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Good morning guys, Tony Maritato here, licensed physical therapist and in today's video I want to talk about plantar fasciitis, also referred to as heel pain
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So this affects a lot of pickleball players. It's one of those conditions that seems to come out of nowhere for a lot of players
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It persists no matter what you try to do and then all of a sudden it disappears as weird as it came on
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So to talk about what exactly it is, if you think of the bottom of your foot, there's what's called
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the plantar fascia. It's a thick connective tissue. It goes from the point of the heel
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spreads out or fans out to the base of the knuckles of the toes. This is the ball of the
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foot, the arch of the foot, the heel. The heel bone is called your calcaneus. So what happens is
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most people will have a severe sharp pain right at the bottom point of the calcaneus the heel bone
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the pain will be most severe if you've been sitting for maybe 20-30 minutes and then you
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go to get up and take those first couple steps the pain will be most severe first thing in the
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morning you've been in bed all night the plantar fascia will shorten and tighten you go to take
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those first morning steps away from your bed and all of a sudden you get this sharp piercing pain But the most characteristic symptom is that after you been moving for a while the pain subsides or completely goes away
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Now if you do too much, the pain will come back. But the idea is that this is an active pathology inside the connective tissue
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whether it's associated with active inflammation or just damage to the connective tissue
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It's frustrating. It's painful. I have dealt with this over the years, usually a couple times a year, but I find that for myself
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my plantar fascia will typically kick in when my immune system is either dealing with other things
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or it's depressed. Maybe I'm not sleeping well, I'm under excessive amounts of stress more than usual
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maybe I'm not eating well. My plantar fascia problem tends to come from my body's chemistry
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more than mechanical changes. But that being said, so there are a couple options you can use to
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manage, I'm not going to say cure, manage plantar fascia when the symptoms are most intense. The
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first is a real simple self-massage. So if you can bring your foot up, put it on the other leg
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I tend to use either one thumb the other thumb and all I do is I apply a fair amount of pressure into the most tender areas I can go parallel with the fiber orientation I can go perpendicular cross fiber
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Effectively, all that I'm doing here is I'm massaging the tissue. Massage will desensitize
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some of the pain sensation. I'm also spreading some of the connective tissue. When you do a
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classic heel cord stretch or calf stretch, you're stretching the plantar fascia lengthwise
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but when you apply that cross friction or cross fiber massage, you're spreading the fibers
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perpendicular to their orientation. So it just it gives it a different kind of mechanical stimulation
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Some people will have pain actually at the sides, the top or bottom, inside or outside
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of the calcaneus. Some people will develop pain down at the Achilles tendon attachment
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So there are different sites of pain. Ultimately, it's the same basic problem. It's a lack of healing
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more than an actual injury. It's a healing deficit. And so we want to do anything we can
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to facilitate the healing process This is where I would tell my patients typically to look at you know monitoring their stress levels try to improve their sleep habits look for any lifestyle changes that might happened recently
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and then do anything that you believe will help your body to recover
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Restful sleep, meditation, mindfulness, exercise, these are all things that are gonna help contribute
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to a condition like this. If the condition persists, it's generally accepted that it's safe
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while frustrating, while painful, while annoying, it's still generally safe to continue to participate
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in your daily activities, continue to play pickleball. But certainly if the condition persists
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more than a couple of days into a couple of weeks and it starts to interfere with your daily activities
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go ahead and schedule that consultation with an orthopedic. But be mindful that even within the world of medicine
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there are lots of approaches to a condition like this. Some will recommend a cortisone injection
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some will advise against a cortisone injection some will recommend icing and heat and massage
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others will advise against it some will recommend a foot bath like a epsom salt soak others will say
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it's it doesn't make a difference you choose what's best for you if you have more questions
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let me know i'll catch you on the next video
