Chronic Plantar Fasciitis Relieved in Series of Treatments (no boot or medication required)
Client Info
Age: 58
Occupation: Corporate Management
Exercise / Type and Frequency: yoga 2 x weekly, gym workouts 3 x weekly, walking/hiking, summer golf 2 x weekly
Currently Receiving Treatment from Another Health Care Provider: none.
Reason(s) for Seeking Treatment: Plantar Fascitis at the base of the right heel.
Frequency: Painful to stand and bear weight, painful during walking especially when golfing. Patient reported that this pain feels similar to 30 years ago when they used to be a fitness instructor and taught step classes.
Injuries or Motor Vehicle Accidents & Dates: N/A
Surgeries & Dates: N/A
1st Appointment
Tests:
Standing Forward Flexion: (-) produced no pain. Manual direct pressure on heel near anterior-medial portion of calcaneas bone: (+) produced pain.
Manual direct pressure on posterior calves and Achilles tendon: (+) tenderness with deep pressure.
Manual direct pressure on hamstrings, lumbar, pelvis and sacrum: (-) produced no pain. However during treatment I discovered one specific point on the hamstrings that radiated directly to the tender point on the plantar fascia, signifying a myofascial tension pattern that is affecting the posterior chain.
Manual direct pressure on pelvis and sacrum: (+) produced mild to moderate tenderness with deep pressure on points around sacroiliac joints.
Treatment Techniques:
Prone: Myofascial Release of lumbar paraspinal muscles Myofascial Release of gluteal and piriformis muscles Joint Mobilization of Sacroiliac joint
Muscle Energy Technique Post Isometric Relaxation (PIR) of piriformis muscles
Myofascial Release of Iliotibial Tract Myofascial Release of hamstrings and calf muscles. Counterstrain of Tender Points (Tp’s) on gluteal and sacral region
Counterstrain of Tender Points (Tp’s) on calf and foot.
Supine: Myofascial Release of Iliacus and Psoas muscles Counterstrain of Iliacus and Psoas Tender Points (Tp’s) Harmonic Oscillation Long lever of lower extremities.
Result: patient reported 80 % relief of pain immediately following treatment.
Home Care Exercise: Structural Alignment Therapy; Shins-In, Thighs-Out Squat Pose*
Therapists' Note: This exercise is covered in my Structural Alignment Therapy Training, among a long list of amazingly effective exercises for various conditions. Learn more >>
Series of Appointments
Treatment Focus:
Myofascial Release, Ligamentous Articular Strain, Joint Mobilization, and Counterstrain of Points (Tp’s) of lumbar paraspinal muscles, iliopsoas muscles, pelvic muscles, sacroiliac joints, and the muscles and joints of the lower extremities. Each treatment also included Harmonic Oscillation for the lower extremities.
Result: patient no longer feels pain during standing and walking, or with manual deep pressure directly on the heel.
Clinical Impression
Plantar fascia tension was a result of muscular imbalance and built up scar tissue.
