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Good morning guys, Tony Maritatto here, Licensed Physical Therapist and in today's video I
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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
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as it came on. So to talk about what exactly it is, if you think of the bottom of your foot, there's
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what's called the plantar fascia. It's a thick connective tissue that goes from the point of the
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heel, spreads out or fans out to the base of the knuckles of the toes. This is the ball of the foot
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the arch of the foot, the heel. The heel bone is called your calcaneus. So what happens is most
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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
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then you go to get up and take those first couple steps. The pain will be most
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severe first thing in the morning. You've been in bed all night, the plantar fascia
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will shorten and tighten You go to take 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
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usual. 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 fibers 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 some of the pain sensation
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I'm also spreading some of the connective tissue. when you do a classic heel cord stretch or calf stretch, you're stretching the plantar fascia
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lengthwise, but when you apply that cross friction or cross fiber massage, you're spreading the
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fibers perpendicular to their orientation. So it just it gives it a different kind of mechanical
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stimulation. 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 monitoring their stress levels try to improve their sleep habits look for any lifestyle changes that might have happened recently and then do anything that you
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believe will help your body to recover. Restful sleep, meditation, mindfulness, exercise, these
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are all things that are going to help contribute to a condition like this. If the condition persists
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It's generally accepted that it's safe while frustrating, while painful, while annoying
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It's still generally safe to continue to participate in your daily activities, continue to play pickleball
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But certainly if the condition persists more than a couple days into a couple weeks and
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it starts to interfere with your daily activities, go ahead and schedule that consultation with
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an orthopedic. But be mindful that even within the world of medicine, there are lots of approaches to
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condition like this. Some will recommend a cortisone injection, some will advise
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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
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soak. Others will say it doesn't make a difference. You choose what's best for
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you. If you have more questions let me know. I'll catch you on the next video
