Spring Is Upon Us!

As spring starts to show itself in Central Oregon many of us are eager to put winter activities behind us and move on to the things we love to do in the spring and summer. Due to the high variability of spring weather on the high desert we tend to see a jump in overuse type injuries in the spring. When there is a truly beautiful day to be outside some people will go a little too far with their chosen activity. We typically see a number of overuse injuries from people pushing themselves too far while running, hiking, cycling, gardening etc.

One of the most common injuries in the spring is plantar fasciitis. In this issue Brian Timm PT discusses the signs and symptoms of plantar fasciitis and basic prevention to keep you out of our office and allow you to enjoy all that Central Oregon has to offer.

Sydne Anderson a former Bend Physical Therapy patient and Central Oregon realtor shares her story of rafting down the middle fork of the Salmon River shortly after total knee surgery. We truly enjoy getting our patients back to the activities they love.

We have teamed up with Central Oregon Acupuncture to provide a wider range of treatments for our patients. They are present in our clinic every Wednesday and other days of the week by appointment. Jennifer Cochrane, MS, L.Ac., Dipl.CH of Central Oregon Acupuncture writes about acupuncture and the therapeutic benefits of acupuncture for a variety of conditions. If you have thought about trying acupuncture please give our office a call.
Thank you for supporting our clinic and have a great spring. See you out on the trails!

Chuck Brockman PT, MPT, OCS, CSCS, Director of Physical Therapy

Common Spring Injuries - Plantar Fasciitis

Brian Timm PT, MPT, CSCS

Staff Physical Therapist

Most Americans will experience some type of foot or heel pain in their lifetime. In some cases it can become very debilitating. The arch of the foot or plantar fascia is responsible for 60% of the stress applied to the foot during the mid-stance of gait and can sustain 1.7 to 3 times your body weight. (Hicks, 1954).

What is plantar fasciitis?

Plantar Fasciitis involves an increase of pain in the bottom of the foot between the ball and the heel (arch). It is usually associated with some type of heel pain over the calcaneal fat pad as well. It can come on either quickly or gradually over time. Usually the pain is worst in the morning when a person first steps out of bed and begins walking. Patients have described this pain as “burning”, “tearing”, or severe “stone bruise” type feeling in the bottom of the foot. The pain lessens with more walking but usually returns after periods of sitting when a person begins walking again.

What causes plantar fasciitis?

Several different causes can be attributed to plantar fasciitis including increased activities such as running or walking, weight gain, or stair-climbing. In many cases a change in shoes can cause it to occur. At this time of year most people have been fairly sedentary, wearing heeled shoes and boots, and have gained some weight over the winter. They begin an exercise routine (often walking or running), switch to flatter sandals or flip-flops, and are heavier from the holidays and winter. This makes for a perfect combination to get some sort of foot or heel pain. Runners usually begin changing their workouts to include more mileage and intensity. Others begin walking Pilot Butte more often which adds increased load on the foot and ankle structures. The change from a full supportive shoe with a heel to a flat flip-flop or sandal or walking barefoot can increase symptoms quickly.

How is it treated?

Treatment is varied depending on the cause, symptoms, and severity of the condition. In severe cases the patient is placed in a walking boot to allow the structures to calm down followed by physical therapy to gradually stretch and strengthen the tissues. Most cases are treated with stretching exercises for the calf and foot, reduction in activities, and use of ice or ice massage or anti-inflammatory medication . Often specific taping techniques such as Lo-dye or Kinesiotaping are very helpful as well as off- the- shelf or custom foot beds. A night splint or specific sock to keep the ankle at 90 degrees while sleeping is also often utilized. Surgery is limited to extreme cases and is usually not recommended. Even without any specific treatment, the condition will usually resolve itself over of a year but most people seek treatment before this due to the pain and limitations it places on their activities.

Prevention

Regular stretching of the calf muscles (multiple times during the day) as well as dynamic warm-up or stretching before activities is very important in the prevention of plantar fasciitis. In addition stretching the hamstrings and other hip musculature is also important. In a recent study in 2011, patients with hamstring tightness were about 8.7 times as likely to experience plantar fasciitis symptoms (Labovitz, 2011). Stretches should be held for a minimum of 30 seconds but longer periods provide more benefit. Dynamic stretching is important for runners and other athletes but caution must be taken to perform these correctly. Other important prevention strategies include use of proper foot wear, gradual increase in exercise or training volume and intensity, along with strengthening of foot and ankle musculature.

References

Hicks, JH: The mechanics of the foot. II. The plantar aponeurosis. J Anat 80:25, 1954.
Labovitz, J and Kim,C. The Role of Hamstring Tightness in Plantar Fasciitis. Foot Ankle Spec. March 2, 2011.

Share Your Experience - Sydne Anderson

"I had a total knee replacement this past year. Therapeutics Associates Bend Physical Therapy did all my post surgery therapy. I cannot tell you how pleased I have been with their caring manner and the great knowledgable techniques to bring me around in record time. My therapists were just the best in every way one could imagine.

You see I had a white water river trip that I was scheduled to do just 10 weeks after my surgery and it was a trip I had wanted to do for a long time on the Middle Fork of the Salmon River in Idaho with 12 other acquaintances. This was no little trip as it was rafting 100 miles of big water for 7 days with 2 days of travel each way. This was a private trip and we all had our own rafts so we all took care of loading, preparing, cooking all the meals and setting up camp each night and launching our rafts……besides rowing the river every day for several hours at a time. It was a lot of work on this trip but the beauty of the wilderness area was so worth all of the work. I am happy to say I was able to make and complete this trip with no pain in my new knee during the whole trip. I will never be able to thank all these wonderful professional people at the Center Therapeutics Associates. I have rafted many rivers and so glad I could also do this river trip, thanks to them."

Sydne Anderson

If Therapeutic Associates Bend Physical Therapy has aided you during your journey to recovery and you'd like to share your story, we'd love to assist! Please visit our website and click on the "testimonials" button to share your experience.

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Central Oregon Acupuncture

Jennifer Chochraine MS, LA.c, Dipl. CH

Traditional Chinese Medicine (TCM) is an ancient form of medicine that originated in China 3,500 years ago and is now the fastest growing health care method in America. The primary modality used in TCM is Acupuncture, the insertion of thin, sterile, disposable needles at specific acu-points on the body.

Acupuncture is recognized by the National Institute of Health and the World Health Organization to be effective in the treatment of a wide variety of medical problems including arthritis, migraines, neurological conditions and pain management. Using a type of brain scanner called an fMRI, scientists have shown that acupuncture works with the nervous system to reset the brain when it is stuck in an unhealthy pattern of pain and illness. Acupuncture triggers the release of pain-relieving endorphins in the body, mediates the inflammation process, regulates hormones, releases muscle tension and increases blood flow to specific areas of the body.

At Central Oregon Acupuncture, LLC our focus is on integrative care. We work closely with your physicians and other members of your healthcare team to optimize the proven benefits of acupuncture in your overall treatment plan. To that end, acupuncture is a safe and effective treatment to be used in conjunction with many other modalities such as physical therapy, chiropractic, massage therapy and allopathic medicine. We accept all insurance companies including workmen’s compensation and auto accident claims. For a free in person consultation or to set up an appointment please call (541) 410-6545.

Please visit Central Oregon Acupuncture's website for more information...