Wednesday, July 30, 2008

Plantar Fasciitis

This condition can be extremely painful, and prevent one from standing or walking for any length of time with any degree of comfort. It can be discouraging, when you get lots of treatment, PT, chiropractic, home exercises, massage, etc and nothing helps. You might contemplate surgery or injections to deaden the pain. 

Here I will describe one such case I had, and the successful outcome, when nothing else helped. For a serious case like his, it takes private work to resolve; nonetheless on your own there is much you can do for yourself, in a Feldenkrais sense. In fact, this condition, more than almost any other, requires full participation and willingness to learn new things, from the client. If you stay with the old way of thinking, you get the old familiar treatments and diagnostics. 

Here is what my client had to say about my work:

The Elusive Obvious
Awareness through movement…that’s what it’s called.
At first glance, the expression may appear as just another cliché; yet I quickly came to understand that the “awareness” referred to is –self-awareness- and I know the value of such knowledge to each and everyone is nothing less than profound. The Delphic oracle’s invocation to “know yourself” is bought to mind when one seriously considers the work of Moshe Feldenkrais.

The Feldenkrais Method, as it is popularly known, was introduced to me by Steven Hamlin when I was suffering with a condition known as “plantar fasciitis.” Before meeting Steven I had tried, in vain, to find relief for my complaint with various conventional and alternative medicine practitioners. By that time, regrettably, I had spent considerable time and money seeking a remedy.

What was missing from all the sources I had earlier consulted was a clear understanding of the causes of the condition which troubled me. And that is the great strength of Feldenkrais: it has the ability to provide you with a comprehensible appreciation of what it is that is happening in your body when you are suffering from a physical ailment. It allows you to know how certain physical/mechanical adjustments to long conditioned skeletal and muscular habits most likely will take you down a path that leads to abatement and relief for your health condition.

For this to occur, of course, two things are necessary (i) a limited amount of patience and (ii) a knowledgeable and skilled practitioner to introduce you to an understanding of the Feldenkrais Method.

For me Steven Hamlin was that practitioner and I am thankful for his effort.

Daniel Collins
West Hollywood
California


Plantar Fasciitis is almost certainly related to how you stand and walk, and how you breathe and move and the stability of your balance, and most especially your posture. It is not simply that something has gone wrong with your feet, and therefore you need to have injections, or stretches, or special arches or shoes or exercises or massage for your feet! All that may help, but as many discover, they are as likely to aggravate the condition if the underlying cause is elsewhere, as it usually is. Plus, all that can be a distraction from doing the real work that is necessary.

For this condition, private work is needed for sure, for three or more sessions. Involvement in ATM - Awareness Through Movement - is also highly recommended. Daniel Collins, in fact, was doing ATM from the online "Open ATM Project."  He simply choose all the ATM's he could find related to balance and the feet or legs, although other choices would have been good also. Plantar fasciitis is one of the more difficult conditions, and it can take a little time. Most likely you created it over a lifetime of poor movement and postural habits, and that cannot be turned around overnight. All of a sudden it hits you, and you want quick relief. 

What will I do if you come to me for this condition? Whatever intuitively comes to me as the important underlying issue, every session, while fully taking into account your history and traditional methods. I do not work from textbooks, or from any proscribed method, although I have learned and studied (and even use, occasionally) many such methods. I deliberately try to empty myself to stay open to the best avenue, moment by moment. I have learned over many years this is the safest, and best approach – and the quickest. Whenever I have a plan, as opposed to being the appreciative creative wanderer, I am less effective, and might even hurt a client. You'll need to push your "reset" button to get used to this type of "treatment". 

But certain true, general statements that apply to all cases of Plantar Fasciitis can be made. When balance is compromised in standing it is natural - no, inevitable -  for the body to grip the bottom of the feet. No amount of stretching or exercise or cortisone shots or custom arches or relaxation drills will change that dynamic. It’s about physical survival – balance – and the low brain, not the conscious mind, is in charge of that arena. So the issue becomes to improve your balance in standing and walking and running (if you run).

Of course, if you tell me that you are no longer able to stand or walk, we will proceed along a different avenue at first – get the feet better first, well enough so you can walk. That involves many things, too much to describe here.

How to improve balance – stability in standing and walking? This can involve many factors, such as ankle mobility, walking style, missing early developmental movements (if some of these were missing, walking will be balance-compromised, too stiff and tense, for the adult, and the best fix is to go back and actually do the missing movements), a rib cage that is too stiff, and more.

Perhaps you were an only child, and because of that your parents encouraged you to walk too soon, before your balance was stable. You stiffened your whole body in fear, even as your mother or father held your hand to force you to walk. From that moment, you learned to walk stiffly, with tight gripping soles-of-the-feet. It just took you all these years for the feet to finally flare up and complain with pain. Your feet were never the problem – in fact they did a heroic work all those years. Don’t try to fix what is not broken. Go to the underlying cause. When you do a Feldenkrais fix, you fix your whole life, as well as the presenting problem.

Perhaps you were toilet trained too early, before you could discriminate between tensing the whole pelvis, and tensing just the necessary sphincter muscles. So, you learned early on to have an uptight pelvis, all the time, to please mommy or daddy. An uptight pelvis guarantees a belly that is too tight, a jaw that is too tight, and soles of the feet that grip the floor all the time your are standing, and even when you are not! And today you do not know how to release that longstanding tension. It takes time, and mentoring, and good movement, some breathing work, patience and willingness and right understanding. Judging from what I see walking down the street, very few persons have learned not to be uptight there.

Perhaps you have learned to stand and walk with a back that is too tight and chest is lifted too high – almost as if you are falling backwards. Like a “good” military posture. If so, that literally guarantees that your toes will always be gripping the floor and the soles of your feet will be tense.

Perhaps  you learned - too well - to "sit up straight" and you did this  will power, stiffening the back, instead of using intelligence and skill, and deep relaxation and movement strategies. All my articles concerning chairs and sitting cover this aspect in great detail. 

Or perhaps the reverse is true. You are too slumped and balance is compromised the other way. Your ankles are working overtime, and your toes are always gripping the floor. Postural correction, and intelligent ankles are the solution here, not fixing the feet!

Or perhaps your posture is more or less OK, but your eyesight is failing, and therefore your balance is compromised. The solution here lies in ankle work, and learning to balance in standing and walking with less visual dominance and dependence. Relaxed, confident and balanced standing and walking then becomes the immediate goal.  If blind people can do it, at any age, so can you - with great success, safely and fairly quickly. Are you willing to jump into that new world of learning? For instance, you could walk along touching a wall with your eyes closed for a little while. This will help your ankles wake up and teach your other proprioceptive senses to get busy and help you balance, since the eyes are doing nothing! The body is smart that way. You could also stand in front of a wall, close your eyes, and fall into the wall – if you can do this safely and confidently. Gradually introduce degrees of difficulty, turn a little, cross the legs, etc. Balance is quickly improved in this fashion. But proceed slowly and safely, and it’s best done under the guidance of a qualified teacher.

Go for a walk, have someone hold your hand, and keep your eyes closed. How long can you do that? Do this once a week for a month, and see the changes.

Any variety you can introduce into your usual routine of body exercise or movement will be beneficial, since it will make your nervous system more competent. For instance, you can run and walk backwards - some persons even run marathons backwards. This is not going to give immediate relief, but long term, it is a helpful strategy. 

An important exercise for all people with this condition: In bed, after waking up, draw the alphabet with your big toes. Relax the feet as you do this, since the movement must come through the ankles. The feet cannot move the feet! Any tension in your feet will interfere with the movement. This develops ankles mobility, softness of the feet, and intelligent usage of the feet and ankles. It will definitely improve your balance. Please read all my articles on feet and balance for more on this issue. 

Another key exercise – which temporarily may seem to make it worse – is to make it a point to stand up and balance on one foot, whenever you tie your shoe laces (If you can). Not everyone can do this, but if you can, it is a sure way to quickly improve your balance. This is more “hard core” and not for everyone. If  you do yoga, emphasize one-legged postures. You want to improve your balance, you want to improve  the competency of  your ankles. 

Another helpful idea – learn to sense your talus bones as you stand and walk. Here you need a teacher to show you the skeleton, and show you - with hands on your feet, as you stand -  how to to sense this part of the body, as you sway your body back and forth, or in circles. We should balance from the talus bone (working with the lower leg muscles), not from gripping the feet, which immobilizes the ankles!! Roman soldiers were taught to stand, march and fight “from the talus bone”. It seems a strange idea, but when you learn it, walking and standing becomes so much easier!

When a foot takes weight it should lengthen and soften – not grip. What is your habit, as a foot takes weight, when walking? Your cure may be as simple as changing that habit. And that means waking up the ankles, being able to sense the talus, and improving your balance skills.

Another idea – walk with many variations of the ankles. Walk toes in, then toes out. Walk on the inside edges of the feet, then the outside edges. Walk on your heels. Walk on your toes. Walk on uneven surfaces barefoot. Give your feet the blessing of natural, uneven surfaces to walk upon. Walk on sand. Don’t use the same shoes all the time. Vary your shoes. The body thrives on variety and the incentive to adapt. Do even a few minutes of this now and then, and improvements will come. Of course, start easy, stop at any sign of pain, and move slowly at first. The paradox here is that the feet crave stimulation and variety of contact in weight bearing - in fact it is essential to have this for full recovery - yet it is painful, because of the inflammation. That's why a skilled practitioner is a must. 

The most important thing you can do for yourself: Do an online ATM lesson as indicated earlier, one hour per week without fail. And practice and review parts of that lesson during the week. This will improve your balance like nothing else can, expand and refine your body awareness and self-image, and reconfigure your movement patterns so that in time, your condition will naturally, unobtrusively simply vanish. In time it will cover all the bases, what is behind your plantar fasciitis, and your entire outlook on life, your ability to sleep, your mood, everything improves.

What is it like to experience this kind of "healing"? You need patience. Those muscles at the bottom of the feet release layer-by-layer. You can work for weeks, or months, and not get to the end. But then, all of a sudden - no pain, you're back to normal. Over many years, your body (your brain) has added a layer of tension and guarding to the soles of the feet, every time your balance was compromised. As we grow older, that happens more often. To reverse this process is something you won't have patience to endure, unless you are warned up front:  it may seem like the process goes on forever, and it seems like so many things to learn. No, there is a definite end. 

As with any condition involving inflammation, diet and lifestyle are best modified to minimize inflammation. Start now, by eliminating grains from your diet for a month or more (especially wheat, rye, barley and oats, the gluten grains), reducing simple carbohydrates, and taking appropriate supplementation – especially anti-inflammatory type fish oils. Work with a nutritionist. 

I also advocate appropriate usage of castor oil, topically, as it helps greatly to speed healing, reduce inflammation, and reduce pain. Please see my article on castor oil. I also recommend getting educated about MSG – see www.MSGmyth.com or Truthinlabeling.org. Whether you not you believe you are sensitive to MSG, go for one month on an MSG free diet (this is not easy); you have little to lose, lots to gain, more than you may realize. MSG can be in the coffee you drink at a fast food restaurant - MSG stimulates your desire to eat more, especially more junk food. MSG is injected into rats, to insure that they become obese!  Yet, MSG is pervasive in our food supply. Even non-organic lettuce has often been sprayed with MSG. One has to take great precautions.  Just try it for 30 days. 

Here are additional strategies: eat more raw foods; increase your intake of Vitamin D or sunlight is also very important. Take MSM supplements. Think green - green drinks, cooked green vegetables (do a web search for Bhieler Broth), more salads. These dietary strategies can reduce inflammation and quicken your healing. 

Take just one or two of these ideas and work with them for a week or two.

Of course your particular situation may be the result of an injury, or trouble with the foot itself (in rare cases). In addition to proceeding along the above lines, I will also work to align the bones of the feet, do stretching work on the calf muscles (as they are usually extremely tight, especially for former runners, who did not stretch enough during their running career!), and soften the rib cage, since comfortable balance in standing is not possible without a supple rib cage – all this, of course, takes time. Also, I will use osteopathic protocols (from Ortho-Bionomy® or Jones – Strain/Counterstrain) to position-release the many tender points that are found in the foot, ankle and knee area (with the understanding that it is not a cure but a necessary and helpful measure).

4 comments:

Sonica said...

This is a wonderful opinion. The things mentioned are unanimous and needs to be appreciated by everyone.

Plantar Pain

Anonymous said...

Very good article Steve, thank you!

deny lost said...

Great webpage buddy, I am going to notify this to all my friends and contacts as well. heal plantar fasciitis

FitOldDog said...

Hi Steve,

I was pleased to find your site. Nice article.

Feldenkrais, and other body movement training, has helped me a lot. I'm still doing Ironman races in my 70s.

Avoiding injury is one key to my continued training.

Thought you might be interested in my latest blog post. It is so hard to get people to listen. They just want a doctor or something in a box, to fix their pain. When just a little work would do the trick.

http://athletewithstent.com/2016/03/21/thirty-second-plantar-fasciitis-cure/

If you're interested in writing a guest post, just let me know (kevin.t.morgan@earthlink.net).

Cheers,

Kevin aka FitOldDog