According to the Canadian Federation of Podiatric Medicine (CFPM), the average person spends approximately four hours on their feet and takes about 8,000 to 10,000 steps in a single day. The pressure exerted on your feet every step you take actually exceeds your body weight, and the overall load can add up to as much as 500 cumulative tons per day. For athletes, the pressure is even greater, with certain activities exerting a force as much as 7 times your body weight.
A large amount of this workload is absorbed by the plantar fascia, a thick band of tissue that extends from the heel to the front of the foot. Plantar fasciitis, also known as plantar heel pain syndrome (PHPS), is a common injury causing pain and discomfort in the sole of the foot.
Massage therapy can be beneficial in aiding pain relief and recovery for patients with plantar fasciitis, helping them get back on their feet.
The plantar fascia forms a longitudinal arch which provides support to the foot when standing, as well as shock absorption during movement. When the mechanisms supporting its function fail, the tissue can degenerate over time, causing varying degrees of pain. The plantar flexor muscles of the calf and ankle may shorten during sleep, making symptoms worse first thing in the morning.
While plantar fasciitis is often caused by overexertion, massage therapy college students should also keep in mind a number of other potential contributory factors, including tight hamstring and gluteal muscles, overpronation and high arched feet. Improper footwear can also put undue strain on the plantar fascia, particularly in athletes.
Since shortening of the plantar flexor muscles can cause undue stress on the plantar fascia, students in massage therapy courses may find that deep tissue treatment of calf and ankle muscles can help reduce symptoms in patients with plantar fasciitis.
A 2013 study conducted at Tel Aviv University showed significant improvements in thirty-six PHPS patients who underwent a six-week treatment program comprising twice-weekly ten-minute deep tissue massage to the calf muscles, integrated with stretching techniques which the patients performed themselves between sessions. The patients reported a significant reduction in morning pain levels, from an initial average rating of 6.8 out of 10 at the outset of the study, to 4.2 out of 10 after treatment.
The massage treatment focused on applying deep pressure to the medial and lateral aspects of the calf, usually with the thumbs or another body part such as the elbow. Patients were taught a twenty second standing calf stretch, and advised to perform five repetitions three times per day.
In addition, the treatment program also integrated a neural mobilization exercise, in which the patient performed a passive straight leg raise with dorsiflexion with the aid of a belt. This was done in order to further relieve pain by increasing tension on the neural structures around the affected area, such as the plantar nerve.
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