Achilles and Plantar Fascia Problems

Wim sent an email to Judith and me, asking for contributions to this month’s WMC newsletter..

“On a purely selfish note, anything about my current injury, tight instep and Achilles (almost plantar fasciitis) would have at least one interested reader.”

Haven’t you been reading any of my articles?

On reflection, I only released one article a month (if that), and in one I briefly mention plantar fasciitis. So it’s an opportune time for a recap, highlight a few key points and attempt to tie everything together.
Achilles and Plantar problems are over-use injuries, especially for men whose bodies aren’t as supple and elastic as they used to be.

Kinetic Chain
Pain in the Achilles or along the soles of the foot is usually a symptom of weaknesses further up the kinetic chain.

What do I mean by the kinetic chain? Have a look at The Running Gait Cycle From foot plant to toe off, the kinetic chain is any anatomically adjacent part – joint, tendon, muscle, fascia that creates a chain of events that effects the body in motion (eg. toe, ankle, calf, knee, ITB, hip, lower back, upper back, shoulder,neck, head).

Tight Calves
Knowing that you are rather inflexible (sorry I don’t mean to be insensitive) but you probably are a prime candidate of Tight Calf Posterior Syndrome.
Tight calf, ankle rocker, causes a collapse in the foot arch. Check out the associated video.

Weak Glutes
You may also have weak glutes? Specifically the Gluteus Medius. I know that you cycle, but cycling mainly uses the quads and the hamstrings, not the gluteals.
In modern day life, we spend far too much time sitting and as a result our glutes become unconditioned.

Posture
Standing and running posture can also have an impact.
“A postural flaw that can lead to gluteal amnesia is known as anterior pelvic tilt. The pelvis tilts forward and the stomach protrudes. The forward tilt of the pelvis stretches your gluteals into a relaxed state which decreases your ability to properly activate them.”

Even the postion of the head (head held too far forward, in a forward leaning running style can result in additional stress further down the body)

Sitting and Sleeping
Too much sitting, especially straight after a long run is a killer.
I used to go to the Cinema straight after a long run on Sundays.
After the movie I become a hobbled crippled wreck. Tight hammies, sore back. I had a lot of difficulty walking down stairs.
This is because the muscles tighten after the run, and the seated position shortens the length of the tendons and muscles down the back of the leg and pulls down on the lower back.


Believe it or not, even sleeping with pointed toes, due to the weight of the blankets or the sheets being tucked in at the bottom of the bed, can shorten your achilles tendon and give you the typical achilles and plantar fasciitis pain you may experience when you get up first thing in the morning. I have been prescribed with a foot brace for two weeks, to keep the ankle joint at right angles, stretching the achilles. And it works!
A shortened achilles tendon repairs over night with all its collagen fibres growing in disparate directions. When you wake up in the morning and stretch the tendon, a lot of the fibres break and need to be repaired again.
A stretched tendon under repair has its fibres orientate along the direction of the force. That’s why the foot brace works.

No One Quick Fix
There may be no one quick fix. It may be a combination of weaknesses or corrections in your body. A holistic maintenance approach is needed rather than an isolated individual treatment of one part of the body.

Get Assessed
I would strongly recommend you go to a good health professional for an assessment.
One that will assess your running technique and standing posture, prescribe exercises and treatments specifically for you and correct your technique.
Conducting exercises with correct technique is everything.

Treatments
Having said that, here are some treatments that could help you:

Basic Floor Sitting Exercises
These are Femke’s Corrective Exercises
These are essential for restoring flexibility in tendons and fascia for your feet and legs and relieve the stress in your lower back. They need to be done daily or on a regular basis.
In an upcoming article I will interview Femke to uncover why floor sitting postures are so beneficial to runners and walkers.

Magnesium
I did mention an holistic approach. The modern diet is low in essential trace elements and you need magnesium supplementation to combat your muscle cramping. The jury is still out on whether ingesting vitamins and minerals actually work. Its always better to get it naturally with your food. But Femke does have magnesium oil that you can apply directly onto your thighs or soles of your foot.

The Alfredson
This is NOT a strengthening exercise. It is mechanotherapy – a movement therapy that promotes tissue repair and remodelling Read The Eccentricites of Alfredsons

Even though Alfredsons is a great effective treatment, I think Femke’s High Toe Sequence is superior, but it does require more technique. Ask her to demonstrate it to you.

Glute Med Exercises
I am sure you can find exercises to strengthen your glutes, but the Clam is glute med exercise that is often not performed properly. So much so, that I wasn’t going to include it here. But then, not everyone has access to a Pilates Reformer (refer further down the page). Check out this Clam video on how to do it correctly.

Femke can also instruct on the finer points on positioning the body for the Clam to target the glute med.

I have also used a glute exercise on a pilates reformer to good effect. Check out this Reformer video as it mimics a running position.

There are a whole range of foot exercises that have been subscribed to me. But that can be for another future article.

Hope this helps, Stan


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