& Address: Plantar
by Whitney Lowe
techniques are quite helpful for plantar fasciitis. Longitudinal
stripping methods applied to the bottom surface of the foot will
help reduce tension in the intrinsic flexor muscles. It will also
maintain better tone in those tissues. Some practitioners advocate
performing most of the longitudinal stripping methods toward the
calcaneus in order not to create additional tensile stress on
the plantar fascia.
transverse friction may be used directly on the plantar fascia
to stimulate fibroblast activity and tissue healing from chronic
overuse. However, caution should be used in applying friction
massage near the attachment on the calcaneus because of the possibility
of a bone spur. Since the practitioner will not know whether a
bone spur is present, it is best to assume that one might be there.
The client’s pain will generally be a good guide as to how
much pressure may be used with various massage techniques. Pressure
that is too painful for the client should not be used.
on the lower leg muscles, especially those involved in plantar
flexion, is also important in addressing plantar fasciitis. Tightness
in these muscles may contribute to excess tension in the fascial
continuities running from the leg through the bottom surface of
the foot. Massage of the gastrocnemius, soleus and tibialis posterior
should be included.
broadening and lengthening techniques applied to the posterior
calf muscles will be particularly helpful. Compressive effleurage,
broad longitudinal stripping, and broadening techniques done with
the palm are all beneficial for this purpose. Addressing these
muscles will help the effectiveness of a tension night splint
should also massage muscles of the entire lower extremity when
addressing plantar fasciitis. Biomechanical compensation may be
occurring as a result of foot pain, the effects of which may not
be limited to the lower extremity. The practitioner is encouraged
to watch for soft-tissue effects throughout the rest of the body.
the gastrocnemius and soleus, as well as all of the other tissues
of the plantar flexor "sling," will be important. Stretching
is most beneficial when performed several times a day. The morning
is especially effective as this is when the plantar fascia has
been in a non-weight-bearing position all night. The classic "wall
stretch" position (see Figure 2) is a good choice for these
tissues. Pulling the toes into hyperextension as the foot is pulled
in dorsiflexion works well in stretching these tissues.
fasciitis is a condition that affects a large percentage of the
population; thus, massage therapists are frequently presented
with this condition in their practices. Fundamental knowledge
of foot biomechanics and the development of this pathological
problem are essential for providing appropriate care. Some of
the suggested treatment methods, such as orthotics or anti-inflammatory
medications, necessitate treatment from other health professionals.
Thus, it may require communication with these other professionals.
As a massage therapist, you have a special and unique contribution
to make in treating this problem. The better informed you are,
the greater your session results will be.