Plantar Fasciitis Treatment for Pain Relief

Image of plantar fasciitis pain on the bottom of the foot. Plantar fasciitis treatment

I originally wrote this article in 2011.

Since then, I have grown in knowledge and understanding of the human body, the underlying movement dysfunctions that cause plantar fasciitis, as well as therapeutic movement interventions that can help relieve and prevent plantar fasciitis.

What is Plantar Fasciitis

Plantar fasciitis is a commonly  Living in Austin, with such an active outdoors culture, plantar fasciitis is one of the more common issues I treat. It is also one of the most common foot injuries in the United States.
As reported by Pubmed, two million Americans are seeking plantar fasciitis treatment each year and 10% of the population over a lifetime. Plantar fasciitis involves pain of the plantar fascia. The plantar fascia is a thick fibrous band of connective tissue located on the bottom of the foot. The plantar fascia attaches to the heel bone and extends along the sole of the foot towards the five toes. Its function is to help maintain the arch of the foot, and it acts as a powerful spring with a fundamental role in shock absorption and forward propulsion.
The three arches of the foot. Self treatment for plantar fasciitis.

Symptoms of Plantar Fasciitis?

Plantar fasciitis develops gradually and commonly starts as a dull, intermittent pain in the heel, mid-sole, or near the toes. The pain is worse early in the morning and tends to ease up once you move around a bit. When untreated plantar fasciitis can progress to a sharp or stabbing pain. It may hurt when climbing stairs or after standing for long periods of time.   It is common for someone with plantar fasciitis to also suffer from knee pain. Plantar fasciitis can become a chronic condition that plagues people for years, with millions of dollars spent on plantar fasciitis treatment. Plantar fasciitis is caused by stress to the soft tissue that supports the arch of the foot. It is possible to develop plantar fasciitis from an acute injury, although it is far more commonly a result of repetitive trauma to the foot from walking or running with poor gait mechanics.Austin Barefoot Running, Austin deep tissue massage therapy, Austin running barefoot, barefoot running austin, barefoot runner The arch of the foot acts like a shock-absorbing spring. With proper walking or running mechanics, the arch absorbs and releases the impact of each step, preventing damage to the knees and hips. The problem that most people have is that they heel strike, a dysfunctional gait pattern developed due to previous injury or poor shoe selection.  When you heel strike, you bypass the natural spring of the arch, and the impact of each step is driven through your heel. This causes an ongoing series of micro traumas directly to the heel — where the plantar fascia attaches — and through the soft tissue of the knee and hip. The repeated stress and strain from each step you take can cause tiny tears in the ligaments and tendons and build restriction in the calf muscles.

Overweight individuals are more at risk of developing plantar fasciitis due to the excess weight impacting on the foot.

Plantar Fasciitis Treatment

GRIDXside
The Grid Foam Roller by Trigger Point Therapy

There is no one single plantar fasciitis treatment that works for everybody. I have had great success using a few different treatments together. I see the best results — by far — with the combination of a NeuroKinetic Therapy movement assessment and deep tissue massage therapy followed with a personalized exercise program. On average it takes three or four sessions for a client to be pain free.  When my clients do self massage using a foam roller, flexibility and corrective exercise, and buy different shoes, they generally are able to get back into the activities they love within a matter of weeks. If you do not have access to a skilled Movement Therapist or deep tissue massage therapist, you can utilize the following self help tools for plantar fasciitis treatment, although it may take a few weeks longer to get to 100%.

Following the directions in the pictures below, place your body weight on the foam roller or ball over taut bands of muscle tissue that need to be released. For the best results, begin near the center of the body and slowly work away from the center of the body.Relax your body, breathe, and slowly roll through the length of the muscle. Your muscles will naturally tense up, especially when you hit a trigger point.  Ease into it and allow yourself to relax.If you find a painful spot, stop and visualize the soft tissue as melting butter and the foam roller as a hot knife. Allow pressure into the tissue and within 30-60 seconds you will notice a significant reduction in pain. Once the pain reduces (20-30%), move on to the next painful spot and repeat.Spend between 3-5 minutes on each side. It is very important that you spend an equal amount of time on both sides and that you work through each of the areas listed to gain the most out of self-myofascial release.Arch

Use a small ball, such as a golf ball to massage the plantar fascia of the foot. For plantar fasciitis treatment.

Calves

Place foam roller beneath calves. Slowly roll from the ankles to the knees. For plantar fasciitis treatment.

Turn your body to work the inside and outside of the calves. For plantar fasciitis treatment.

Use a soft ball to perform self-trigger point therapy. For plantar fasciitis treatment.

Hips

Place foam roller lengthwise to your body. Bend your knee to 90 degrees with your inner thigh on the foam roller. For plantar fasciitis treatment.

Place foam roller beneath the top of the hip bone. Lie with one hip on the roller. Opposite hip is off the foam roller. For plantar fasciitis treatment.

Sit on the foam roller. Turn your body to one side. Massage through the entire gluteal area from the crack of your butt to the outside of your hip, top of the pelvis to the top of the thigh. For plantar fasciitis treatment.

Stretch calves using a foam wedge

Using a foam wedge, press heel into the ground and actively straighten your knee. Stretch to slight discomfort, NOT pain. Hold for 1-3 minutes each stretch. For plantar fasciitis treatment.

Using a foam wedge, press heel into the ground and bend knee down and forward. Stretch to slight discomfort, NOT pain. Hold for 1-3 minutes each stretch. For plantar fasciitis treatment.

Because the way you walk or run is a large contributing factor, changing your shoe selection and changing the way you walk and run are huge keys to fixing the problems that caused plantar fasciitis.Read What Happens to Our Foot When We Wear Traditional Running Shoes by Dr. Nicholas Campitelli to learn more about how shoes change your gait.

The Grid foam roller by Trigger Point Therapy. Self treatment for plantar fasciitis.

This is the foam roller I recommend: The Grid by Trigger Point Therapy. This is an affiliate link. If you click it and make a purchase, The Art of Fitness will receive a small commission. These commissions help support TAO-Fit to continue producing life-changing content. Thank you for your support.

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Is barefoot best for kids? By David Tensen

Me and my 6 year old and 3 year old kids. On a Barefoot Walkhttp://www.davidtensen.com/is-barefoot-best-for-kids/ Me and my 6 year old and 3 year old kids. On a Barefoot Walk

Is barefoot best for kids?  6 months ago I would have said No.  Now I encourage my family to go barefoot as much as possible.

5 months ago I happened across a series of books and studies on barefoot running and living. I made the switch,  ditched my arch supports and decided to go barefoot as much as possible. My feet and posture have never been better.  I’m running an average of 20km per week barefoot on pavement, road and a little grass.

“So what about kids? Why encourage your three kids to go barefoot as much as possible? ”

The clincher for me was reading of foot health studies done across children and teens in developing countries and those in developed countries.  Basically looking at the affect of shoes on kids.  No one could argue the results.  Kids in places like India,  Africa and Haiti who didn’t wear shoes showed nearly no signs of bad foot health like fallen arches, fungal infection, ingrown toenails etc.

Contrast that against children in countries where shoes are encouraged and often mandatory and you find cases like me. Before age 14 I had three ingrown toenails surgically operated on, several pairs of orthodics (custom arch supports) and the inability to run without pain in my legs or lower back as a result of fallen arches (due to weak feet.) In my adult years I’ve suffered with much back and leg pain not to mention all the fungal stuff that breeds in warm moist socks wrapped in shoes 12 hours per day.

Without going into to much detail, I had a innate feeling that I wanted to go running. I stumbled across a book called Born to Run and just read the glowing Amazon reviews. A few weeks and barefoot running books later and I was running (slowly) albeit 1km a few days per week. Slowly and surely I improved on this, working on my posture and spending as much time barefoot as possible. I can’t tell you how much enjoyment and physical good it’s brought me already.

Back to the kids.  Anyone I share my story with that’s over 30 or 40 and grew up outside the city say “Yeah, I remember spending years without shoes and loving it. I hated shoes!”  Yet, they insist on their kids wearing clunky rubber shoes that seriously affects their gait and ability to walk with good proprioception.

My advice? Do the study for yourself.  Keep in mind that kids footwear is a multi-billion-dollar per year industry so you’re not going to hear Nike or Adidas tell you otherwise but…

Save yourself HOURS of TIME.

Save yourself HUNDREDS of DOLLARS on shoes.

Save yourself HEADACHES and STRESS of choosing and remembering shoes and…

LET YOUR KIDS GO BAREFOOT.  AS MUCH AS THEY WANT.  WHEREVER THEY WANT.

My kids go to the shops, church, park, everywhere  – barefoot. Yes, there are school uniform criteria and places like a job site or hot cement that require footware, but outside of this, allowing them to go barefoot has so many benefits and their feet will thank you for it.

Published with the kind permission of David Tensen.

Pain Changes The Way We Move BY ROBERT VIGNOLI

“Pain is inevitable. Suffering is optional.”

Massage therapy can help with poor movement patterns and painPain is part of the evaluation process when you are presented with it in your daily life and activities. Your movements will be complicated, dysfunctional and any sustainable activity that requires strength, endurance or flexibility will not be possible. Pain changes motor control function, it does this by increasing or decreasing muscle activation.

Because of these changes in muscle activation, we alter movement patterns as a way to work around the muscle pain or injury. Even after the recovering from the initial injury and with no current pain present this altered movement pattern may be ingrained or learned in our CNS (central nervous system).

Our body has adopted a new (dysfunctional) movement pattern with no current pain present. This helps to explain why previous injuries are the most common reason for future injury. And this cannot be resolved without retraining proper movement patterns. I see this often in our massage practice when I am stretching hamstrings on clients who reported injuring their low back but with no current pain in that area; as I passively stretch their hamstrings their hips or upper body will jerk. These clients are doing so because their bodies have learned to avoid that movement even with no current pain reported.

“What is it about pain that changes the way people move? What is it about the way people move that causes pain?” Gray Cook

Pain in Society Today

Try massage not meds for muscle painHave you ever injured a body part? Do you remember how well or not-so-well you moved with that injury? Modern technology has so many different creams, pain-killers, prescription drugs, braces, wraps and athletic tape for you to cover up or mask the pain so that, you can go about your daily lives. In the short term these therapeutic aides may help you; many athletes use them so that they can continue to play their sport. But the problem that I see is that you routinely go to these methods without any thought or consideration to what is causing, your pain to begin with.

I find it very amusing that, you will react to a computer virus, bug or alert faster than, you will with your own alert system. Pain is a warning sign just like the one flashing on your computer. It is an indicator to a problem before it becomes a chronic issue. So if you are experiencing pain, be thankful that your nerves are still firing.

Fight pain with proper movement and functional exercises

Have you been to the gym lately?. These “so-called” fitness machines have us sit, lay or get buckled in without fully utilizing our musculature or even our core stabilizers muscles.

This is not healthy; it is not fitness and it is not functional. Imagine your mom trying to carry a bag of groceries up a flight of stairs. This is truly when she will need her legs, feet and low back muscles to judge load balance and stabilize. Or try to imagine yourself boarding a plane and putting your carry-on in the over-head compartment are you buckled in or sitting on a machine now? No! This is when you need your core, without it you will injure yourself.

Tell me if this makes sense, what good is it to have an aesthetically pleasing body when this person cannot touch their toes in forward flexon? Or to have someone who competes in triathlons and yet cannot do a full squat without their heels staying flat on the ground or watching their knees go into valgus collapse?

Massage Therapy and its role for me

I am 43 years young and recently someone asked me if, I was going through a mid-life crisis because I have shaved my head and have become a fanatic about running, going to yoga, working out and getting massages.

If I am going through a mid-life crisis, I am going to re-define what that means and what that should look and feel like. I have a beautiful 17 month young baby girl and a 2 month old baby boy. I have found myself with a new role; living for my kids. And I want to live well for them, be able to play outside with them as well as be a GREAT role model for them.

So the role that massage therapy plays for me is it takes my body out of the equation. And what this means to me is training without pain. Massage therapy or bodywork as I like to call it has effectively allowed me NOT to worry about my physical limitations due to pain and simply allow me to concentrate just on my mental game. And you cannot do that if you have pain present anywhere.

Your body will avoid a movement when there is something wrong. When your body is affected by limited range of motion and other dysfunctional patterns of movement, pain will develop every time.  As my business partner would say, “take the excuse out!” Let massage therapy and bodywork take the excuse out for you, so that you can train, move and live pain-free.

Reposted with permission of Robert Vignoli of Roman Paradigm Massage & Therapy

The Role of Fascia on Muscle Stiffness and Pain BY ROBERT VIGNOLI

Did you wake up this morning with a stiff back? If so, the “Fuzz” could be the reason why.

Fascia a.k.a. “The Fuzz” is  a tough connective tissue that spreads throughout the entire body in a three-dimensional web from head to foot without interruption. The fascia surrounds every muscle, bone, nerve, blood vessel and organ in the body, all the way down to the cellular level.

Therefore, malfunction of the fascial system due to trauma, poor posture, repetitive activities, sitting for prolonged periods of time or inflammation can create a “binding” of the fascia. This binding of the fascia makes movement difficult and painful.

What is the role of Fascia:

  • It covers everything from head to toe (bone, organs, veins and muscle tissue)
  • It is needed for muscle contraction and relaxation
  • It creates an attachment surface for tendons and ligaments
  • It holds the body’s organs in place
  • It is vital for movements and helps transmit tension from muscle to tendon to bone and from ligament to bone
  • It is conduit for nerves, blood and lymph vessels as they pass through and between muscle

This short speech given by Dr. Gil Hedley, Ph.D (and really animated guy), discusses the accumulation of fascial fibrosis, or ‘fuzz’, which accumulates both within, and between fascial planes as a result of injury, lack of movement or postural patterns.

Gil Hedley: Fascia and stretching: The Fuzz Speech

Reposted with permission of Robert Vignoli of Roman Paradigm Massage & Therapy

Foam Roller Massage Therapy For Beginners

It is estimated that over 116 million Americans suffer from debilitating chronic pain each year, of which low back pain is the most common. According to The American Academy of Pain Medicine, “Back pain is the leading cause of disability in Americans under 45 years old.  More than 26 million Americans between the ages of 20-64 experience frequent back pain.” There is a proven and effective way to treat most forms of chronic pain — self-myofascial release using foam roller massage therapy.By performing self-myofascial release techniques using a foam roller or ball, you can reduce trigger points, decrease tissue tension, and break down scar tissue adhesions in injured myofascial tissue (muscle and fascia) formed by a combination of acute trauma, poor posture, repetitive movement, over-training, or inadequate sleep. The goal of self-myofascial release is to speed up the healing and recovery process, reduce pain, improve joint range of motion, balance the body, and prevent injury.How does self-myofascial release work?Fascia is a three-dimensional fibrous matrix interconnected throughout the body from the top of the head to the bottom of the feet.  Fascia surrounds muscles, bones, and joints providing the body structural integrity and strength. Dysfunctional fascia is a leading cause of chronic pain, reduced flexibility, and decreased athletic performance.Located within the muscle and tendon tissue are two sensory receptors called the muscle spindle and the golgi tendon organ.  These sensory receptors monitor muscular and tendon tension from the surrounding tissue and relates it to your nervous system. They are highly sensitive to changes in muscle tension and rate of change. Stimulation of the golgi tendon organ leads to a decrease in soft tissue tension.Placing pressure directly on tight or overly toned muscle tissue using deep tissue massage therapy or self-myofascial release techniques stimulates the golgi tendon organ to relax tension in the soft tissue.  Decreases in soft tissue tension will help break down scar tissue adhesions, increase joint mobility, reduce pain, and improve overall function.

BENEFITS OF Foam Roller Massage Therapy

  • correct muscle imbalances
  • increase joint range of motion
  • decrease muscle soreness and relieve joint stress
  • decrease tight or overly toned muscle tissue
  • increase extensibility of muscle and tendon tissue
  • increase performance
  • maintain normal functional muscular length

Self Foam Roller Release Instructions

Self-myfascial techniques are very simple to learn.  To perform self-myofascial release you will need a foam roller and a small ball (such as a golf ball, tennis ball, lacrosse ball, or softball).

In this article I will go over self massage therapy using a foam roller for beginners. This is a shorter session that should take between 30-45 minutes to complete. The goal of this session is to begin to unlock the hips and shoulders. After you have spent a few weeks and feel more comfortable with self-myofascial release therapy, there is an intermediate and advanced session that I teach.

Following the directions in the pictures below, place your body weight on the foam roller over taut bands of muscle tissue that need to be released. For the best results, begin near the center of the body and slowly work away from the center of the body.

Relax your body, breathe, and slowly roll through the length of the muscle. Your muscles will naturally tense up, especially when you hit a trigger point.  Ease into it and allow yourself to relax.

If you find a painful spot, stop and visualize the soft tissue as melting butter and the foam roller as a hot knife. Allow pressure into the tissue and within 30-60 seconds you will notice a significant reduction in pain. Once the pain reduces significantly (20-30%), move on to the next painful spot and repeat.

Spend between 3-5 minutes on each side. It is very important that you spend an equal amount of time on both sides and that you work through each of the areas listed to gain the most out of self-myofascial release.

Beginners Session Pictures
Arches

Using a golf ball to release the plantar fascia - self massage using a foam roller and ball
Use a small ball, such as a golf ball.
Adductors
Place foam roller lengthwise to your body. Bend your knee to 90 degrees with your inner thigh on the foam roller.
Place foam roller lengthwise to your body. Bend your knee to 90 degrees with your inner thigh on the foam roller.
Slowly massage out to the knee seeking out the most painful spots - Foam roller at inner thigh
Slowly massage out to the knee seeking out the most painful spots.

Tensor Fascia Latte

Place foam roller beneath the top of the hip bone. Lie with one hip on the roller. Opposite hip is off the foam roller.
Place foam roller beneath the top of the hip bone. Lie with one hip on the roller. Opposite hip is off the foam roller.
With foam roller on front of hip, massage from the hip bone to the top of the thigh. Slowly rotate your opposite hip up towards the ceiling.
Massage from the hip bone to the top of the thigh. Slowly rotate your opposite hip up towards the ceiling.
Gluteals
Sit on the foam roller. Turn your body to one side. Massage through the entire gluteal area from the crack of your butt to the outside of your hip, top of the pelvis to the top of the thigh.
Sit on the foam roller. Turn your body to one side. Massage through the entire gluteal area from the crack of your butt to the outside of your hip, top of the pelvis to the top of the thigh.
Teres Minor
Placing the foam roller at the armpit. Lie on your side with your arm overhead. Slowly massage from the top of the arm to below the shoulder blade. Do not massage in the armpit area.
Placing the foam roller at the armpit. Lie on your side with your arm overhead. Slowly massage from the top of the arm to below the shoulder blade. Do not massage in the armpit area.
Upper Back
Place foam roller at on upper back. Massage from the top of the shoulders to the bottom of the rib cage. Roll your body 10 degrees to massage the spinal erectors (muscles that run parallel to the spine).
Place foam roller at on upper back. Massage from the top of the shoulders to the bottom of the rib cage. Roll your body 10 degrees to massage the spinal erectors (muscles that run parallel to the spine).
With foam roller on upper back, changing arm position will expose different muscles around the shoulder blade.
With foam roller on upper back, changing arm position will expose different muscles around the shoulder blade.

Other areas you can roll out are the calves, IT band (outside of thigh), quads (front of thigh), chest, and shoulders.

The first couple of weeks of foam roller therapy will be painful. It is important to be diligent and commit to doing it every day for two weeks, because the payoff is well worth it. If you use the foam roller every day, within a couple of weeks you will begin to notice not only does the exercise not hurt as much, it will begin to feel good and you will be on the path to feeling great.  Over time the muscle and fascial tissues heal, improving flexibility, function, and performance providing chronic pain relief and injury prevention.

When to foam roll?

  • When you hurt
  • Before you exercise
  • After you exercise
  • In the morning
  • Before bed
  • While watching TV
  • Just about any time is a good time

Self massage therapy on a foam roller offers an effective, inexpensive, and convenient way to reduce muscle tension and reduce scar tissue adhesion. Self-myofascial release can help you get relief and recovery from chronic pain and injury, improve athletic and work performance, and help you reach your health and fitness goals.

The Grid foam roller from Trigger Point Therapy

This is the foam roller I recommend: The Grid by Trigger Point Therapy

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Sciatica Pain tips for Low Back Pain Relief

As a licensed massage therapist, I specialize in chronic pain and injury management using deep tissue massage therapy. Most of my clients come in with a common complaint: pain in the low back, hips (primarily on one side), and/or shooting pain or numbness down the back of the leg commonly referred to as sciatica pain. More than two million Americans suffer either from back pain or a form of sciatica that is often misdiagnosed and improperly treated.   Many suffer from pain for months or years without a proper diagnosis.  I work with these symptoms so frequently that I have noticed some common characteristics with this all-too-common pain complaint.

Pelvis with sciatic nerve and piriformis
Hip joint. Red: Piriformis muscle. Blue: Sciatic nerve.

The most common characteristics I find are aggravated myofascial trigger points (TrPs) in the piriformis muscle.  Piriformis trigger points are often confused for a herniated disc, sciatica, or other back issues, and many sufferers undergo unnecessary and costly tests, injections, and surgeries.

What is the piriformis?

The piriformis muscle is a small external rotator of the hip whose function primarily is to turn the knee and foot outward. It lies deep within the gluteal muscles, originates from the sacral spine, and attaches to the greater trochanter of the femur — the big bony “bump” on the outside top of the thigh.  The sciatic nerve passes beneath through an opening called the sciatic notch.

 

Hip abduction

Function

In non-weight bearing activities, foot unloaded and hip extended, the piriformis rotates the thigh outward. When the hip is flexed at 90 degrees it aids in hip abduction. Hip Abduction. In weight-bearing activities, foot loaded, the piriformis is often needed to control the rapid medial rotation of the thigh — for example, as the foot strikes the ground during walking or running, the knee turns inward.
Trigger point referral pain pattern from sciatica nerve impingement due to piriformis
Piriformis trigger points and referral pain pattern

 

Piriformis Trigger Points Symptoms

The myofascial sciatica pain component includes pain in the low back, groin, buttock, and hip.  A trigger point may cause the muscle to compress and irritate the sciatic nerve, causing the pain to travel along the course of the nerve. The pain may radiate down the back of the leg and into the hamstrings, the calf muscles, and possibly the foot. The pain may initially be confused with a hamstring strain or diagnosed as true sciatica. Weakness, stiffness and a general restriction of movement are also quite common. Tingling, numbness, or shooting pains down the leg can also be experienced.  Symptoms tend to be aggravated by prolonged sitting or by intense activity.

Causes
Piriformis trigger points are predominantly caused by a shortening or tightening of the piriformis muscle.  Piriformis trigger points are commonly associated with sports that require a lot of running, change of direction, or weight-bearing activity.  Piriformis trigger points can result from acute overload (as when catching oneself from a fall), from repetitive overload (as with the rapid internal rotation of the weight bearing experienced by walkers and runners with poor biomechanics),  or from sustained overload (as when holding the leg bent and turned outward for prolonged periods while driving a car or working at a desk).  Sciatica pain from piriformis trigger points is also a common complaint during pregnancy.
Pic of inflamed sciatic nerve due to piriformis impingement
Impingement of sciatic nerve from piriformis TrP

The piriformis muscle is responsible for the symptoms of pain by projecting pain from activation of the trigger points and by nerve entrapment upon the sciatic nerve.  Once trigger points are activated, the piriformis muscle begins to put pressure on the sciatic nerve.  The sciatic nerve runs under (and sometimes through) the piriformis muscle on its way out of the pelvis. The piriformis muscle can squeeze and irritate the sciatic nerve in this area, leading to the symptoms of sciatica.

Treatment and Prevention

The first two steps in treating piriformis trigger points can provide the most significant and immediate relief: deep tissue massage with stretching of the external rotators of the hip.  Deep tissue massage techniques such as myofascial release and trigger point therapy are highly effective at reducing active trigger points. Once the trigger point is released, there will be a significant reduction in pain.

GRIDXside
The Grid Foam Roller by Trigger Point Therapy

Following up the massage with flexibility training will help loosen the muscle and help prevent a return of the trigger point and sciatica.  I have found that it takes between four and ten massage sessions to move out of the acute pain phase from piriformis trigger points.  It may be shorter or longer depending on the cause and severity of the initial injury.

For long-term prevention of piriformis TrPs, self-myofascial release and flexibility will be your most invaluable tools.  Below are some pictures of how to relieve piriformis TrPs using a ball (preferably a tennis ball for beginners) and how to stretch the piriformis muscle and other external rotators of the hip.  With each stretch, it is important to breathe into the stretch and only stretch to slight discomfort … NOT PAIN.

Using a soft ball to release the piriformis muscle and gain relief from sciatic pain patterns.
Self-trigger point therapy using a ball. Find a painful spot in the glutes, relax your body into the ball, hold the position for 30-60 seconds or until you notice a significant reduction in pain. Move to the next painful spot. 5-10 minutes total.
Stretching the piriformis muscle in a supine figure four stretch.
Lying piriformis stretch. Place the leg you are stretching mid-calf on opposite knee. Pull opposite knee towards chest while at the same time pulling the knee of stretching leg towards opposite shoulder. Hold 30-60 seconds.
Seated gluteal stretch. Cross the leg being stretched over opposite leg. Wrap opposite elbow around the knee and pull towards opposite leg. Keep your back straight. Hold 30-60 seconds.
Seated gluteal stretch. Place ankle of the leg being stretched on opposite knee. Throw both hands over your leg, take a deep breath, and, as you exhale, allow your chest to drop toward the floor. Hold 30-60 seconds.
Modified pigeon pose. Place leg being stretched on a table, couch, or bed with knee bent and opposite leg resting on the floor. Drop your chest toward to table. Hold 30-60 seconds.

Other suggestions to prevent Piriformis TrPs

Get assessed by a qualified movement therapist. The exercises shown here are a guide to provide temporary relief. They are not a permanent fix. The underlying movement issues that are causing your piriformis to impinge your sciatica nerve need to be addressed. Find a highly skilled movement therapist in your area who can assess muscle function and gait mechanics.

Our bodies were designed to move.  It is important to keep moving.  Try not to sit down for more than an hour at a time. Stand up, take breaks, go for a walk, and move your body throughout the day. Lack of movement causes muscle dysfunction. Proper movement is key to an active healthy life. With an exercise program that focuses on functional movement patterns with core strength and stabilization, regular full body massage (self-massage or professional), and full body flexibility you will reduce your chances for chronic pain and injuries.

Running/walking

Change the way you walk and run. Heel strike is the most common dysfunction in running/walking gait. As soon as the heel strikes the ground, the knee rapidly moves into external rotation followed by rapid inward rotation. This places repetitive trauma on the piriformis muscle and leads to TrP formation and activation. I suggest hiring a coach who instructs forefoot or midfoot strike running form.

Replace your shoes. Modern running shoes promote heel strike. I advocate shoes with as little cushion and arch support as your body can handle.

Be smart with a shoe and form transition. Your body has adapted to how you walk and the shoes you wear.  A fast transition without proper instruction and training raises your risk of significant injury.  Below is a great article about what is wrong with your running/walking shoes.

What Happens to Our Foot When We Wear Traditional Running Shoes

This is the foam roller I recommend: The Grid by Trigger Point Therapy. This is an affiliate link. If you click it and make a purchase, The Art of Fitness will receive a small commission. These commissions help support TAO-Fit to continue producing life-changing content. Thank you for your support.

Chronic Pain and Trigger Points

According to a new report by the Institute of Medicine, “Chronic pain affects an estimated 116 million American adults—more than the total affected by heart disease, cancer, and diabetes combined.” Chronic pain is defined as “severe pain that lasts 30 to 60 days or more and taxes one’s professional and private life.” (Time)  What is the cause of so much pain and suffering?  There is a good chance that myofascial trigger points may be to blame.Trigger Points are the cause of many types of pain (WebMD Video)

 

 

 

 

 

 

Myofascial Trigger Points

 

What is a myofascial trigger point?
Myofascial trigger points are hyper-sensitive knots in skeletal muscle and fascial tissue.  The spot is painful with pressure and can cause referred pain–pain that manifests away from the trigger point site.  Trigger points are extremely common and are a primary cause of chronic pain.What causes a trigger point?
A trigger point forms in fascial tissue affected by mechanical stress or overload, which may be due to acute trauma, poor posture, repetitive movement, over-training, or inadequate sleep.  The affected tissue contracts (shortens) and blood flow can become restricted, leading to a metabolic backup; poor nutrient delivery and waste product build up within the tissue.  The build up of waste forms a toxic glue that adheres to surrounding tissue causing joint and movement restrictions, neurological impingement, and pain.

Referred pain from SCM trigger point
Trigger Point Symptoms
Trigger points cause motor dysfunction, stiffness, and restricted range of motion; resulting in overload to the central nervous system.  The neuromuscular system becomes stressed, causing weakness, fatigue, numbness, tingling, balance problems, headaches or migraines; chronic pain and injury; less efficient motor skill performance, and a long list of other symptoms. 

“The severity of symptoms caused by myofascial trigger points ranges from agonizing incapacitating pain caused by very active trigger points to the painless restriction of movement and distortion of posture due to latent trigger points that are so commonly overlooked.” (Travell & Simmons’)
Active trigger points can cause headaches, neck and jaw pain, or low back pain.  Often symptoms are misdiagnosed as arthritis, tendinitis, bursitis, carpal tunnel syndrome, or a ligament injury.  Trigger points can also cause symptoms such as dizziness, earaches, sinusitis, nausea, heartburn, false heart pain, heart arrhythmia, genital pain, and numbness in the hands and feet.  Even painful disorders such as fibromyalgia have been connected to myofascial trigger points.

There is also an emotional toll to chronic pain.  Anxiety, stress, depression, anger, and fatigue often accompany chronicpain and affect one’s ability to cope in their daily life.
For a visual guide to trigger points check out The Trigger Point & Referred Pain Guide

Prevention and treatment of chronic pain is often “delayed, inaccessible, or inadequate.” (ABC News)

 

Ischemic Compression

Trigger point therapy
Trigger point therapy is a specialized form of massage therapy.  Treatment consists of ischemic compression: concentrated pressure placed directly on a specific myofascial trigger point to break cycles of pain and spasm.  Passive stretching and corrective exercises are also utilized.  Trigger point therapy restores muscle tone and balance; enhances the function of muscle and joint biomechanics; improves blood flow and lymphatic drainage; and reduces painful spasms.  Trigger point therapy can be part of a comprehensive program complementing all other health care modalities.Among steps to improving care, healthcare providers should increasingly aim at tailoring pain care to each person’s experience and self-management of pain should be promoted. (Institute of Medicine)

Jesse James Retherford is a certified personal trainer and licensed massage therapist.  For over 12 years, Jesse has been passionate about helping his clients reach their fitness and health goals.

Jesse specializes in chronic pain and injury management, movement assessment, corrective exercise, and advanced sports conditioning.

Jesse offers personalized programs designed to improve performance and efficiency, reduce chances of injury, and allow you to move pain free so you can re-engage fully with your life.

Welcome to The Art of Fitness

Reposting is permitted as long as it is posted in its entirety, including links, and author’s bio.

 

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Self Massage Using A Foam Roller

Self Massage Using A Foam Roller

Deep tissue massage therapy modalities, such as myofascial release, improve flexibility, function, and performance; speed up the recovery process; and reduce chronic pain and injury risk. Regular deep tissue massage therapy breaks down adhesions and scar tissue that form in the fascia. With the use of a few simple, inexpensive tools (foam roller and a soft ball), you can perform daily self massage and receive much of the same benefits as weekly professional bodywork.

The Grid Foam Roller by Trigger Point Therapy - self massage calf muscles.How does self massage work?

Fascia is a three-dimensional fibrous matrix interconnected throughout the body from the top of the head to the bottom of the feet. Fascia surrounds muscles, bones, and joints providing the body structural integrity and strength. Dysfunctional fascia is a leading cause of chronic pain, reduced flexibility, and decreased athletic performance.

Located within the muscle and tendon tissue are two sensory receptors called the muscle spindle and golgi tendon organ. These sensory receptors monitor muscular and tendon tension from the surrounding tissue and relates it to your nervous system.  They are highly sensitive to changes in muscle tension and rate of change.  Stimulation of the golgi tendon organ leads to a decrease in soft tissue tension.

golgi tendon organ Located within the muscle and tendon tissue are two sensory receptors called the muscle spindle and golgi tendon organ. These sensory receptors monitor muscular and tendon tension from the surrounding tissue and relates it to your nervous system.  They are highly sensitive to changes in muscle tension and rate of change.  Stimulation of the golgi tendon organ leads to a decrease in soft tissue tension.

Placing pressure directly on tight or overly toned muscle tissue using deep tissue massage therapy or self-myofascial release techniques stimulates the golgi tendon organ to relax tension in the soft tissue. The decrease in soft tissue tension can be used to reduce pain, reduce scar tissue adhesions, increase joint mobility, and improve overall function.

BENEFITS OF SELF MASSAGE

  • correct muscle imbalances
  • increase joint range of motion
  • decrease muscle soreness and relieve joint stress
  • decrease tight or overly toned muscle tissue
  • increase extensibility of muscle and tendon tissue
  • increase performance
  • maintain normal functional muscular length

The Grid Foam Roller by Trigger Point Therapy - self massage gluteal muscles.What to do
Self massage techniques are very simple to learn. One of the best tools for self massage is the foam roller.

Place your body weight on the foam roller over taut bands of muscle tissue that need to be released. For the best results, begin near the center of the body and slowly work away from the center of the body. Breathe, relax your body, and slowly roll through the length of the muscle.  If you find a painful spot, stop and visualize the soft tissue as melting butter and the foam roller as a hot knife. Allow the pressure into the tissue and within 30-60 seconds you will notice a significant reduction in pain. Repeat this until you have reduced all the painful tissue.

The first couple of weeks of foam roller therapy more than likely will be painful.  It is important to be diligent. The payoff is well worth it. If you use the foam roller every day, within a couple of weeks you will begin to notice not only does the exercise not hurt as much but also it will begin to feel really good.

Self massage on a foam roller offers an effective, inexpensive, and convenient way to both reduce scar tissue and adhesions. For the most effective self massage techniques, I offer a foam roller therapy session geared towards beginner, intermediate, and advanced users.

Check out Foam Roller Massage Therapy For Beginners for more details on how to begin self massage.

The Grid foam roller by Trigger Point Therapy for self massage

This is the foam roller I recommend: The Grid by Trigger Point Therapy

What is causing your pain?

There are usually multiple factors that lead to pain: 

• how much you move

• the way you move

• how you manage stress

• what kind of shoes you wear
• your history of injuries

Each of these things play a role in how you feel.

What is causing your pain?

This is a question I attempt to answer many times each week.  My most common answer is:

duration x repetition = pain

When movement hurts, it can usually be traced back either to a repetitive movement pattern or a repetitive lack of movement pattern — how much time you either repeat a single movement or maintain a specific position.  Both repetitive movement and lack of movement create stresses within the fascial system.

Fascia is a three-dimensional continuous web of connective tissue that wraps around your body from the bottom of your feet to the top of your head. Fascia surrounds your muscles, tendons, ligaments, bones and organs. Fascia is the organ system that gives your body shape and plays a fundamental role in your posture.

The way you move each day determines the shape and well-being of your fascia and the structure it supports, your body. If, for instance, you sit for long hours each week (duration and repetition), the fascia in your hips, shoulders, and neck will begin to form adhesions at the folds of your fascia in these positions.  These adhesions impinge upon your body’s “working parts;” bind the head, shoulders, and pelvis into a forward position; create trigger points; and restrict range of motion.

Over time and repetition, these adhesions become semi-permanent obstructions that change your body’s shape. The change in shape shifts the balance of the body, placing stress and strain throughout.  This leads to the tightness, discomfort, and pain that many people feel in their back, knees, neck, or shoulders.

Given enough time and repetition, it may lead to more serious structural injuries, i.e., tears of the soft tissue in the shoulder, herniation of vertebrae, or wearing down of the cartilage in the knees and hips.

Below is a short list of tools that you can utilize to help remove adhesions, restore joint mobility, improve circulation, and reduce chronic injury and pain.

1. Deep tissue massage therapy is one of the most effective methods of breaking down painful adhesions in the body. Deep tissue therapies such as myofascial release and trigger point therapy can remove painful trigger points, restore functional range of motion, speed the healing process, and reduce chronic pain.  Recommended weekly, bi-weekly, or monthly deep tissue therapy session.

2. Foam roller therapy is a fantastic tool for breaking down restrictive fascia, improving flexibility and functional range of motion, aiding the recovery and healing process, and reducing chronic pain.  A foam roller is, in my opinion, the best investment for your fitness and health.

3. Corrective exercise is vital to regain and maintain full movement patterns. The body is designed to move with great ranges of motion with agility, stability, speed, and power. It is important to use your body in the way it was designed to move.

 

Jesse James Retherford is a certified personal trainer and licensed massage therapist.  For over 12 years, Jesse has been passionate about helping his clients reach their fitness and health goals.

Jesse specializes in chronic pain and injury management, movement assessment, corrective exercise, and advanced sports conditioning.

Jesse offers personalized programs designed to improve performance and efficiency, reduce chances of injury, and allow you to move pain free so you can re-engage fully with your life.

Welcome to The Art of Fitness

Reposting is permitted as long as it is posted in its entirety, including links, and author’s bio.

 

[email_link]

Deep Tissue Massage Therapy

Are you suffering from chronic pain in your back, neck, shoulders, or knees?  Deep tissue massage therapy can help.  Deep tissue massage utilizes a variety of techniques designed to alleviate symptoms of chronic pain, increase functional range of motion, and improve posture.

The goal of deep tissue massage therapy is to break down adhesions in the fascial tissueAdhesions are fibrous bands of scar tissue that bind together normally separate tissues.  Adhesions restrict the flow of blood, oxygen and waste products; limit joint range of motion; and are the primary cause of most soft-tissue pain and discomfort.  It is common for adhesions to form between fascial tissue and to the muscles, tendons, ligaments, bones, or organs that it surrounds.

Adhesions are commonly caused by inflammation or injury due to an accident such as a fall or car crash; poor bio-mechanical movement patterns such as walking, running, or other highly repetitive activities; scar tissue from an old injury or surgery; lack of movement from sitting for long hours each day; or even the day to day stresses of life.

As adhesions are broken down, you will experience an increase in joint range of motion; reduction in the symptoms of pain and discomfort; and an improvement in the ability to maintain a healthy pain free posture.

Deep tissue massage can benefit anyone who is suffering from chronic pain, tight muscles, restricted range of motion, or stress.

Feel better with deep tissue massage therapy with Jesse James Retherford.

Jesse James Retherford is a certified personal trainer and licensed massage therapist.  For over 12 years, Jesse has been passionate about helping his clients reach their fitness and health goals.

Jesse specializes in chronic pain and injury management, movement assessment, corrective exercise, and advanced sports conditioning.

Jesse offers personalized programs designed to improve performance and efficiency, reduce chances of injury, and allow you to move pain free so you can re-engage fully with your life.

Welcome to The Art of Fitness

Reposting is permitted as long as it is posted in its entirety, including links, and author’s bio.

 
[email_link]

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