Plantar Fasciitis

Plantar fasciitis is an inflammation caused by excessive stretching of the plantar fascia (the tissue that extends the entire length of the bottom of the foot).  Heel pain is a common condition in which weight bearing on the heel causes extreme discomfort. Plantar tendonosis is an adhesion or thickening in the plantar fascia caused by repetitive micro tears in the plantar fascia.

Plantar fasciitis or tendonosis may be caused by the following:

• Additional or excessive weight on the foot
• Wearing shoes without any arch support or proper arch support
• A foot with an unusually high arch
• A sudden increase in physical activity

Symptoms usually consist of pain near the inside of the foot where the heel and arch meet.  The pain is often worse first thing in the morning, or after a rest, because the plantar fascia contracts back to its original shape when you are resting.  As the day progresses and the plantar fascia stretches, the pain often subsides or significantly reduces.

The key for proper treatment of plantar fasciitis or tendonosis is determining what is causing the excessive strain and stretching of the plantar fasciitis.  Often changing your footwear is the first step towards recovery.  You can also follow these recommendations:

• Don't go barefoot
• Stretch your foot before getting out of bed or before standing .
• Ice your heels (or the painful area) 2-3 times a day to reduce inflammation
• Maintain a healthy weight
• Avoid running on hard or uneven ground.
• Wear shoes with proper arch support and shock absorption
• If none of the above tips work, see our clinicians for evaluation using Graston Technique or Active Release Technique to assess whether the heel or arch pain is related to a relative thickening or scarring called tendonosis. Generally, this is present if pain is chronic or not relieved with ice therapy or ibuprofen.
  

Plantar fasciitis is one of the most commonly diagnosed foot ailments.  Please contact us to see how we can treat your symptoms and help you avoid further pain.

Bike Fit Basics

Whether you ride on-road or off, pedal casually or competitively, it's important to pay close attention to how your bicycle fits your body. A properly fitted bike will allow you to ride comfortably and safely, avoid injury, and produce more power, so you can go faster with the same or less effort.

In general, when fitting a bicycle, there are five basic components to consider.

1. Frame size is not necessarily dependent on your height; rather, it is more a matter of leg length. Simply, the frame should be easily straddled with both feet flat on the ground, and with an inch or two of clearance for a road of hybrid bike and about four inches of clearance for a mountain bike.
2. Saddle height should be set so that your knee is slighly bent when the pedal is at its lowest position and the ball of your foot is on the pedal. A saddle, or seat, that is too high or too low can cause pain and lead to injuries of the back and knees.
3. Saddle position can be checked by sitting on your bicycle (hold onto a friend or a stationary object) and rotating the pedals until they are horizontal. Your forward knee should be directly over the respective pedal axle when the ball of your foot is on the pedal.
4. Saddle tilt can be gauged simply by feel or by using a carpenter's level. Generally speaking, your seat should be level with the ground. If the saddle tips too much in either direction, pressure will be placed on your arms, shoulders and lower back.
5. Handlebar position and distance is mostly a matter of personal preference because it affects shoulder, neck and back comfort. Typically, handlebars are positioned higher for comfort (a more upright riding position) and lower for improved aerodynamics.

Always Wear a Helmet!

A bicycle crash can happen at any time; however, according to the National Highway Safety Traffic Administration, a properly fitted bicycle helmet reduces the risk of head injury by as much as 85 percent and the risk of brain injury by as much as 88 percent. The following are tips to help ensure the correct helmet fit.

• The helmet should be level on the head, and it must cover the forehead.
• The Y of the straps should meet just below the ear.
• The chin strap should be snug against the chin so that when you open the mouth very wide, the helmet pulls down a little.
• Put your palm on the front of the helmet, and push up and back. If it moves more than an inch, more fitting is required.
• Shake your head around. If the helmet dislodges, work on the strap adjustments.
• Do not wear a hat under the helmet.

All helmets sold in bike shops must be approved by the U.S. Consumer Product Safety Commission (CPSC) and should carry a CPSC sticker.

Get Out and Get Walking

Want to start an easy and enjoyable exercise program?  Then get out and get walking.  Walking is the perfect exercise for many people.  It is inexpensive and needs only a place to walk and a good pair of shoes.  Walking reduces the risk of heart disease and cancer, lowers total cholesterol, raises healthy HDL cholesterol, and lowers blood pressure.

Walking also has these benefits:

• Helps to control weight
• Maintains healthy bones and muscles
• Burns 350-500 calories per hour on average
• Eases back pain
• Boosts energy
• Fights the aging process

So how do you start a walking program? First, check with your medical professional if you have any health concerns that would affect your ability to exercise safely.  Once you have the go ahead, try this routine:

Start walking 20 minutes a day, preferably 5 days a week.  Walk 10 minutes, then turn around and walk back home.  Pretty simple.

If that goes well, add another 5 minutes to each days total the next week.  So now you are walking 25 minutes per day, 5 days a week.

Add 5 minutes to each days total the next week, and continue doing this until you have reached your desired total time.  60 minutes per day, 5 days a week is a perfect goal for all the walking benefits described above. So lace up your shoes, get out there, and get walking!

Tips For Buying Walking Shoes, Co-written by Richelle Fenber, P.T.

If you are in the market for some new walking shoes, here are some tips to help you find the right pair:

1. Always buy shoes at the end of the day or after exercising when your foot volume is 5% larger.
2. Bring athletic socks with you when fitting your shoes.
3. Athletic shoes should fit comfortably right out of the box – there is no “break in” period.
4. Your toes should be 1/2 “ from the end of the shoe.
5. Walking shoes are curved up at the toe and heel to allow your foot to roll through from heel strike to push off.  They also do not have a flare at the heel like running shoes.
6. The shoe should be flexible.  Try to bend the shoe in half at the forefoot with minimal force (2 finger push).
7. Do not buy shoes based on price or style.  More expensive does not always mean a better shoe.
8. Athletic shoes are divided into 3 categories: Motion control for the heavier walker or over pronator; stability for the neutral foot; and cushioning for the supinator. Ask a knowledgeable sales person to fit you with the right shoe.
9. Replace your shoes before they get holes in them.  On average, 60% of the shock absorption is lost after 250-500 miles based on running studies, or after 6 months for avid walkers.
10. If you use your shoes daily, buy 2 pairs.  It takes 48 hours for the cushioning to regain its form.  You will get better shock absorption and your shoes will last longer.

Shoe companies come out with new models every year, so if you find a model you really like, consider buying an extra pair.

Neck Pain and Chiropractic Care

Your neck, also called the cervical spine, begins at the base of the skull and contains seven small vertebrae. Incredibly, the cervical spine supports the full weight of your head, which is on average about 12 pounds. While the cervical spine can move your head in nearly every direction, this flexibility makes the neck very susceptible to pain and injury.

What are some typical causes of neck pain?

• Unfortunately, growing older in itself can be a cause of neck pain.  As we age, we are more likely to develop conditions such as osteoarthritis, degenerative disc disease, and spinal stenosis.
• Injuries and accidents are common causes of neck pain.  Muscles react to injury by tightening which can result in pain and stiffness.  Car accidents are the leading cause of whiplash which occurs when the head or neck is suddenly forced in one direction and rebounds in the opposite direction.
• Our daily lives contribute to neck pain too.  Obesity, poor posture, muscle weaknesses and stress can all cause neck pain.

What can a chiropractor do for neck pain?

Your chiropractor will perform an examination and may take x-rays of the painful areas.  Physical and neurological tests may also be performed.  Your chiropractor will ask you questions about how the pain started, what makes it better or worse, and if it affects other parts of your body as well.  Observations of your posture, tests of muscle strength, and other objective tests will be performed.

Should you be a candidate for chiropractic treatment, your chiropractor will develop a program of care that may include chiropractic adjustments, therapeutic modalities such as ultrasound or interferential therapy, physical therapy and/or exercise therapy.

Our goal is to help patients enjoy healthier, active lives.  If you have a condition that is outside our scope of treatment, be assured that you will be referred to the appropriate medical professional.

Does Sleeping Position Matter?

Did you realize that you spend 1/3 of your life sleeping?  Are you sleeping in a position that allows you the best sleep possible?  Does it really matter which position you sleep in?  The answer to the last question is YES!

There are three main sleeping positions – on your side, on your back, and on your stomach.  Let’s look at how each of these sleeping positions may affect you.

Sleeping on your back:

Sleeping on your back is a great position because it allows you to support your head, neck, and lower back area.  If you have lower back stiffness or discomfort, try sleeping with a few pillows or a wedge under your knees.  If you use a cervical support pillow, your head and neck will be supported in the position that produces the least amount of stress on your cervical spine.

Sleeping on your side:

Many people find sleeping on their side the most comfortable.  And many people who start out sleeping on their back will tend to end up sleeping on their sides.  To make this position supportive, use a cervical support pillow that is the correct height for your body type.  If your pillow is too low, your head will tilt down.  If your pillow is too high, your neck will be uncomfortably stretched.  Most cervical pillows have different height options to chose from in one pillow so you are sure to find a comfortable fit.  To make the side lying sleeping position even more comfortable, consider sleeping with a pillow or leg spacer between your knees.  This will align your legs hip width apart and will properly support your lower back region.

Sleeping on your stomach:

Under most circumstances, this is THE WORST sleeping position for you!  Consider that your neck and head will be turned to one side for a prolonged period of time.  This places extra stress on your cervical spine and your upper back area.  The result is morning stiffness, headache, and neck pain.  Using a cervical pillow makes it very difficult to sleep on your stomach, and many patients will use a cervical pillow to help break them of this nasty sleep habit.

Obviously, most people will start sleeping in one position and move to other positions during the night.  However, if you can train yourself to limit your sleeping to back and side lying positions, you will do your spine a big favor.  We also strongly recommend that our patients use a cervical pillow.  The pillow will pay for itself as it will help reduce your morning pain and stiffness and probably your visits to the chiropractor too!

Which Cervical Pillow is Best For You?

We carry three different cervical pillows to meet the varying needs of our patients.  This information along with consultation with your chiropractor will help you chose the best pillow for your condition. 

Makura Miracle Pillow:

Using this hull filled pillow will help you sleep better and awake more refreshed, free from headaches and neck pains.  It provides superior comfort, versatility and lasting results.  The adjustable size and shape give you the comfort and relief you want, with the proper support you need.  The all natural Buckwheat hull filling moves with you as you move.  The Makura Miracle Pillow forms itself to you giving firm, uniform, passive support to the entire head and neck area.  Another benefit, unlike many contoured foam pillows, is that it will not wear out needing replacement.

Pillo Pedic:

Using this cervical support pillow helps the adjustments you receive "hold" longer.  The pillow's gentle traction works while you sleep to help provide correct neck alignment and cervical spine support.  Durable construction features non-allergenic polyurethane and polyester fiber - not foam rubber - for the longest-lasting pillow available.  The Pillo Pedic pillows are good for both side lying and back lying positions. 

Ultima 2000:

The Ultima 2000's revolutionary design cradles your head and supports your neck while your are sleeping on your side as well as your back.  Special bounce-back fibers and exclusive wing-shaped sides provide luxurious comfort even when you turn to your side.  This pillow is another option for those who prefer a contoured pillow that is a bit more forgiving from a comfort standpoint.

All of the above pillows are available in a variety of sizes, so we are sure to find the perfect pillow for you.