#AskCorrectToes: Heat or Ice for Plantar Fasciosis (Fasciitis)?

This month’s featured #AskCorrectToes question comes from @RyanHisner, who asks the following:

Can applying heat to the plantar fascia (in conjunction with proper footwear and Correct Toes) facilitate healing?

Ryan’s follow-up question is:

Since plantar fasciosis is due to insufficient bloodflow, does this mean that you should avoid icing your feet?

Great questions, Ryan! Dr. Ray McClanahan answers these questions in this video:

Introducing #AskCorrectToes

#AskCorrectToes is a brand new educational program that we are pleased to introduce. You can now ask Dr. Ray questions about Correct Toes and natural foot health topics on Facebook or Twitter using the tag #AskCorrectToes. Each month we will select the top questions and Dr. Ray will answer them on video. Answers will be featured on our blog and in our regular monthly newsletter.

Here is the first #AskCorrectToes video answer to a question about orthotics and Correct Toes:

Correct Toes Play an Important Role in Physical Therapy

TAI LogoTherapeutic Associates Inc (TAI) is physical therapist-owned and operated partnership of unique clinics that aim to be an integral part of an individual’s journey toward positive health and wellness. TAI phsycial therapy clinics are located throughout Oregon, Washington, California, and Idaho. Many TAI practitioners have incorporated Correct Toes into their practices, and we were curious about their, and their patients’, experiences. We recently interviewed Belen Vala-Haynes, PT, DPT, OCS of Northeast Portland PT and Julie Dresch, MS, PT, OCS of Ballard PT. What follows is our discussion:

CT: Please tell us a bit about yourself and your PT clinic.

BVH: I work at a manual therapy focused clinic – meaning that we do hands-on work in combination with a very specialized home exercise program aimed at improving musculoskeletal problems. When we see our patients, we aim to give them a hands-on approach as needed with soft tissue work and mobilizations or stretches that the patient can’t do or that are aimed to progress their body area impairments and carried over with their home exercise program.

BVH: I myself am a physical therapist (PT), and I have my board certification in orthopedics (OCS), and I have been through some specialized training through Kaiser’s residency program in manual therapy. My personal philosophy is: talk to patients, listen what they want to get out of PT and try to give that to them. I think it is really important to explain what I can do and what their role is in their own improvement. I let them know that they need to take responsibility for their injury in order to get better, because they aren’t going to be in PT forever.

JD: Julie Dresch MS, PT, OCS. My clinic is in the Ballard neighborhood of Seattle. We are a busy outpatient practice with 3 full-time physical therapists, and we specialize in general orthopedics. We have an active group of employees from our front office to professional staff who pride themselves on creating great experience for our customers.

CT: What are the most common foot complaints you hear from your patients?

BVH: The most common foot complaints I treat are plantar fasciitis, post tibial dysfunction and generalized foot complaints from equinus posture in the foot (tight calf syndrome).

JD: We see a great deal of foot and ankle patients at TAI Ballard PT. The injuries are quite varied including plantar fasciitis, a variety of tendon pathologies, great toe arthritis, ankle sprains, and post-operative management.

CT: What are patients’ initial reactions when they see or experience Correct Toes?

BVH: Most of the time they really love them. I have them try them on to see what they do for their foot alignment. Then I make them walk around in them and usually that is where they are sold. The only problem I encounter is the price point – it’s sometimes a hard sell, but usually if they really want to get better, they buy them.

[CT: To address any concern about the Correct Toes price-point, please visit our Correct Toes Advantages page.]

JD: On observation, they look a little silly (thank my 3 year old, for me describing everything as silly!). With a good explanation on neutral foot positions and the effect returning to a nice wide forefoot can have on mechanics, pain relief, and muscle recruitment, they are usually willing to try. I almost always have foot/ankle patients try on our clinic pair (we keep all sizes on hand in our gym for trials), then have them perform balance and gait activities with and without so they can feel immediate changes..

CT: What results have you seen in your patients using a natural foot health approach?

BVH: I have had good results in the patients that work really hard at home to strengthen their feet. The ones that want me to do all the work, never feel satisfied. They may see some quick improvement with wearing the Correct Toes, but if they don’t do anything else they tend to plateau and get frustrated. They have to do the work.

JD: We live in a very educated world, and I think people are doing more proactively to find out about conservative and natural treatments. I have had nothing but praise for our approach to trying to find solutions that our own bodies can be trained to manage.

CT: Will you share your favorite foot rehabilitation tip or exercise?

BVH: I like tibialis anterior strengthening without toe extensor use – so you curl your toes, keep them curled and them tap your foot. I also give a lot of calcaneal eversion self mobilizations and a “Foot Rainbow” – which is a pronation/supination active foot exercise.

JD: Strengthen your hips along with your feet! Never ignore the top of the chain, because we are only as strong as what the foot is attached to.

CT: Please feel free to share a patient or personal testimonial about recovery from a foot problem, using Correct Toes and natural foot care.

BVH: I wear the Correct Toes everyday, and it has done wonders for my bunionette on my right foot!

Thanks, Belen and Julie, for sharing your experience and for all your work in helping alleviate foot pain in the Pacific Northwest!

Damian Stoy- Correct Toes Sponsored Runner

Correct Toes has recently started sponsoring Damian Stoy, an ultramarathon runner.  We wanted to congratulate both Damian and his girlfriend, Lindsey, on a great run at the Spokane River Run a few weeks- see what they had to say about the race and Correct Toes below!

spokane

The Spokane River Run race went well.  I finished in 5th place in the 50k, 10 minutes faster than my two previous times.  My girlfriend Lindsey Hintz won the 25k and almost beat all the men.  She rocked it!

Lindsey says, “My feet feel much stronger and aligned because of Correct Toes. They are definitely helping my running performance.

For me, my feet don’t ever get sore even after ultramarathon races because I use Correct Toes.  My feet are stronger and more flexible.  We both love them!

 

Meet Running Wild

Running Wild
Running Wild
is a fantastic shoe store in Pensacola, FL that carries Correct Toes. We recently reached out to our friends at Running Wild to see how their customers are responding to Correct Toes. What follows is our Q&A with Running Wild:

CT: What are some of the most common foot complaints you hear from customers?

RW: Plantar Fasciitis is definitely #1. But most often customers just complain of heel and/or arch pain rather than identifying their condition as PF. Others tend to be: pain in their big toe area from a bunion or burning/pain in one of several of their metatarsals.

CT: What are customers’ reactions to Correct Toes once they see a visual demonstration of how it works?

RW: We have yet to have someone not buy them once we put them on a customers feet. It’s amazing when they try on the Correct Toes they say: “Wow I’ve never had anything on feet feel this good.”

CT: What are some of the most common questions you receive about Correct Toes from your customers?

RW: Usually before a customer tries them on, they ask about comfort, but as soon as they try them on they ask if they can buy them.

CT: What are the advantages of offering a product to your customers that addresses so many foot and toe ailments?

RW: Well the advantage is that the Correct Toes are seemingly so simple and non-invasive. The response that we’ve had is overwhelming. We started carrying them just a few weeks ago and we’re ready to place our third re-order.

CT: Can you share with us your personal experience with Correct Toes and how this device has helped you or people you know?

RW: As soon as we received our first order I snagged a pair and have not taken them off. OK, maybe a few times. They have definitely made my feet feel more stable and running more comfortable. I wanted a pair for my 11 year old daughter because she has a slight bunion on one foot, but we sold out of her size the second day after we received our order. I finally got her size in and once I put the Correct Toes on her feet, she had instant relief. She’d previously complained of her toes cramping and arch pain, but not any longer.

Thanks, Running Wild, for sharing your experience and for helping Pensacola’s runners to… run wild!

Common Foot Pains, Men’s Health Response

Aside

Men's Health ImageDr. Ray McClanahan was recently interviewed for an online Men’s Health article. He and the rest of the Correct Toes team are grateful for the opportunity to pass on natural foot health knowledge to Men’s Health readers.

Unfortunately, the final version of the article did not accurately depict the interview with Dr. Ray or NWFA/Correct Toes’ message. We are dedicated to providing the best possible information on foot health, and so in this post we’d like to correct some errors in the article and provide clarification.

Please find below the original article and Dr. Ray’s follow-up comments. We hope this response will eliminate any confusion and provide you with the most helpful information. Dr. Ray’s principle goal, after all, is optimal foot health for all people.

Common Foot Pains for Men — 5 Ways to Keep Your Feet Happy

Don’t let foot pain stop your life. Stop your dogs from barking with these quick tips

By Brian Dalek, March 15, 2014

Your feet allow you to do amazing things: run a marathon, jump for the rim, carry you anywhere and everywhere. So it’s a shame that you don’t pay more attention to the 26 bones and 100-plus muscles, ligaments, and tendons in each one. Nearly 75 percent of people report at least one foot ailment a year—and that’s whether you’re an athlete or not, reports research from the American Podiatric Medical Association.

To get to the bottom of guys’ most common foot problems, we turned to Ray McClanahan, D.P.M., a podiatrist based in Portland, Oregon. He breaks down the 5 top foot ailments, and the best ways to relieve the pain. 

Pain: bottom of your heel 

This sharp, shooting pain is typically plantar fasciitis. It comes from inflammation of a band of connective tissue—called the fascia—that extends along the bottom of your heel to the ball of your foot. Studies show that more than 40 percent of people who see podiatrists deal with heel pain like plantar, says McClanahan. 

Dr. Ray: “Fascia” should say “plantar fascia,” and “plantar” should say “plantar fasciosis.”

A chronic case of fasciitis could turn into plantar fasciosis—where the tissues aren’t inflamed but actually degenerate due to repeated stress. You’ll feel the pain most after waking up or prolonged sitting.

Dr. Ray: The following statement from above is inaccurate: “A chronic case of fasciitis could turn into fasciosis.” For more information on this topic, please see our detailed description of plantar fasciosis and our video discussion.

It is true, however, that heel pain typically results from degeneration, and not inflammation.

Causes: Runners and athletes often get plantar fasciitis because of excessive training, especially if they pronate—a rolling in of the foot and ankle with each stride. But your shoes may also be a cause. Footwear with a tapered toe box forces your big toe in an extended position. This causes the muscle that controls your big toe—the hallucis—to pull your foot unnaturally, which restricts blood flow to the bottom of your foot, says McClanahan. Over time, this can lead to plantar fasciosis.

Dr. Ray: There are a several problems with the first sentence above. First, “fasciitis” is an inaccurate term. The “-itis” implies inflammation, which typically is not present in this condition. “Fasciosis” is the correct term. Second, pronation is not a cause of plantar fasciosis. Inappropriate footwear (i.e., footwear with heel elevation, toe spring, and toe box taper) is the main culprit. And third, excessive training is not, in and of itself, a principle cause of plantar fasciosis, but weight-bearing in footwear that holds your feet and toes in a deformed position is.

“The hallucis” should say “the abductor hallucis.” This is the muscle that moves the big toe away from the rest of the toes.

Pain relievers: Give yourself a massage by rolling a golf ball or frozen water bottle under your foot. This relieves the inflammation. You can also insert a metatarsal pad into your shoe, shortening the plantar fascia ligament and re-distributing pressure away from the troubled area. If your shoe has a tapered toe box, switch it for one that allows your feet to splay naturally, like the Altras.

Dr. Ray: Regarding the sentence: “This relieves the inflammation,” again, plantar fasciosis is not a condition of inflammation. The massage techniques described do indeed relieve pain, and they most likely do so by mobilizing the accumulated dead tissue in the plantar fascia, so that it can be removed by the bloodstream.

Pain: big toe

Blame the redness, soreness, and swelling on a bunion, a bony bump that forms at the base of your big toe. You’ll often notice a “bump” on the outside edge of the foot because of swelling. 

Causes: Heredity can play a factor. Chances are if your father has bunions, you’ll inherit his odd foot shape and get them, too. Wearing shoes with tight toe boxes can exacerbate the problem.

Dr. Ray: It’s a common (and understandable) misconception that bunions are inherited. However, I do not believe heredity plays a direct role in bunion formation. The main cause of bunions is footwear that forces your big toe toward your second toe. Unfortunately, this applies to any shoe that has a tapering toe box. Everyone has a unique foot shape and connective tissue integrity, and certain foot shapes are more likely to be negatively impacted by tapering toe boxes than others. But the biggest problem remains the footwear, not the foot shape. For more information, please see our detailed Bunion Information article and our video discussion.

Walking, running, or exercising with poorly-fitting shoes applies pressure to the joint. 

Pain relievers: Acute pain can be handled with ice and anti-inflammatories. If it’s a progressive problem, wear shoes with a wide toe box and try a toe-spacer device like Correct Toes that helps to re-align your toes. 

Dr. Ray: I do not generally recommend either ice or anti-inflammatories for this condition. Wide toe box shoes in combination with Correct Toes is indeed helpful for many longstanding and progressive foot and toe problems.

You can also try a bunion stretch. Here’s how to do it: With one hand, pull your big toe away from your other toes. With your other hand, apply a deep tissue massage with your thumb on the tissues between your first and second metatarsals.

Dr. Ray: Please check out our video demonstration of this stretch.

Pain: between your toes or on the ball of your foot

If you have a stinging sensation on the bottom of your foot, as if you’re stepping on a pebble, you may have a neuroma—an enlarged growth of nerves. This is essentially a pinched nerve in your foot, and usually occurs between the third and fourth metatarsal. This spot represents the confluence of two plantar nerves joining together, and with a larger volume it’s more likely to be pinched/squeezed.

The cause: Neuromas occur from ill-fitting shoes, repeated stress, or trauma to the feet.

Pain relievers: Go with a well-cushioned shoe that has a lower heel and level platform. A metatarsal pad can help relieve pressure on the nerve, as well. “If that doesn’t work, you can ask your doctor about cortisone,” says McClanahan. This destroys the scar tissue around the affected nerve.

A simple toe extensor stretch may help, too. Do this: While seated in a chair, keep one foot flat on the floor and bring the other foot underneath the chair. Your heel should be off the floor. Now curl your toes toward the ball of your foot, and push the top side of your toes into the floor. Hold this for 20 to 30 seconds. You should feel a stretch of the extensor muscles on top of the foot. (Click here to watch McClanahan demonstrate the toe extensor stretch.)
 
Pain: ankle top

When walking or running, the quick pinch you feel just below where your shoelaces are tied could be your peroneal nerve—a nerve that runs down your leg and through your foot.

The cause: You may aggravate your peroneal if you tie your shoelaces wrong or your shoe’s tongue hits your ankle.

Pain reliever: Release the pressure from the nerve. “Skip the last two or three shoelace eyelets or cut off the top inch of the tongue,” says McClanahan. If this doesn’t help or it’s more than a fleeting shock of pain, see a podiatrist.

Pain: Achilles

This shooting pain above the heel and below the calf muscle is commonly tendonitis. Over time, your ankle feels less flexible.

The cause: Overuse can cause inflammation and swelling of the Achilles tendon, a strong tendon that connects your calf muscles to your heels. If you’re new to more minimal shoes, research shows that transitioning too quickly to a lower profile shoe can put strain on calf muscles. In turn, this puts a larger burden on the Achilles with each step.

Pain relievers: First and foremost, you need to rest. Ice your Achilles for 15 to 20 minutes throughout the day, and take anti-inflammatory medication like Ibuprofen. You can also use a heel lift—a shoe insert that helps absorb shock—to take pressure off your Achilles. 

Dr. Ray: This treatment information for Achilles tendinitis is inaccurate. Our Achilles Tendinitis article contains our best recommendations for addressing this condition.

If you want to prevent this pain from starting in the first place, increase Achilles and calf flexibility, says McClanahan. That includes a slow transition into minimal shoes if you’re a runner, and stretching the Achilles.

Do this: Stand on the balls of your feet on a stair or a curb. Keeping your legs straight and the balls of your feet on the stair, release your heels toward the floor. Pause for 10 deep breaths. To increase the intensity of the stretch, keep one foot flat and lower the other heel. Then switch legs.  Do this a couple times a week or more if you’re noticing tightness.

Dr. Ray: Please visit our website – NWFootAnkle.com – for extensive information on foot problems and natural foot health!