Pilates for Plantar Fasciitis
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1 Pilates for Plantar Fasciitis Lucia de Jager March 2018 BASI CTTC Oct 2017 Living Life Pilates - Cape Town 1
2 Abstract Pain is one of the most obvious symptoms of plantar fasciitis. This common condition involves the inflammation of the plantar fascia. In this research paper we address the underlying cause of the problem. Exercise programs, such as a regular Pilates, can help achieve and maintain the muscular flexibility and strength leading to relief and recovery. Within this paper I present a Pilates program addressing the body to ensure it can serve as a strong foundation for optimum movement and function through planter fasciitis. 2
3 Table of Contents: Page 4. Anatomical Description of Plantar Fasciitis Page 5-6. Introduction, Why Plantar Fasciitis occur, and How to treat it Page 7-8. BASI Pilates Conditioning program Page 9. Summery Page 10. Bibliography 3
4 What is Plantar Fasciitis: The plantar fascia is the band of tissue that runs along the bottom of the foot, connecting the heel bone to the toes. The plantar fascia provides a strong mechanical link between the heel bone and the toes so that it supports the impact of weigh bearing through the foot. Plantar fasciitis is pain on the underside of the heel bone where the plantar fascia attaches. Pain is usually worse first thing in the morning and with increased weight bearing activity. 4
5 Introduction. Research supports both stretching and strengthening for this condition. The recommendation is to treat the fascia like any other tendon injury and improve its loading capacity as the fascia needs to stretch and contract to support the weight of the body. We also know that this is not just an inflammatory condition but also degenerative one hence the plantar fascia needs to be strengthened. Why does it occur? The main cause of plantar fasciitis is usually an overuse injury, sometimes brought about by repetitive stress on the outside of edge of the foot that increases the tensile force on the plantar fascia and results in a lowering of your plantar arch. This results in the plantar fascia s inflammation and degeneration, usually where the fascia connects to the heel bone. Most of the time the condition erupts in a one foot or the other, typically from subjecting your feet to various factors that contribute to the condition. People in occupations that involve a lot of standing or walking are prime candidates for plantar fasciitis, as are those who are overweight or pregnant. The condition is also known to hit people who habitually wear poorly supportive, thin-soled footwear or are consistently working or playing sports on hard surfaces. The calf and foot may not be strong enough to support the weight required in everyday activities. Faulty biomechanics like reduced ankle flexibility and tight calf muscles can also be to blame. Excessive pronation caused by tight calves and weak foot muscles can result in too 5
6 much loading through the planar fascia. Pronation can increase with age, as can the reduction in the fascia s elasticity, increasing the risk even further. How to treat? STRENGTHENING/STRETCHING STAGE: Once the symptoms are less acute and painful you can start the strengthening phase with some stretching. The common approach has been to just stretch the fascia and there is some research to support this. More recent studies have shown that straightening the foot and ankle muscles is effective as well as strengthening and stretching the calf s and hamstrings. Every case is different therefor by using the Pilates approach we address the body to achieve the goal, balance. 6
7 Conditioning Program DAY Reason for selection: Basic warm up: Pelvic curl, Supine Spine Cadillac warm up series: Roll up with RUB, Basic warm up: Pelvic curl, Supine Spine To warm up the body following the BASI comprehensive block Warm up Twist, Chest Lift, Mini Roll-ups, Twist, Chest Lift, system. Chest Lift with Mini roll-ups Chest Lift with Rotation with oblique, Roll-up top Rotation Foot work Abdominal work Hip work Spinal Articulation Reformer Foot work series: Parallel heels, Parallel toes, Baby V-toes, Open V-heels, Open V toes, Calf raises, Prances, Prehensile, Single leg heels, Single leg toes, Hundred Prep. Hundred Coordination. Frog Circles Openings Bottom lift Bottom lift with extensions loaded Cadillac Foot Work Series: Parallel heels, Parallel toes, Baby V-toes, Open V-heels, Open V toes, Calf raises, Prances, Single leg heels, Single leg toes, Hip Opener Cadillac. Roll-Up with RUB. Mini Roll-Ups Mini Roll-Ups with oblique. Roll-up Top loaded. Cadillac Supine Single leg series. Frog Circles down Circles up Hip extension Bicycle & Reverse Cadillac. Monkey Original Wunda Chair Foot Work Series: Parallel heels, Parallel toes, Baby V-toes, Open V-heels, Open V toes, Calf raises, Single leg heels, Single leg toes Standing pike Cat stretch. Pike sitting Cadillac Side lying single leg series. Changes Scissors Circle forward Circle back Cadillac. Tower prep Tower To strengthen, stretch and straighten the foot and ankle muscles. Focus on maximum dorsi flexion. To strengthen the abdominals adding to core strength for full body strength and stability. To condition the mobility of the muscles acting on the hip joint focussing on hamstring strength and flexibility. Spinal articulation with the additional dorsi and plantar flexion control and strength 7
8 Stretches Full Body Integration (F/I) Ladder Barrel. Gluteals Hamstrings Adductors Hip flexors Cadillac. Sitting Forward Saw Standing lunge Elephant Up stretch 2 Kneeling lunge Reformer Stomach massage series. Round back Flat back Reaching Stretches focussing on the posterior line including the planter fascia. Full body conditioning with additional posterior line active stretching and plantar/dorsi flexion control. Arm work Frog back Reformer Kneeling Arm series. Chest expansion Circles up Circles down Triceps Biceps Cadillac Arms Standing Series. Chest expansion Hug-a-tree Circles up Circles down Punches Biceps Arm conditioning selected requiring awareness of foot and leg position. Full Body Integration (A/M) Tendon stretch (only for advanced / master level client) Tendon stretch (only for advanced / master level client) Balance control front (only for advanced / master level client) Full body conditioning with additional posterior line active stretching and /or plantar/dorsi flexion control. Leg work Lateral Flexion / Rotation Leg press standing Frog front Side Stretch Forward lunge Backward strep down Side pike Jumping Series. Parallel position V position Single parallel Leg Changes Mermaid Leg work selected with plantar and dorsi flexion control and strengthen. Additional hamstring strengthening. Lateral Flexion / rotation work for full body conditioning according to the BASI block system Back Extension Step Barrel. Swan prep Swan Swan on floor Pulling straps 1 and/or 2 Back extension work for full body conditioning and focussing on length in the posterior line. 8
9 Summery Plantar Fasciitis can affect both the athletic and more sedentary population. There are many factors that can cause the plantar fascia to become irritated. Generally, research and clinical experience supports both strengthening and stretching programs. Runners and very active patients will need a more specific program to deal with the training demands on the plantar fascia. More sedentary patients will still need an exercise based approach to treat the underlying cause. It can be a stubborn injury to settle down as we are on our feet a lot, so it can be difficult to rest the foot. However, there are lots of treatment options to assist with this recovery period. 9
10 Bibliography: 1. Healey K, Chen K. Plantar Fasciitis: Current Diagnostic Modalities and Treatments. Clin Podiatr Med Surg. 2010;27: Orchard J. Plantar fasciitis. BMJ. 2012;345: Yi T, Lee G, Seo I, Huh W, Yoon T, Kim B. Clinical Characteristics of the Causes of Plantar Heel Pain. Ann Rehabil Med. 2011; 35: Labovitz J, Yu J, Kim C. The Role of Hamstring Tightness in Plantar Fasciitis. Foot Ankle Spec. 2011;4: Cleland J, Abbott JH, Kidd MO, Stockwell S, Cheney S, Gerrard DF, et al. Manual Physical Therapy and Exercise Versus Electrophysical Agents and Exercise in the Management of Plantar Heel Pain: A Multicenter Randomized Clinical Trial. J Orthop Sports Phys Ther. 2009;39(8): Reeboonlap N, Satismithpong N, Phisitkul P, Charakorn K. Outcome of Plantar Fasciitis Treatment Using Monochrome Infrared Irradiation. J Med Assoc. Thai. 2012;95(10): Ref: The Oxford Physiotherapy Service: Body Arts and Science International Comprehensive Course: Movement Analysis Workbooks and Study Guide by Rael Isacowits 10
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