The Pain Maestro - Pain and alternative Solutions: Recent Episodes
Charlie Rickard
Pain comes in many forms. In this podcast series we explore various levels of pain, common areas of pain, treatments and alternatives to traditional approaches to pain relief.
Many people experience problems with their Achilles tendon. 24% of athletes suffer Achilles injuries at some point in their lives.
As we progress in age, we are more prone to Achilles issues, and men are three times more likely to have an Achilles rupture than women.
The Achilles is a common tendon, and it is one where three different muscles merge, gastrocnemius, soleus, and the lesser known plantaris.
It is the strongest tendon in the body, and works a bit like a spring. When it is stretched during running as the heel hits the ground, it stores energy that is released as we push off the foot minimising the work the muscles have to do.
What Are The Causes of Achilles Tendinopathy
The most common issues that cause Achilles tendon pain are insertional tendinitis, mid-body tendinitis, and paratenonitis.
Insertional tendinitis refers to pain around the Achilles attachment to the heel bone, the calcaneus.
Mid-body tendinitis affects the Achilles tendon further up, closer towards the calf muscles.
The paratenon is a thin sheet of elastin rich cells surrounding the tendon, bundling the tendon collagen fibres into a unit that still allows movement in between.
This is where paratenonitis occurs. When it gets inflamed, excess fibrin causes adhesions.
In a chronic condition, this is a form of scar tissue, less of the healthy collagen type 1 and too much scar-like collagen 3.
How Can I Help Achilles Tendinopathy?
Traditional management of Achilles pain includes reducing activity, non-steroidal anti-inflammatory drugs, physiotherapy like eccentric stretching exercises, progressive tendon loading and change of aggravating footwear.
Extracorporeal Shockwave Treatment
Extracorporeal shockwave treatment has proven to reduce pain by 60% in persistent tendinopathies without the side effects and risks of surgery.
Nevertheless, surgery does have its place in extreme circumstances and is the recommended form of treatment if the tendon is ruptured by at least half.
Surgical Therapy has about 80% of success but also depending on the study, up to 40% complications.
Early treatment of Achilles tendon pain promises better outcomes.
Extracorporeal shockwave was initially used to break up kidney stones and has since shown impressive outcomes for musculoskeletal complaints, including Achilles and other tendinopathies.
It is also commonly used to treat tennis or golfer’s elbow, rotator cuff tendinopathy, plantar fasciitis, and Morton’s neuroma.
Shockwave therapy improves blood flow to the painful area and breaks up adhesions, facilitating the natural healing process.
Another affected pathway is on the pain perception through activating serotoninergic systems increasing the pain threshold on a chemical level.
Recommendations
In clinical practice, as a rule of thumb, we believe the longer you leave it and put up with your pains and niggles, the longer it will take to get rid of them.
Seeing an expert early, and not giving up if the physio exercises did not get you the promised result will more than likely eventually get you over the finish line.
Give us a call now on 04 385 6446 to arrange a time to see us at City Chiropractic. We will help you with your Achilles pain problems.
Let’s talk About Gut Bacteria And Health … What?
The following information is primarily about resolving chronic mechanical pain, not about the gut.
Bear with me however, because it is useful to reflect on the way our knowledge about our bodies progresses.
It seems like only a scientific moment ago we had virtually no awareness of the importance of the gut biome to our health.
In fact, we have only been aware of the existence of microscopic life itself for a handful of generations, and aware of the importance of gut bacteria for a few short years.
In a few years we have watched our general awareness of gut bacteria’s significance shift from virtually zero to common knowledge.
It is now widely known and accepted that the health of the lifeforms in our gut do not only dictate whether we have a tummy upset but are implicated as playing a role in everything from Alzheimer’s to eczema.
The ultimate value of any development in our understanding of health is determined by whether we can actually use that information to become healthier and stronger.
The dawning of our awareness of the ecosystem within our gut most definitely has value in this respect.
It is still early days but there are a rapidly growing number of us finding we are able to use this awareness to improve our health, mood, wellbeing and quality of life through what we choose to eat… and even more importantly ‘what we don’t eat’.
The basic realisation we have had about the gut ecosystem may yet prove to form somewhat of a ‘unifying theory’, tying together many of the problems we suffer within our digestive and nervous systems.
Somewhat astonishingly we are learning that we rely on the gut bacteria to manufacture the neurotransmitters that are used in the brain for example.
It’s a lot of understanding in a very short space of time, understanding that we can put to good use.
So How Does This Relate To Weakness, Scar Tissue And Chronic Pain?
Well, keep listening and all will be revealed.
The combination of strength work and scar tissue ‘remodelling’ is not enough to make us all pain free or save the world; but it will make a huge difference I promise you.
And it is entirely possible that it will be enough to make you totally pain free.
For many pain sufferers merging strength work that targets the right muscles in the right way with deep release of scar tissue adhesions is the game changer they had been looking for.
It’s a beautiful thing. There is nothing quite like the feeling you get when you realise you are finally getting better!
Give us a call now on 04 385 6446 to arrange a time to see us at City Chiropractic. We will help you with your pain problems
Many people experience problems with their Achilles tendon.
24% of athletes suffer Achilles injuries at some point in their lives. As we progress in age, we are more prone to Achilles issues, and men are three times more likely to have an Achilles rupture than women.
Extracorporeal Shockwave has a long and successful history. It was initially used to break up kidney stones, and has since shown impressive outcomes for musculoskeletal complaints, including Achilles and other tendinopathies.
In addition to the before mentioned it has helped with various other pains, such as - but not limited to - tennis or golfer’s elbow, rotator cuff tendinopathy, plantar fasciitis, and Morton’s neuroma.
Extracorporeal Shockwave is thought to improve blood flow to the area, and break up adhesions, facilitating the natural healing process.
Another affected pathway is on the pain perception through activating serotoninergic systems increasing the pain threshold on a chemical level.
It is a safe treatment, even helping in the treatment of cancer patients.
Here at City Chiropractic, as a rule of thumb we believe the longer you leave it and put up with your pains and niggles, the longer it will take to get rid of them.
Seeing a specialist early, and persisting if the physio exercises did not get you the promised release straight away, will have better – and faster – outcomes.
Give us a call now on 04 385 6446 to arrange a time to see us at City Chiropractic. We will help you with your Achilles pain problems.
Experiencing chronic pain is an ordeal, and often a multifaceted approach to pain treatment is necessary to make a significant and lasting difference.
Being aware of the lifestyle factors that influence your pain may help to change how we approach our pain treatments.
Among the 9 other Lifestyle factors we are talking about to day there is Co-Morbidity
If you suffer from other chronic conditions, such as coronary heart disease, or obstructive pulmonary disease, you are more likely to report chronic pain than the general population.
One suggested mechanism is the added challenges for people with chronic pain to exercise, increasing their cardiovascular risk.
Other consideration are chronic conditions turning up the volume and making pain more intense in an already challenged body, and the influence of stress and disability from other diseases.
Chronic pain cannot be treated in isolation; the whole person with any other illnesses needs to be considered.
Pain
It sounds silly but the main risk of suffering pain is pain.
If you already experience pain, you are more likely to develop pain at other sites or acute pain becoming chronic.
It is important to address any pains as soon as possible to avoid changes in the brain to make you more susceptible to pain.
If you are willing to fight all the battles you have a far better chance of winning the war.
Give us a call now on 04 385 6446 to arrange a time to see us at City Chiropractic. We will help you with your pain problems.
Injuries are probably the most over-estimated and over-rated cause of pain in our cultural pain paradigm. And scar tissue may be the most under-rated and under-estimated cause of pain in our world. This can seem like somewhat of a contradiction in terms unless you understand that scar tissue can often come about as the result of repetitive strain and persistent lifestyle factors like poor posture.
A true injury is when we are 100% healthy one minute and then broken the next. Many of the back injuries, ankle injuries and knee injuries we experience are however a little more complex than that. It is often our weaknesses that come to the surface during relatively minor incidents, which masquerade as true injuries. This being said there are obviously many other occasions when we sustain true injuries.
Regardless of whether they come from weakness or genuine bad luck, many of our injuries leave us with lasting challenges. This is obviously true of the majors like back pain and whiplash injuries after major car crashes, but it is in many ways just as true of the common garden variety ankle sprains.
Physical injuries cause chronic pain through the legacy of scar tissue and muscle wasting. Ineffective rehabilitation is injury management that doesn't deal effectively with the scar tissue and muscle wasting left by classic ankle sprains. And – For Your Information - effective injury rehab is the exception not the rule in our society. These principles where chronic pain is the long term result of an injury applies to all pains in your body.
The point of this info series was firstly to acknowledge what a pain pickle we are in as a society, and perhaps reassure you that you aren’t alone if you are struggling with chronic pain. And secondly to demystify all this pain, as a start point on the journey towards full rehabilitation and recovery. Because the good news I have to share is each and every one of the lower body pain causes I have touched on here comes with a wide range of reciprocal and effective solutions.
The scar tissue that causes so much of our knee pain and ankle pain can be broken down.
The muscle wasting causing our back pain can be sorted with the right exercises.
The impact of hard surfaces can be mitigated with exercises and custom orthotics to provide support and shock absorption to our joints.
We can learn about how to take better care of our muscles, joints and soft tissues.
And our trauma can be healed and released, often with surprisingly simple tools and exercises.
And when we put all this together for ourselves in a way that works for us - we will have taken a small but hugely meaningful bite out of the largely silent pain pandemic we are living in the midst of.
Now that you are armed with all this information it is time to take some action on your journey to recovery from your Lower Back Pain.
Make sure you listen to episodes 1,2,3 and 4 of this information series to get the full picture of the Pain Pandemic you are living in right now.
I am going to make this really, really simple for you, and that’s going to be easy because on the level that we need to understand it here - it is simple. The following principles you are going to listen to are more than likely all you will ever need to know in terms of what causes your lower body pain. Bearing in mind - if we know roughly what is causing our pain we can make far more educated choices around which type of solutions we roll out. Because in the end all this info is only for the purpose of bringing us closer to effective tools so that we can get ourselves free.
The following causes of our lower body pain pandemic are inevitably not the whole story. But they are enough to guide 99% of us to get rid of 99% of our pain if we are willing to make them, and it could be the basis of our holistic roadmap for full rehabilitation. so listen closely.
Make sure you conclude this series with Part 5 of this presentation where I tell you about the remaining 3 main causes for lower back pain, and the way forward to help you.
For a better acknowledgement of how severely we struggle with pain: there is some value in being aware of the opiod crisis that has plagued the US over the past 20 years. Prescription opioids are a justifiable tool for about 0.0001% of pain sufferers. The class of poor unfortunate souls who have suffered the likes of extensive burns or nerve damage. Significant trauma and significant disease, are sound justifications for the use of this class of drugs.
At the height of the American opioid epidemic in 2012; the number of annual prescriptions peaked at 255 million. OxyContin is to heroin what treacle is to table sugar; the distinctions are more micro-molecular than they are meaningful. So realistically this was a case of 255 million ‘heroin’ doses being dispensed to chronic pain sufferers by American doctors in 2012. A huge number of these patients would have been back pain, knee pain, hip pain, foot pain sufferers and the like.
Statistics published in the American Journal of Public Health: estimate that there were between 17,000 and 32,000 deaths from prescription opioids during 2016. Each of whom was someone's mum, dad or at least someone's child, lest we forget what statistics represent.
On top of the thousands of deaths you can safely assume that for each death there are perhaps 5-10 or even 20 other patients living an utterly miserable addicted existence.
The American CDC estimates the total economic burden of prescription opioid misuse in the US is $78.5 billion a year.
Realistically, all the stats are glorified guesses, no one really knows how bad it all is. Death certificates for the 42,000 total opioid overdoses in 2016 do not make a distinction between deaths caused by illegal opioids like heroin, and deaths caused by prescription opioids.
These opioid deaths are not like the inevitable toll we associate with extreme medicine, like emergency open heart procedures where it was touch and go for the patient pre-admission. These are deaths caused by pain relief medications!
Make sure you continue with parts 4 and 5 of this presentation where I tell you about the real causes of lower body pains, and the best ways we use to help you.
The World Health Organization have officially christened lower back pain ‘a major cause of disability’ across all industrialized nations. The WHO have also stated clearly that back pain is the leading cause of work absence throughout the developed world.
The 2010 ‘Global Burden Of Disease Study’ placed back pain among the ‘10 most impactful conditions to people's overall well-being in developed countries’.
In industrialized societies the lifetime frequency of back pain is estimated at 60-70%.
Studies in the United Kingdom have revealed back pain as being the leading cause of disability in young adults and attributes 100 million lost work days per year in the UK alone.
A survey carried out in Sweden during the 1980’s identified back pain as the cause in 21 of their 28 million total lost work days in Sweden per year.
The US estimate for the financial cost of back pain to society through people missing work alone - is between 100-200 billion dollars per year. *Even allowing for a few mental health days and hangovers being blamed on back pain these numbers should have the power to shock.
Make sure you continue with parts 3, 4 and 5 of this presentation where I analyze the specifics and causes of lower body pains, and some of the methods we use to help you.
You have lived your entire life in the middle of a pain pandemic, that almost no one talks about. We suffer terribly with pain and disability, even (some say especially) in the world's wealthiest countries. Large population based studies indicate that somewhere between 30-50% of people in developed countries suffer with chronic pain. The researchers behind these studies predict a steady increase in these rates of pain due to our increasingly sedentary lifestyle and an aging population.
How Much Pain Are We talking About? An Awful Lot!
It is hard for anything to compete with the likes of refined sugar, smoking and alcohol in terms of impact on societal wellness. The impact these highly lethal yet culturally sanctioned products have on our health makes for disturbing reading. But you might be surprised how competitive chronic pain can be. Pain is a legitimate major public health issue, especially when you take into account … - All the pain, in and of itself. -All the physical disabilities associated with chronic pain. - The financial cost to society through the loss of productivity, impact on our individual careers and healthcare spending created by chronic pain. - The well documented (and completely awful) impact chronic pain has on mental health. - The incredibly serious mental and physical impact of pain medications have on pain sufferers. Including the shocking death toll of opioid based pain medications in certain developed nations - The well documented interaction of chronic pain and poverty. - The common and tragic illicit drug addiction that can arise from chronic pain (this is a huge topic in the US). - The death toll on operating tables, the failed surgeries and post surgical infections. -The fact that chronic pain can wreak havoc on close relationships. -The serious long term harm done to people's cardiovascular system through forced inactivity (this is an extremely common and and largely untold epidemiological story that impacts a very significant number of people) It is very difficult to put total numbers on the amount of heel pain, ankle pain, ankle sprains, iliotibial band pain, knee pain, hip pain, plantar fasciitis and back pain that we suffer with in our society. Such is the enormity of this situation we don't stand much of a chance in effectively unifying the statistics. In reality though, the data on individual complaints easily speaks to the bigger grimmer picture. The data on back pain alone is indicative of a profoundly serious global healthcare issue.
I love helping people move past their pain and find the kind of freedom and happiness that comes with being free of physical limitations. As a chiropractor and general pain management enthusiast I really wish that there were clear cut ‘cures’ for more of our pain conditions - including plantar fasciitis heel pain. But for the most part pain management just isn’t simple. Life can be pretty un-neat and un-tidy.
The good news though is that while I never feel comfortable talking about ‘cures’- there are some very very powerful tools out there for those of you who wish that there was a clear cut cure for plantar fasciitis heel pain. They aren't traditional chiropractors tools however - but they are used by many chiropractors.
Plantar Fasciitis is not the most useful or the most descriptive of names for what the condition really is. Given that an ‘itis’ is technically a condition that involves inflammation – modern research having shown that plantar fasciitis is not caused by inflammation.
Nearly all plantar fasciitis patients have successfully self-diagnosed before they walk into a clinic, but very few actually understand the underlying physical process. And if you suffer with chronic pain, knowing what is actually going on is a kinda useful start point.
Plantar fasciitis is a form of repetitive strain injury that occurs in the sole of the foot. Like all repetitive strain injuries, plantar fasciitis relates in part to lifestyle (think footwear choices / hobbies etc.), partly to environment (think concrete/tarmac etc.), partly to genetics (think flat feet, knock knee’s etc.); and also like all repetitive strain injuries – plantar fasciitis sucks to live with.
Repetitive strain in the sole of the foot caused by a combination of factors, that all conspire to create scar tissue. So plantar fasciitis is essentially repetitive strain, leading to a build up of scar tissue in the sole of your foot. To be clear, we aren’t talking about the happy, well resolved type of scar tissue either – we are talking about really grumpy scar tissue that is a lot like a partially unhealed wound.
So What About Plantar Fasciitis Taping Then?
Ultimately the value of plantar fasciitis taping is determined 100% by whether it works for YOU, both in the long and short term. It is worth bearing in mind at all times however that while it might make life easier, plantar fasciitis taping will never break up the scar tissue in your foot. That being said, there are some general principles to be aware of when choosing treatment options for plantar fasciitis, including the taping part of the jigsaw.The upside of plantar fasciitis taping is that it is relieving, quick and cost effective. The downside of plantar fasciitis taping is that for most people it is quite temporary and doesn’t get to the heart of the plantar fasciitis issue which is - scar tissue. We will address that in another segment.
Give us a call at City Chiropractic on 04 385 6446 and let’s talk about how we can help you today!
There is an exciting prospective, randomized and single-blinded study to measure the influence of shock wave therapy on patients with low back pain.
In todays world there are many ways of treating and managing lower back pain and sciatic pain. The common medical approach for lower back pain therapy is still mainly pharmacological – which definitely has its place. Physiotherapy, chiropractic and osteopathy all take a more biomechanical look to the treatment of back pain.
International guidelines for the management of lower back pain have been developed and only vary slightly from country. Treatments like spinal manipulation, core stabilisation training, cognitive behavioural therapy and acupuncture all feature. Shock wave therapy on the other hand has not been studied enough for us to know whether it warrants inclusion into guidelines for the treatment of lower back pain.
Shock wave therapy is defined as a series of high energy acoustic wave impulses that produce momentary turbulent pressure changes in the target tissue. Shock wave therapy was initially developed as a non-invasive procedure for breaking up kidney stones. This is made possible by the fact that the shock waves are absorbed by soft tissues to a depth of down to 12 cm.
Radial shock waves (the ones used in the study) are generated by a pneumatic (ballistic) method using a device that produces compressed air, which fires a special bullet inside a short tube. This bullet, after accelerating, hits the head of the device and causes the transformation of kinetic energy into a pressure wave. This wave then propagates into the tissue.
There has been a good deal of interesting research into the benefits and physical effects of shock wave therapy on injured and sick tendon, bone and connective tissue: and its effects on pain. There is however very little high quality research on Shock Wave Therapy’s effects on lower back pain. The researchers in this study were therefore, aiming to assess the influence radial shock wave therapy in the treatment of patients with lower back pain.
In human lives we need the stress of exercise and gravity or out bones and soft tissues turn to mush. These are all examples of a natural principle called ‘Hormesis’. Hormeses is a positive and fortifying response to a controlled dose of stress. This is the principle by which shock wave therapy impacts conditions like shoulder pain, back pain, wrist pain, hand pain, ITB band, ankle pain, hip pain and knee pain.
Walnuts and gluten are an excellent reminder of how cautious we should be about assuming that other peoples physical journey will be the same as our own. They are also an excellent reminder that we should keep an open mind about what treatments we ourselves pursue. We are all the same but in some physical areas we differ greatly on the same topic.
Stubborn cases of sciatic pain, back pain, headaches, migraines, shoulder pain, plantar fasciitis, heel pain, neck pain, ankle pain and knee pain are all signs that we need to heal something – realign something – stop doing something – strengthen something – move something … they are seldom a sign that we are ‘broken’!
And the journey towards healing is seldom one size fits all. So go nuts and be willing to try out a wide spectrum of approaches.
Plantar fasciitis is notoriously difficult to treat, thankfully though difficult is not the same as ‘impossible’. The difficulty in getting treated successfully is partly due to the sheer number of management options available. The number of possible ways to manage plantar fasciitis makes it tough to know which you should pursue. One of the key decisions that faces plantar fasciitis sufferer is around whether they pursue treatment or just rely on taping.
Before we weigh up the relative benefits of plantar fasciitis taping and plantar fasciitis treatment it’s worth defining these two terms. In many ways plantar fasciitis taping and plantar fasciitis treatment are not entirely separate topics but are interlinked. There is however a difference between the intention of plantar fasciitis taping and the intention behind plantar fasciitis treatment.
Plantar Fasciitis Taping – The application of tape to the sole of the foot in order to stabilise the plantar fascia and provide support for the arch.
Plantar Fasciitis Treatment – The use of tools and techniques that target the pain and scar like tissue of plantar fasciitis.Plantar fasciitis taping techniques that aim to reduce strain in the plantar fascia and supporting the arch include a range of techniques and taping patterns.
The plantar fasciitis treatments that aim to break up scar tissue and promote blood flow include..
-acupuncture
-shockwave therapy
-guasha or scraping
-acupressure
-post isometric stretches
-mechanical massage machines
If you are looking for help with plantar fasciitis treatment, plantar fasciitis taping or even help with a full rehabilitation plan for plantar fasciitis, heel pain or any other pain for that matter look no further. I recommend you reach out and tell us what is happening and we will give you an honest indication of whether we think we can help.
The current evidence that the lion’s mane mushroom has a wide variety of medicinal properties is extremely compelling and makes for very interesting reading.
It would be unsurprising many of the findings within animal studies translate to humans. After all, the mushroom has been used in traditional medicine for centuries and it seems as if the science is now simply catching up to what people have been observing for a long time. However, to provide further clarification if there are any differences between what has been observed in animals, more research is needed in humans.
From a pain perspective, the idea that lion’s mane can help with reducing inflammation and nerve regeneration alongside improving brain function and mood means we think that they could be a powerful alternative to traditional pain and mood medications – which can often come with a bunch of side effects that impact quality of life further.
Lion’s mane has proven to be safe in even reasonably large doses in rats with little side effects, and if the same held true with humans it may provide an alternative to medicines that can sometimes come with a cost.
Plantar Fasciitis Treatment & Fillings
If you have a cavity in your tooth there is no point in trying to floss your way out of that scenario, as you know. There are times in life where all our attempts to preserve our ‘wellness’ fall flat on their face, and when they do it’s time to pull out the scalpel, the drill or the pill.
When it comes to plantar fasciitis treatment at your chiropractors office you are pretty much in the same boat as toothache – the good ship tooth cavity. Except, instead of drilling – going through the steps necessary to break up scar tissue and increase blood flow in the sole of the foot is the order of the day. The best way to do this is by finding someone like me who is willing to throw the kitchen sink at that process.
When it comes to plantar fasciitis treatment you want to look at some combination of deep tissue release, scar tissue scraping (guasha), acupuncture, icing, taping & stretching. Not all chiropractors are into this kind of work – but those who do it are generally very good at it. The best policy with plantar fasciitis treatment is to get help – but you can easily try some of these out yourself with a bit of research.
Plantar Fasciitis Treatment & Preventing Tooth Decay
The problem with getting plantar fasciitis treatment from your chiropractor is the same as the problem with fillings… they just aren’t enough. If you get your filling and head straight to the nearest grocery store and stock up with Coca-Cola and forget to buy toothpaste you know what to expect. By the same token if you saw your chiropractor for a month of plantar fasciitis treatment and you jump straight back on the basketball court with no custom orthotics, flat feet and no strength in your glutes – it amounts to the same thing as the ‘Coca Cola but no toothpaste’ scenario.
The equivalent to the sugar in thisplantar fasciitis treatment scenario is concrete because it’s really hard on your soft tissues – in the same way that sugar is really hard on your teeth. The equivalent to the brushing and flossing in the plantar fasciitis scenario are exercises that strengthen the muscles of your legs and feet. This is because to a large degree it is all those muscles that help to maintain good alignment which reduces stress in the arch and the heel.
Soplantar fasciitis exercises that strengthen you through the legs and feet are the equivalent of your dental hygiene regime. Plantar fasciitis exercises of this nature work preventatively by strengthening the muscles that maintain foot alignment.
The type of plantar fasciitis exercises involved are those that involve balance and stability, like those on a wobble board or lunges. There is a bit of work involved in getting the technique right for full benefit but once you know what you are doing you are good to go
We live in a world that has widely embraced the concept of rehabilitation and that is a beautiful thing indeed! A generation ago there was almost no rehab – regardless of the severity of your injury. All you did was get ‘healed up’ and resume normal activity, no chiropractor, no physio, no mobilisation, no strength training, no proprioceptive training.
Having broadly understood the value of ‘rehabilitation’ as a concept we are only left to decide which exercises we should use to assist with the recovery of any given injury or pain complaint. This is more of an issue than one might think. I frequently meet people who have worked hard but not on the right exercises, and who’s result reflect that fact. They have done the work but still need to see a chiropractor regularly for pain.
The truth is that even with prefect willpower and a shiny halo if we aren’t doing ‘functional’ and ‘tissue specific’ exercises we might as well stick our toothbrush in our ear twice a day for 5 minutes in the hope of lasting pearly whites.
Rehabilitation for Plantar Fasciitis & Foot Pain
If you’ve been suffering from plantar fasciitis and you have had enough it’s treatment o’clock – the first order of business is pain relief. People often seek out exercises to relieve their plantar fasciitis and foot pain, unfortunately for many of us exercises just don’t cut the mustard. Fortunately, this is where treatments to manage the pain of plantar fasciitis come in and they have a very respectable hit rate! It isn’t the type of treatment most people associate with chiropractors but we do a lot of it.
Plantar fasciitis is a condition that involves a build-up of microscopic scar tissue and collagen trauma in the sole of the foot. It’s understanding that this scar tissue is the primary pain mechanism that guides treatment choices. Breaking up the scar tissue and promoting blood flow is key to reducing the pain and without doing that we often struggle to get any traction with exercises for plantar fasciitis. Treatment options to precede exercises for plantar fasciitis include acupuncture, post isometric stretches, manual fascial release and vibration massage.
Once you have at least a good degree of relief from your foot pain or plantar fasciitis the topic of rehab should be the first thing your practitioner raises with you. For many of us custom orthotics for plantar fasciitis and foot pain are essential for a good longer term outcome, but there is also of course the topic of which exercises to do.
It is VERY useful to be clear on the fact that there are 2 types of exercise for us to consider when rehabilitation plantar fasciitis and foot pain. These 2 types of exercise are extremely different in terms of their intent and what they can potentially do for you.
Humans have been manipulating each other’s spines to relieve pain and other symptoms for literally thousands of years. There are pieces 300-year-old Egyptian papyrus that describe the administration of chiropractor style spinal manipulation. Bonesetters and ‘lay healers’ have a long tradition of manipulating the spine.
It is worth remembering that hospitals and doctors are essentially a brand new thing - less than 350 years old.
Thousands of years before that though there were already healers – not all of whom had bones in their noses and crystals in their belly buttons. It’s a little presumptuous of modern medicine to operate on the assumption that all that preceded it was 150,000 years of placebo.
Like hospitals and doctors, chiropractors are a more recent development. A clever and charismatic man with a great beard – Daniel Palmer - was the first chiropractor. Palmer merged the tradition of spinal manipulation with a modern understanding of human anatomy and birthed the modern chiropractic profession.
Much in the same way as modern surgeons merged the long standing tradition for humans cutting off each other’s limbs with deeper understanding of the body – to created modern surgery. If you follow the breadcrumbs most healing disciplines have their roots in our distant past!!
The basic intention behind chiropractic is to re-mobilise areas of the spine which have become stuck or locked and are causing pain. Daniel Palmer - the first chiropractor - took this one step further and theorised that these stuck areas within the spine can make a person unwell – due to the importance of spinal nerve traffic and the fact that the spine is very much an internal organ system. Whether it’s true that the spine can make you sick or not is a chiropractic conversation for another day – nonetheless it is a core part of the chiropractors professional genesis story.
It goes without saying that manipulation of the spine is what chiropractors are most known for. And after many long hard years of being misunderstood and often maligned by medical doctors and members of the general public chiropractors are now a fully established primary healthcare profession. And spinal manipulation is now a key feature in the international guidelines for the management of back pain.
Many of us have scar tissue in our necks without realising it – scar tissue is a far bigger topic than most of us realise. Scar tissue can build up after an injury – but it can also build up slowly over time due to issues like bad posture.
Headaches
Research has shown that there are nerve pathways in your brain stem that can’t always tell where pain is coming from. These pathways will often report a headache when the problem is really tension, inflammation and scar tissue in the neck.
Persistent Tightness
It’s pretty obvious that muscle tension can cause tightness in the neck. It’s a common side effect of stress and desk work, the muscles tighten and they limit motion of the bones. A lesser known but major cause of stubborn neck tightness is scar tissue like fibrous change deep in the neck. This can come through injury or just years of poor posture.
Pressure Sensitivity
If the tissues in your neck are chronically compressed by tension & scar tissue you can develop what is known as ‘hyperalgesia’, this is when the tissue develop heightened sensitivity to touch. For people with this even the slightest touch can feel like being jabbed really hard in the neck and shoulder region. Not a nice way to be.
Pain
Neck pain is one of the most common symptoms that we humans suffer with and require treatment for. The majority of neck issues are caused by stress, poor posture and old injuries. Any of the above can leave a legacy of scar tissue in the neck. Once this has built up the soft tissues of the neck lose their elasticity and neck pain often becomes an intermittent or even persistent issue.
A Neck Crease
If we hold tension in our necks and/or have poor posture over an extended period of time we can build up scar tissues and shortened muscles groups. In particularly bad cases and in particularly bad moments this can be seen as a skin crease across the back of the neck.
So there you have it – 5 signs you might have scar tissue in your neck that is a part of the reason for your neck problems – or even headaches. The good news is that if you word with the right chiropractor and the right tools there is every chance you can find a way to lead a life with less neck pain.
For the most part we associate chiropractor treatments with neck pain and back pain. But the truth is that the spine is an internal organ that regulates the bodies processes – so are there any other conditions that might be made easier by checking in with your chiropractor?
Headaches
Headaches are no fun! Like any pain, the headaches pain has levels. Some of us have mild tension type headaches that are easily managed with some Panadol, annoying but not exactly the end of the world. For others their headache is a skull splitting migraine that puts them out of the work force for two days out of every month, really bad!
Chiropractors have the necessary training and skills to correctly diagnose your headache in most instances and quite possible also offer some relief. Many headaches are caused in part by muscle tension and joint inflammation in the top of the neck and in the jaw. By releasing tension in the neck and jaw chiropractors can sometimes help a great deal, even with severe migraines and the like.
Sciatic Pain
One of the worst complaints that chiropractors deal with on a regular basis is sciatica or sciatic pain. There is a common misconception that sciatic pain always comes from a disc. The truth is however far more complex than that. Sciatic pain is in technical terms ‘pain in the sciatic region’ (down the back of the leg) and it has many possible causes.
Your chiropractor should be able to give you a very clear idea of what the most likely cause of your sciatic pain is. Sometimes this will require further tests to be ordered but often a physical exam is enough to confirm the most probable cause. If you are one of the lucky ones your sciatic pain will be coming from muscle tension in the back of your pelvis, this type of sciatic pain is very common and can be managed by your chiropractor.
What Really Causes Migraine
To be clear, my chiropractor’s version of the migraine headache story is not proven scientifically and in fact has yet to be studied scientifically either. As you will see though it’s not entirely chiropractor waffle – and there are some scientific foundations to the theory that make it pretty solid. In the end however, this chiropractor’s explanation of migraines is currently a matter of clinical experience – handed down through generations of practically minded practitioners and healers to the present day.
Migraines are caused by chronic muscles tension and soft tissue irritation in the neck!
It feels good just to have that out here in the open doesn’t it? Feel free to say it out loud 3 times, go on see how it feels. There are a percentage of you reading who kinda knew this all along, because you could feel it.
Chronic muscles tension & chronic soft tissue irritation in the scalp, jaw, neck and shoulders, that’s fundamentally what causes migraines. Now that you know this, the next questions are How? Why ? and ultimately what can we potentially do about it with our chiropractor’s help.
How Does The Neck Cause Migraine?
So let’s say that the chiropractor is right about that cause of migraines, how can muscle and soft tissue tension in the scalp, jaw, neck and shoulders cause a migraine? After all – migraines are felt in the head, behind the eye and involve all sorts of strange symptoms like sensitivity to light, nausea and visual disturbances that we wouldn’t usually associate with muscle tension.
Muscle tension bad enough to cause migraines comes from 3 main sources.
- Old Injuries like whiplash
- Postural Issues
- Stress and suppression of emotions.
As any chiropractor will tell you, old injuries in the neck can lead to chronic muscles and soft tissues problems if they don’t heal successfully. The human neck is a delicate weight bearing column that has to support an unusually large cranium. The neck never gets a single day off in its entire lifetime of performing its supporting role for the head. The difficulty of its job and the lack of rest mean that without extensive rehab many of life’s knocks don’t recover fully.
Data from the US estimates that they spend 1.2 billion dollars per year on orthotics. With this many people using orthotics there must be a range of benefits to their use, but what are the main ones?
Well, there are a huge number of specific benefits that people report once they start wearing orthotics that range from improvements in pain from plantar fasciitis to bursitis and even osteoarthritis.
We live in a time where there is an epidemic of lower body pain in the developed world. If we were to combine the social impact of all the back pain, hip pain, knee pain, ankle pain, foot pain and lower body osteoarthritis we would see that it is a modern healthcare disaster.
There are 2 major factors that influence and create this incomprehensible mess created by a technologically advanced culture :
Urban Terrain
We live far longer lives than our ancestors did and we do so on extremely hard unnatural surfaces. Concrete, tarmac and paving stones put horrendous amounts of strain on the soft tissues in the lower body. The flatness of our urban and domestic surfaces also contributes to the problem because it requires no balance, our stabilising muscles don’t get the kind of workout nature imposes on them.
Sedentary Lifestyle
We are probably less than 70% less active than our great grandparents were as of now, they lead far more physical lives on average. Who knows how we stack up against our hunter gatherer ancestors... not great is the broad answer. This inactivity leads to weakness and the weakness leads to pain.
The Benefits Of Wearing Orthotics
There are 3 basic mechanisms that form the basis of all the more tangible and specific help with symptoms that foot orthotics offer.
How Come My Hand & Wrist therapy not working?
Hand and wrist pain can be very frustrating and that’s putting it mildly!
At our clinic we regularly meet people with wrist & hand pain. Many of whom are so bad that they’ve begun to worry about their livelihoods.
But what’s even more frustrating than hand & wrist pain?
Getting complete STUCK with hand and wrist pain because the treatment we receive isn’t working! As someone who had crippling wrist problems for an extended period once upon a time – I can totally empathise with this.
The HAPPY NEWS is that most hand and wrist pains get better very quickly – as long as they are getting THE RIGHT KIND OF TREATMENT! Which is generally not ‘just exercises’!
Most hands and wrist issues have SCAR TISSUE that needs to be broken up by someone who knows how. There also tends to be locking of the small bones in the wrist – which need mobilising. That’s what brings relief.
Then – only once they are feeling good - tendon strength exercises to make the improvements last!
Not ticking these specific boxes is what causes the majority of hand pains that fail to recover to become frustrating. The same truths hold for many other conditions – like stubborn neck pain and back pain for example.
Regardless of what pain you have that requires the support of custom orthotics, its essential that you seek the right help. The orthotics that are prescribed for you will dictate the biomechanical wellbeing of your legs and feet for many years, having the right people on the job is crucial! Here are some guidelines on what to look for when choosing an orthotics centre or clinic to prescribe orthotics for you.
An Orthotic Centre That Treats You As An Individual
The orthotic centre or health practice you should go to should be a place where they take the time to really understand your specific needs. The truth is that we are similar in some ways and very different in others.
Some of us need custom orthotics for flat feet and knee pain, others need custom orthotics for plantar fasciitis and flat feet. There is really no use thinking and acting as if all our needs are exactly the same, even though the types of solutions we often need are common to many of us.
In addition to each of us having a unique set of ‘clinical’ needs we each have unique needs when it comes to footwear. The ideal orthotic centre or orthotic clinic will be willing and able to prescribe you custom orthotics that fit in all of your shoes (yes even heels). Part of this is being able to prescribe orthotics for specific sporting needs as required.
An Orthotic Centre That Provides Rehabilitation
Problems with the feet that you take to an orthotics centre or orthotic clinic are basically all ‘postural’ problems. Although we normally reserve the term ‘postural’ for matters relating to the spine our bodies observe the rules of posture right down to the tips of our toes. Posture is alignment.
One thing that I think most of us know about posture and alignment these days is that muscle strength and muscle activity are a major part of the story. It’s all well and good having the most perfect skeleton in all creation, if your muscles don’t hold those perfect bones in the right position your posture will be a non-event.
Orthotics provide natural support to the arch of the foot as natural surfaces did before we invented paving and concrete. Orthotics made by a good clinic or orthotic centres will give great support and help immensely with any issues you have with your feet, ankles, knees and hips. What they won’t do is strengthen the muscles that had weakened as part of the underlying cause of your problem! That’s an important job! All stubborn pain complaints from sprained ankles and plantar fasciitis to chronic back pain have a major component of muscle wasting.
Chiropractors are not doctors in the medical /pills/prostate examination sense.
They are doctors in their own sense.
They are qualified to diagnose and treat disorders of the neuro-musculoskeletal system... in the same sense that a dentist is qualified to diagnose and treat disorders of the teeth, gums and jaw.
The traditional way of doing dentistry was to identify painful little holes in teeth and then pull the whole tooth out.
In a far less invasive but similarly basic sense the traditional way of doing chiropractic was to sniff out locked spinal bones - and manipulate them back to full mobility.
Both the dental profession and chiropractors have evolved somewhat since their more simplistic and 1 dimensional beginnings.
Chiropractors now embrace a broad 'scope of practice' which includes the management of a broad range of complaints and techniques.
Some chiropractors’ practices consist of as little as 25% pure chiropractic technique and complaints.
The rest of what they do is a broad and flexible approach to pain management that merges chiropractic tools with techniques most people would associate with physiotherapy, acupuncture, fitness coaching and osteopathy. This includes managing a million sprained ankles.
No.3 Chiropractic Isn't Neck Cracking
Most healing professions start off with a fairly basic methodology or tool and expand their scope over time.
If you took a peek at what surgeons were doing in Victorian times and then compared it what they can do now you would most likely be a little shocked and amazed.
When surgeons founded their profession they were essentially in the business of cutting peoples legs and arms off with no anaesthetic and no hand or knife washing between patients.
In far less horrifying but similar terms chiropractors started off with some simple procedures and have expanded their scope of practice over time.
The original chiropractic intervention was the mobilisation of a spinal bone which gave an audible pop as it released.
But chiropractic is a profession not a procedure - spinal manipulation is something that chiropractors sometimes do.
Chiropractic is a set of principles, theories and beliefs about pain and the spine which has given rise to many different techniques and tools.
Whether you’re a chiropractic person and have chiropractors work on you or you prefer physiotherapy, massage or osteopaths - basic principles will help you to avoid the whole lot of us much more often... which let’s face it - is the whole idea behind successful pain relief.
Research is the necessary hallmark of any mature healthcare profession.
A profession that has made a significant contribution to legitimate scientific knowledge of its own area of speciality can consider itself a ‘grown up’ in the eyes of the law - and in the eyes of modern medicine.
If you go back to the 1980s there was barely even the beginnings of such research from chiropractors, and the chiropractic profession.
Millions of people have chosen the prescription of orthotics for plantar fasciitis as part of their attempts to free themselves from pain. Many claim great success using orthotics for plantar fasciitis while others find the results to be more on the ‘meh’ spectrum.
Orthotics for plantar fasciitis are a powerful and essential tool for preventing stress in your feet in the long term. Far from being an artificial support they offer a more natural life for our feet than the combination of fashion shoes and concrete. But like all good things we must utilize them wisely.
At my clinic we prescribe orthotics for plantar fasciitis as part of a comprehensive pain management and rehabilitation process. We can offer these services both on and off site if you are in need of help and we offer money back guarantees on your satisfaction with our services in many instances.
Plantar fasciitis is not the same as a blood-borne disease - in the sense that we have no ‘lab test’ to confirm it. X rays and MRI don’t show up plantar fasciitis although they may in badly neglected cases eventually show signs of strain and adaptation in the tissue that run alongside particularly bad cases of plantar fasciitis.
Fortunately your chiropractor or physiotherapist can usually figure out whether you have plantar fasciitis pretty quickly though. Diagnosis of plantar fasciitis is generally guided by symptom and a basic physical exam / health history combo. This is usually enough to make sure your symptoms are not being caused by anything more sinister.
The following is a list of classic plantar fasciitis signs and symptoms and is not designed to replace a consult with a qualified professional like your chiropractor, osteopath or physiotherapist.
Sign 1 - Arch pain or heel pain first thing in the morning.
This is the most classic symptom of plantar fasciitis you could ever have the misfortune to experience. The first few steps of the day are excruciatingly painful until your feet have ‘warmed up’ - at which point thankfully most people find weight bearing becomes more comfortable.
Sign 2 - You are a very active person or a very inactive person.
If you are a runner or badminton player for example this increases the likelihood of your foot pain being plantar fasciitis. At the other end of the spectrum if you consider yourself to be very unfit you are at increased risk of developing plantar fasciitis also. Plantar fasciitis tends to occupy the extremes of the human activity spectrum.
A recent increase in the type or amount of exercise you do or an increase in time spent on your feet can trigger the onset of plantar fasciitis.
Sign 3 - Your pain is worsened either during or a short time after exercising.
For some mysterious reason not all plantar fasciitis sufferers experience pain during exercise - but most will find there is an increase in pain after exercise - possibly even finding that they are consistently worse the next day.
Sign 4 - Your pain eases when you point your toes downward.
Pointing your toes downward takes some of the stretch out of your plantar fascia, if it feels slightly relieving it may indicate that your pain is in fact plantar fasciitis. Painful tissues under a stretch usually complain - and the plantar fascia is no different.
That covers 4 classic signs of plantar fasciitis. There is no substitute for a proper consultation and exam with your chiropractor or physiotherapist though. Especially if your pain is persistent or you really want to understand the underlying causes of your case of plantar fasciitis - figuring that stuff out does get a little more involved.
Pain is complex – it’s big topic – but there are some general rules that form a good basis for navigating your way out of most aches and pains in the longer term.
With the right mindset and the right tools, the overwhelming majority of pains can be managed in one way or another.
I have 8 Tips for you in this Podcast
Millions of people have chosen the prescription of orthotics for plantar fasciitis as part of their attempts to free themselves from pain. Many claim great success using orthotics for plantar fasciitis while others find the results to be more on the ‘meh’ spectrum.
Let’s look at the arguments for and against custom orthotics for plantar fasciitis; then we’ll look at some of the pitfalls in using custom orthotics for plantar fasciitis.
My disclaimer is that if you are on the beach or on a nice piece of grass it is definitely great to not wear your orthotics and go bare foot all the way, soft ground will always be the best thing for your feet after all !!!
Conclusion
There you have it, orthotics for plantar fasciitis are a powerful and essential tool for preventing stress in your feet in the long term. Far from being an artificial support they offer a more natural life for our feet than the combination of fashion shoes and concrete. But like all good things we must utilise them wisely.
At my clinic we prescribe orthotics for plantar fasciitis as part of a comprehensive pain management and rehabilitation process. We can offer these services both on and off site if you are in need of help and we offer money back guarantees on your satisfaction with our services in many instances.
The best treatment for ankle pain depends on what the underlying cause of the ankle pain is. For this reason, all good treatment plans start with correct diagnosis.
By far the most common changes we see underpinning ankle pains are combinations of tendinopathies, micro-tears, weakness, poor alignment and scar tissue.
Depending on which specific physical issues you have some of the following treatments may help your ankle pain.
Most chiropractor’s patients with ankle pain to don’t show up asking for treatment for ankle pain. Our typical ankle pain sufferer comes to the chiropractors with some other primary complaint like shoulder pain or neck pain and they mention in passing that they also have some ankle pain that they had assumed wasn’t treatable.
Many chiropractic patients assume that an ankle sprain had not healed properly and never would. A good chiropractor looks at ankle pain the way most people look at dental pain, it’s just something to fix. In terms of long term quality of life, the rewards for taking the chiropractors ‘can-do’ attitude to ankle pain can be very significant in the long term.