You Take that First Step and OUCH

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You get out of bed and go to take that first step. OUCH! 

A sharp pain hits your foot. You limp a few steps but before you are out the door, the pain is gone. After sitting at work for a couple hours, you get up for another cup of coffee and the pain returns. 

It’s possible you are dealing with plantar fasciitis.

But what exactly is plantar fasciitis and what can we do about it? 

The suffix -itis indicates inflammation. Plantar fasciitis is inflammation of the plantar fascia. This leads to the next question, what is the plantar fascia? Plantar is the bottom side of the foot and fascia is a thin casing of connective tissue. Putting those two together, the plantar fascia is a band of connective tissue that runs from your heel to your toes, and it helps support the arch of your foot, stability of the foot, and is involved with normalized foot mechanics. Unfortunately, through a series of microtears from overstress and over stretch, the fascia can get inflamed and plantar fasciitis occurs.

Why exactly does plantar fasciitis occur is a great question. There are a few common risk factors to look at first. Generally, it will occur in people 40-70 years old. Activities such as running and dancing can increase the risk of developing plantar fasciitis. Occupations that keep you on your feet also increase the risk for developing it. People who are overweight or obese place more stress on their feet and this can cause plantar fasciitis. Lastly, if you have abnormal foot posture or walking pattern, e.g. flat feet, high arches, this can increase risk as well.

Now what to do about it? 

  • It is important to keep your calves loose. When the calf muscles become tight, they will pull up on the achilles, which pulls up on the heel, which stresses the plantar fascia.
  • Improving the strength of the arches of the feet can also reduce stress placed on the plantar fascia.
  • Stretching your big toe backward (toward the top of your foot) can provide an excellent stretch on the plantar fascia and rolling your foot on a lacrosse ball is another great option.
  • Orthotics can also help to normalize your foot if you have high arches or flat feet, thus reducing the stress on the plantar fascia.

Although plantar fasciitis can be a painful way to start the day, it is certainly treatable through a variety of stretches, exercises, and lifestyle modifications. If you feel you are suffering from plantar fasciitis, make an appointment with your local Physical Therapist and get back on your feet and  walking pain free.

Alex Strahle, PT, DPT, CSCS graduated from the University of Evansville with a Bachelor of Science in Exercise Science and a Doctor of Physical Therapy.  He is currently a Physical Therapist in the Employer-Based Clinic setting for Tx:Team.  Alex enjoys seeing patients return to an active lifestyle after treatment for their pain and dysfunction.

August is Spinal Muscular Atrophy Awareness Month

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August is Spinal Muscular Atrophy Awareness Month!

Spinal Muscular Atrophy (SMA) is a hereditary neurodegenerative disorder that negatively affects the motor control of 1/10000 people across the lifespan depending on type with which diagnosed. A decline in muscle strength is common affecting an individual’s ability to contribute and participate in society, increasing their economic burden, and in extreme cases, results in death. Hospitalization costs an average of 100k annually for these individuals. Therapy can help reduce hospitalizations, burden on caregivers, and provide education on how to manage this progressive chronic condition to improve these outcomes.

How Physical Therapy Can Help

Physical therapists screen for neuromuscular delays while monitoring gross motor developmental milestones as part of their SMA assessment. They reduce fall risk by slowing the decline of range of motion, endurance, and strength to maintain and possibly increase mobility (walking, standing, sitting etc.) through therapeutic exercise and neuromuscular electrical stimulation. Seating/mobility device and orthotics recommendations may be made. Preventing the worsening of scoliosis may be included in treatment.

How Speech Therapy Can Help

Speech therapists screen for oral/laryngeal/pharyngeal motor delays as part of their typical assessment. Communication devices and vital stim to aid in breathing and swallowing function may be recommended to aid the individual with SMA in returning to social and mealtime participation.

How Occupational Therapy Can Help

Occupational therapy can assist people with SMA in becoming more independent in their daily activities, including with basic self-care, work, or hobby pursuits through the use of therapeutic activities. A screening for fine motor and self-care developmental milestones is part of the typical assessment for SMA. Home and lifestyle modifications, adaptive equipment and assistive technology recommendations, energy conservation strategies, and basic mental health care may be provided.

Therapy has been associated with reduced anxiety/depression and increased hopefulness for the future. Early intervention and collaboration with physicians is the key to comprehensive care. Help facilitate access to therapy services for individuals you may know with SMA today!

Alita Borkar MA, OTR/L, CPAM is an Occupational Therapist in the outpatient setting.  Alita believes everyone deserves access to therapy services that improve the ability to live a happy, meaningful, and productive life.  She believes in ethical, evidence based, high quality services and is passionate about developing evidence based programs, advocacy, and mentoring students for effective family services.

 

References

Ch’ng, G.S., Koh, K., Ahmad-Annuar, A. et al. A mixed method study on the impact of living with spinal muscular atrophy in Malaysia from patients’ and caregivers’ perspectives. Orphanet J Rare Dis 17, 200 (2022). https://doi.org/10.1186/s13023-022-02351-4
“Cure SMA, Novartis Publish Economic Burden of SMA Analysis in Journal of Market Access & Health Policy – Cure SMA.” Cure SMA, 20 Dec. 2020.  www.curesma.org/cure-sma-and-novartis-gene-therapies-publish-economic-burden-paper/#:~:text=Results%20of%20this%20analysis%20highlight Accessed 26 July 2023.
“List of Treatments for Spinal Muscular Atrophy.” MySMAteam, 2023.  www.mysmateam.com/treatments.
“Spinal Muscular Atrophy (SMA) | CDC.” Www.cdc.gov, 20 Dec. 2021.  www.cdc.gov/nceh/dls/nsmbb_sma.html#:~:text=Spinal%20Muscular%20Atrophy%20(SMA)%20is.