tennis match do you really think your therapist/instrument/machine can resolve this by placing MORE pressure and massaging harder to overcome these restrictions? Doubtful without risking further injury to the area.
Stretching and soft tissue work should be done with LESS pressure....if anything is MORE, it should be MORE time held in a stretch or tissue work like trigger point or myofascial release. Remember, when the body feels forced it will contract to guard itself. If you've activated that guarding state by forcing a stretch or soft tissue work now you've just made it that much harder for you to heal. Healing can occur but it'll take that much longer. That's why you hear these poor sufferers taking months to recover (
@tlm 9 months!! Heartbreak brother but glad you're feeling better)
Walking barefoot, strengthening and all that is fine, but set up the environment first for proper healing and it makes all those things that much more effective.
You can give a plant water and food and it can grow nice and strong and blossom, but how fast do you think it can get to it's optimal state if you plant it in concrete? Vs if you plant it in nice fertile soil? If you align it so it gets sunlight vs if it's in darkness?
Apologies in advance for grammatical errors and incomplete thoughts; typing too fast without thinking too much plus need sleep
