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Your 4 Questions About Plantar Fasciitis Answered!

What is the plantar fascia anyways?

Plantar fascia is a thick band of tissue running along the bottom of your foot extending from your heel to the base of the toes. This band of tissue helps to propel you forward when you walk and run. You also have multiple muscles that attach to and/or cross the plantar fascia.

So what is plantar fasciitis?

Plantar fasciitis is when the plantar fascia becomes inflamed and can be very painful with walking, standing, and running. Plantar fascia can have many causes and the pain can vary from very severe, sharp pain, to a less intense, achy pain. Usually there is a significant and sudden change in your activity level that will give rise to inflammation of the plantar fascia, such as starting a new walking routine or increasing the mileage of your walking/running routine too quickly.

How do I know if I have plantar fasciitis?

If you have pain around the bottom of your heel, arch, or around the base of the toes along the bottom of your foot this could be indicative of plantar fasciitis. You may also have tightness through your calf muscles and/or your big toe. Do you have pain in your feet when you take your first few steps after getting out of bed in the morning which resolves at least somewhat with walking around? Do you also have pain with prolonged standing and walking? These factors can all be indicative of plantar fasciitis, but you should go see a Doctor of Physical Therapy at Live to Move to determine if you have it and could benefit from therapy.

How can physical therapy help?

A physical therapist can assess you for the root cause of your pain through reviewing your history and performing a physical exam. Your physical therapist will then write a plan of care to determine how much therapy you may need. Your treatment sessions will likely include a combination of manual therapy to get the joints and soft tissues moving optimally, as well as strengthening and stretching of the ankle, knee, and hip muscles to address any muscles imbalances. You will also receive education regarding any activity modifications you should make with your daily activities. (You can also ask about dry needling which is another tool used at physical therapy to address your pain and get you back to your activities as quickly as possible!)

Don’t let plantar fasciitis hold you back any longer. Contact Live To Move Physical Therapy today to schedule your consultation and start your journey toward a pain-free, active life. Your feet—and your future self—will thank you!

What exactly is pain?

Pain is a multi-dimensional phenomena affected by many internal and external factors. The purpose of pain is to warn the body of tissue damage OR the threat of potential tissue damage. You may have pain because you recently sprained your ankle, or you may have pain from an old back injury long after the injured tissues have healed. In both cases pain is present, but only in one case is there current tissue damage. When you experience pain, the brain is trying to warn the body of a perceived threat which may or may not actually be threatening. Regardless, pain is pain.

Why do I have pain?

You may be someone with appropriately regulated pain which subsides as the tissue heals. Or you may be someone with acute pain that extends past the point of tissue healing, which is considered chronic pain. This is when the brain’s pain modulation system is no longer working as it is intended. A lot of people in this category have had multiple experiences with pain in the same area or multiple areas of the body sensitizing the brain to pain. This further leads to a cycle of decreased sleep, activity, and overall brain function making it difficult for your pain modulation system to restore itself. You can break this cycle over time by restoring general brain health through nutrition, exercise, sleep, and even something as simple as prioritizing things in your life that make you happy.

According to the CDC, in 2019, 20.4% of adults had chronic pain and 7.4% of adults had chronic pain that frequently limited life or work activities

How can physical therapy help?

The cycle of chronic pain CAN be broken, and Physical Therapy can help you with this process. Whether you have low back pain, chronic headaches, or widespread pain, our Doctors of Physical Therapy can help you with physical rehabilitation as well as helping restore your brain’s pain modulation system. This is achieved through strengthening, improving neurovascular health, and pain neuroscience education.

Physical Therapy can help you to overcome your pain and return to participating in the things you love!

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What does Spondylosis mean?

Despite the peculiar name it’s given, Spondylosis is simply osteoarthritis in the spine or what can also be called “normal aging changes.” This is a relatively common diagnosis, especially in the neck and low back. Because this is an age-related phenomena, spondylosis is much more common in older individuals, with up to 80% of adults over 40 having the diagnosis. However, you can have the diagnosis at a much earlier age as well.

So what are these so-called “normal aging changes” involved in Spondylosis?

Absolutely all of us have normal wear-and-tear in our joints as we age and the spine is no different. These changes include degeneration of the disc, or “cushions,” between the vertebrae which can eventually lead to boney changes of the vertebral bodies. There are many contributing factors as to when you may have this diagnosis including your lifestyle, posture, and even genetic/hereditary components. Typically, this diagnosis is given after X-rays are taken and the individual has started having pain in their neck or low back, as well as reduced range of motion. The most common type of spondylosis is in the cervical spine, or neck, and the second most common is in the lumbar spine, or low back.

How can Physical Therapy help to treat Spondylosis?

A Doctor of Physical Therapy can address your Spondylosis diagnosis in various ways. Manual therapy, prescribed strengthening and stretching exercises can help you to regain as much range of motion as possible, as well as decrease the stress on the joints. Physical Therapy can also help you achieve optimal posture and lifestyle changes that will help to decrease the progression of Spondylosis and keep you pain-free for as long as possible.

Now.. what are spondylolysis and spondylolisthesis?

Despite the nuanced difference in spelling, these are very different pathologies from Spondylosis. Spondylolysis is a fracture in the portion of the back of the spine called the “pars interarticularis.” When this type of fracture occurs on both sides of the spine, the affected vertebrae can potentially slip forward in position in the spine. If this forward slippage occurs then the condition is called Spondylolisthesis. It is important to understand the difference in these terms and that if you are diagnosed with Spondylosis, you DO NOT have a fracture, but rather arthritis and some degenerative changes.

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In Texas especially, the summertime can be brutal with the scorching heat. This is why we have compiled a few exercises you can do in the pool to stay cool and keep up your fitness (even when it’s 100 degrees outside). The water is an excellent exercise medium as the buoyancy is easy on the joints and the water resistance can be an effective tool for strengthening. These are exercises anyone can do, no matter your physical level or age. You can even add some extra fun by purchasing dumbbells and weights that are water-resistant to add more challenge.

Exercise 1: Squats

Squats are an excellent exercise to perform in the pool as this can be very easy on the joints. The deeper you are in the pool, the easier the squats will be. You may want to start with the water at chest level and by hanging onto the edge of the pool if you feel unsteady. You can start with 1 minute of squatting and work your way up.

Exercise 2: Tin Mans

Tin mans are a great exercise for your upper body which allows you to stretch and improve the range of motion in your shoulder joints. The resistance of the water can also act as a strengthening tool, allowing you to increase the resistance the faster you move through the water. Try going through a small range first, and as you practice, you notice you will be able to go further with more repetitions.

Exercise 3: Lateral Walks

Walking in the pool is beneficial in many ways for cardiovascular health, but with this exercise you get to maximize the strength in your hips which is important for your gait (the way you walk) and your stability. If you have a small pool, try multiple laps. If you are in a large pool, try your best to go the entire distance! You want to face the same direction down and back to ensure you get both sides.

Exercise 4: Arm Raises

This exercise is great to maintain the range of motion in your shoulders. Just like with the Tin Mans, the faster you move in the water, the more resistance you will create. You can also add dumbbells to create more resistance for strengthening. Make sure the water is up to shoulder/neck level to ensure you stay submerged through the whole range.

Exercise 5: Noodle Stomps

Get creative in the pool with your noodles! The pool noodle can be used for a variety of strengthening exercises for your upper and lower body. The trick is to position the noodle first without it shooting out of the water! This is a great exercise for the glutes in the water.

While you are working to stay healthy this Summer, don’t forget to mention to your doctor if you think you may need skilled physical therapy to address your aches and pains. We would be happy to help with any of your mobility, strength, or cardiovascular needs!

Pelvic floor physical therapy is a specialty that is now becoming more known as our health care providers are exploring more conservative options for treatment of pelvic pain and dysfunction. As a physical therapy provider, I see dysfunction across the spectrum, ranging from mild incontinence to debilitating pain which prevents people from getting out of bed. Pelvic floor physical therapy is a treatment provided by physical therapists aimed to strengthen the muscles that support our internal organs, function to assist in bowel/bladder voiding, and is important for overall sexual health and satisfaction.

If you are wondering if this is a service you might need, here are a few reasons why you might want to ask your MD to refer you to a pelvic floor specialist:

1. “I pee when I sneeze.” According to the National Association for Incontinence, of the 25 million adult Americans suffering from some form of urinary incontinence, 75-80% of those are women. Whether you laughed too hard with your best friend, jumped too high on the trampoline, or simply got up from your chair too quickly, urinary leakage is something many Americans deal with (but don’t have to).

2. “I have to go to the bathroom a lot… I always know where the exits are in case I have to go in a hurry.” The “norm” for urination is 6 – 7 times in a 24-hour period or once every 2 hours. Many people find themselves having intense urges to go, despite only having maybe a “drizzle” when they actually go. Often this can be a byproduct of pelvic floor muscle dysfunction since many people have a hard time “relaxing” those muscles in order to go to the bathroom. Think about your urethra as a garden hose and the pelvic floor muscles as a nozzle of that hose, if your muscles are “tight” or are not lengthened properly, urine will not have the opportunity to escape out of the hose. This may also be due to signals to your brain that are “overactive” which cause you to experience urgency even though your bladder isn’t full. A pelvic floor physical therapist can also discuss options for you regarding adjusting your bladder schedule, water intake, and discuss ways to sit on the toilet which will help you take pressure off so you have an easier time going (this goes for constipation too!).

3. “I just can’t enjoy sex, it’s so painful.” If you are having difficulty with sexual intimacy due to increased pain or even difficulty with tampon insertion, you are not alone. Many women suffer with the same issue, which can lead to difficulty enjoying intimacy with their partner or even tolerating gynecological medical examinations involving a speculum. Often a pelvic floor therapist will give you the proper instruction and feedback to lengthen pelvic floor muscles and may even provide manual therapy to treat any muscle trigger points that may be associated with muscular pain. Your therapist will discuss treatment options that are right for you given your medical history and other factors involved with your care.

If you’ve ever sat in the waiting room at Live to Move Physical Therapy & Wellness, you’ve probably wondered about the credential “COMT” that appears after Molly and James’ names. This stands for “Certified Orthopedic Manual Therapist” and it’s earned after completing (and passing) a year-long program composed of lecture and lab style courses to further the physical therapist’s specialization of orthopedics and manual therapy.
The classes are taught by top local clinicians and professors and presented in an in-depth, outpatient-focused manner that just isn’t possible during the entry-level education of a Doctor of Physical Therapy. As a new therapist, I’m following in Molly and James’ footsteps and working my way through the COMT Program. So far, it has been just what I knew I needed plus a bit more! See, entry-level physical therapist education is like drinking through a fire hose – it’s impossible to absorb everything and, unless you’ve got a really big mouth, you’ll look clearly overwhelmed afterwards. The COMT Program, on the other hand, is like sipping on a glass of wine while taking the time to appreciate all the details – the ambience, shape of the glass, temperature of the beverage, etc. The aim of the program is to create truly exceptional clinicians in the specific practice area of outpatient orthopedics with a focus on utilizing manual therapy to compliment exercise prescription. Manual therapy refers to the ancient art and science of mobilizing bones and soft tissue to achieve increased range of motion, improved joint mobility, decreased swelling, decreased pain, and many other neurophysiologic effects.
The curriculum covers the human body from head to toe and across the lifespan. It contains an eclectic mix of foundational science concepts, pain neuroscience education, joint manipulation and mobilization techniques, purposeful tissue specific and irritability level exercise progressions, return to sport and life considerations, and movement impairment syndrome classifications. As a new physical therapist, I feel so fortunate and appreciative of Molly and James’ support and encouragement as I pursue this credential that so few physical therapists will earn. So far, my favorite part has been learning about modern pain neuroscience – how our perception of pain has little to do with the extent of actual physical injury and much more to do with our beliefs, past experiences, expectations, stress, etc. and how to empower patients to take advantage of this knowledge.
Patients benefit from being treated by a certified orthopedic manual therapist through improved outcomes in potentially less recovery time than if being treated by another PT without the advanced certification and education. Live to Move Physical Therapy & Wellness values the highest quality of care for our patients and strives to use the most up to date and evidence-based interventions for our patients.
– Clancy Nelson, PT, DPT

• Try to keep your level of activity consistent from day to day, especially with walking and running. For instance, do not walk 5 miles one day and then not walk for 4 days in a row. Instead, try to walk 1 mile each of the 5 days and spread it out, providing your feet with more rest breaks in between. You should also try to vary the type of activity you do each day like rowing or biking to mix things up. Exercise and walking are still good for you, but in the right dosage.
• Stretch your calf muscles and massage the bottom of your feet first thing in the morning which will help you to get moving more quickly with less pain. Improving your flexibility early in the day will help prepare you for the day to come.
• Put a golf ball in the freezer than you can use to massage the bottom of your foot on the ground. This is a good way to help relieve pain after a long day of walking and standing when you get home at the end of the day!
• Single leg balance! Practicing balancing on one leg is an easy way to begin strengthening multiple muscles in the foot and ankle which will provide you with more support. This is one of the simplest exercises to add into your routine right away that gives you the most “bang for your buck.” You can easily perform this while doing dishes, folding laundry, watching TV, etc. Make sure you have something stable to hold onto if you need it! Come see your physical therapist at Live to Move for additional exercises more tailored to your specific needs!

(For any other questions you have about PF, please see our additional blogs and videos)

Make the change gradual-

Like many other major life changes, you will have more success when making the change from your current way of eating to plant based. If you are a person more set in your ways with eating, then you may need to start with cooking one plant-based meal a week. Others may do better with having one full day a week where they eat fully plant-based. You may even need to start by cutting out meat from these meals first before dairy if you tend to eat a very animal-based diet. This is a process that cannot happen easily overnight. It is best to let your brain and body adjust to a new way of eating. Give your taste buds a chance to accommodate to new foods!

Surround yourself with support-

                Again, like any lifestyle change, you will have more success if you surround yourself with a support system of others who also eat plant-based. This could involve online groups where you can share recipes and tips as well as encourage one another. Eating plant-based has gained a lot of traction in recent years and you will find a lot more people who are also eating this way as well as restaurants that are fully plant based or at least have plant-based options. Encouraging your family and friends to join you on your journey can also be very hopeful since you will have someone to cook and eat the same foods with!

Live to Move offers nutritional counseling centered around a plant-based whole-food diet, which is also a great way to have someone hold you accountable and support you through the change!

Educate yourself!

                Knowledge is power, and gleaning information about what a plant-based diet is and what it can do for you is limitless. Watching documentaries and reading books and current research regarding the physiologic benefits of whole food plant-based eating can be a helpful tool. Learning about the ways in which eating plant-based can benefits the environment can be another strong motivating factor towards eating a more plant-based diet. You can start your knowledge journey by reading our website and scheduling an appointment with our certified nutritionist on eating whole food plant-based!

What is arthritis?

Arthritis is chronic inflammation of a joint, or multiple joints, which can cause deterioration of cartilage and other structural abnormalities over time such as bone spurs. Between 2013-2015, 54.4 million (22.7%) adults had physician-diagnosed arthritis, and 23.7 million had arthritis-attributable activity limitations. There are hundreds of different kinds of arthritis with various causes; the most common type is Osteoarthritis, followed by Rheumatoid Arthritis, and then Psoriatic Arthritis.

• Osteoarthritis (OA): According to the CDC, Osteoarthritis affects nearly 32.5 million US adults, and is one of the most expensive conditions to treat when joint replacement is required. Joints that weight bear are most commonly affected, such as knees, hips, spine, and feet. OA can be caused by anything that put excess stress or “wear and tear,” such as injuries, obesity, or age. A sedentary lifestyle can also be a risk factor for OA.
• Rheumatoid Arthritis (RA): RA is an autoimmune disease leading to inflammation of the joint lining causing pain, swelling, and stiffness which is often worse following rest. Wrists and hands are the most commonly affected areas, occurring symmetrically on both sides of the body. This type of arthritis can also cause overall fatigue and muscle weakness.
• Psoriatic Arthritis: Psoriasis is another autoimmune disease initially presenting as a dry, flaky, red skin rash that can spread to the joints causing inflammation and swelling. Other symptoms include nail bed changes and general fatigue.

Diagnosis of Arthritis:

• Arthritis is diagnosed through a combination of X-ray imaging, pattern of stiffness of the affected joint with rest and activity, as well as decreased function and range of motion.

How can physical therapy and physical activity help treat arthritis?

• Addressing muscle imbalances and strengthening surrounding musculature can decrease the stress placed on the affected joint
• Manual therapy can improve range of motion, decrease swelling and pain using soft tissue massage, traction, and joint mobilizations
• Physical therapy can help to improve daily function, slow the progression of arthritis, as well as decrease the risk of arthritis in the future through preventative care.
• Regular physical activity is an important strategy for relieving pain and maintaining or improving function in people with arthritis
• Nearly half of adults with arthritis report no leisure time physical activity. Not being physically active is detrimental for arthritis and is a risk factor for other chronic diseases.
• Regardless of the type of arthritis you are diagnosed with, the physical therapists at Live to Move can help you achieve your goals for the future and desired level of function

References

• Barbour, K. E., Helmick, C. G., Boring, M., & Brady, T. J. (2014). Vital Signs: Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation — United States, 2013–2015. Morbidity and Mortality Weekly Report, 66(9), 246-253. doi:10.15585/mmwr.mm6609e1

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