Diagnosis and Treatment of ITBS

If you are actively involved in athletics, dance, martial arts or fitness, you have an appreciation of the important role played by the “core” muscles of your trunk in providing pelvic and low back stability and mediating load transfer between your upper and lower body. In a very similar way, the core muscles of your feet provide stability and facilitate motion of the medial longitudinal arch (MLA) that compresses and recoils during running.

Your intrinsic foot muscles (IFM) play a key role in postural control and balance by controlling the height of the MLA and regulating your foot’s degree of pronation. During running, the IFMs act in parallel to the plantar fascia, lengthening during shock absorption and shortening as the arch recoils during propulsion, contributing to force production. If your IFMs are weak, your risk of injury may increase, predisposing you to conditions such as plantar fasciitis, Achilles and posterior tibialis tendinopathy, metatarsalgia and medial tibial stress syndrome. Weak IFMs can reduce arch height and lead to uncontrolled foot pronation, which may contribute to athletic injuries.

Just like any other muscles in your body, your IFMs can be made bigger and stronger, improving their ability to provide balance and support of the MLA. Two approaches to strengthening the foot core include “short foot” exercises, and isolated neuromuscular electrical stimulation of the IFMs. Foot core strengthening may benefit athletes whose feet tend to over-pronate by reducing their risk of injury. It may also be beneficial in the rehabilitation of patients with lower limb injuries whose IFMs have experienced detraining.

Plantar Fasciitis Physical Therapy

Plantar fasciitis pain results from an inflammation of the thick tissue on the bottom of the foot known as plantar fascia. Because plantar fasciitis pain may create serious abnormalities in a person’s gait, finding the right plantar fasciitis treatment is essential. New York Dynamic Rehabilitation clinic (NYDNRehab) employs technologically advanced methods like shockwave therapy, gait analysis, and Computer-Assisted Rehabilitation Environment (CAREN) to diagnose and rehabilitate injured feet.

The plantar fascia begins at the heel bone and runs along the bottom of the foot, forming thick, tendinous sheathes that help to hold the toes in place. Within and surrounding the plantar fascia are small nerves that innervate the foot and register pain in the lower part of the body. This is one of the reasons plantar fasciitis is so painful. The plantar fascia tissue is composed of three sections, of which the middle portion is the largest and most vulnerable. The plantar fascia is instrumental in providing support and shock absorption to the foot, carrying up to 14 percent of the weight supported by the foot.

Plantar fasciitis occurs as a result of exercise or other strenuous activity, which is one reason athletes are so susceptible to it. Patients may develop plantar fasciitis from running and jumping that loosens the plantar fascia. Athletes may also render themselves vulnerable through sudden and drastic changes in their exercise routine because the body has not had sufficient time to adjust to the new pressures it’s undergoing.

Plantar fasciitis treatment includes copious amounts of rest and exercises designed to stretch the calves and plantar fascia. Plantar fasciitis pain physical therapy exercises are designed to disrupt the cycle of pain and inflammation that patients are likely to experience throughout the day. One method of doing this is through morning calf stretches undertaken before getting out of bed, during that moment in the day that is typically most painful for a sufferer of plantar fasciitis. Individuals undergoing plantar fasciitis therapy may also be given shoe inserts, also known as orthotics, to stabilize the feet. Orthotics prevent tearing and inflammation of the plantar fascia by elevating the foot. Elevation prevents excessive pressure from being placed on the plantar fascia.

At NYDNRehab we provide several important options for plantar fasciitis treatment. Technological running and gait analysis uses a treadmill to expose and diagnose abnormalities in a patient’s movement, often before the symptoms of a painful condition even begin to manifest. The runner is placed on a treadmill and markers are affixed to his or her body. These markers send information to a computer that provides real-time feedback. With this information the physician and patient are able to make strategic decisions about the best methods of rehabilitation available. Extracorporeal shockwave therapy (ESWT) has proven effective in relieving inflammatory conditions by treating the tissue surrounding an injury. High-frequency shockwaves are sent through the skin of the plantar fascia, halting the inflammation process. Finally, CAREN is a highly advanced technology that re-trains the patient’s movement through the creation of virtual-reality exercises that can’t be done in a normal clinical environment. Each of these has its place in the treatment of plantar fasciitis, and NYDNRehab offers them.

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