Month: March 2017

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome-Physical Therapy vs Surgery

Carpal tunnel syndrome is a common problem leading to wrist and hand pain, tingling, numbness and weakness.  It is caused by pressure on the median nerve as it passes from the forearm through a small tunnel into the wrist and hand.  This pressure is generally caused by swelling that narrows this small tunnel and can be caused by repetitive wrist motions, pregnancy, or diseases such as rheumatoid arthritis, diabetes, and hypothyroidism.

Treatment options include surgery and physical therapy.  A recent study of 100 women randomly assigned to either surgery or physical therapy showed equal outcomes in self-reported function, pinch grip and symptoms.

Physical Therapy
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Plantar Fasciitis


Oh my aching feet….

Foot and heel pain is a very common complaint among athletes and non-athletes alike.  Plantar fasciitis is a very common condition causing heel pain.  Symptoms usually start suddenly, often occur after a rapid increase in activity and are felt as a stabbing pain on the bottom or side of the heel, or as a sensation of tenderness or tightness along the arch.  

What is Plantar Fasciitis?

The plantar fascia is a thick band of tissue that supports your arch and connects the ball of your foot to the heel.  This tissue can become inflamed with repetitive weight-bearing activities.  This condition can develop in athletes and non-athletes alike.

Symptoms are usually worst when getting out of bed in the morning taking the first few steps, standing up after prolonged sitting, after prolonged standing, after walking barefoot or in shoes with poor support, or after an intense weight bearing activity such as running or stair-climbing.  Frequently, people report that symptoms improve over the course of the day as the body warms up, but then progressively get worse later in the day with prolonged walking or standing.


What are the risk factors for developing Plantar Fasciitis?

  • Age over 40
  • Sudden increase in running or other weight bearing activity
  • Prolonged standing with work or leisure activities
  • Increased body weight
  • Decreased flexibility in calf muscles
  • Walking barefoot or in shoes with poor support
  • A tendency towards a flat foot, increased pronation


How can I prevent Plantar Fasciitis?

  • By regularly stretching your calf and foot muscles, especially before and after walking and running
  • By wearing well-fitting shoes with good arch support
  • By replacing your shoes regularly so that they provide good shock absorption
  • By maintaining or regaining a healthy body weight
  • By working out smartly, including a warm- up with your exercise program and gradually building up the duration and intensity of your program

A few exercises that can help you improve flexibility through your ankles and fascia:

Stand with arms against the wall or solid surface 
Standing Calf Stretch – sideview

Repeat 2 Times
Hold 30 Seconds
Complete 1 Set
Perform 2 Time(s) a Day

If the standing ankle stretch is too uncomfortable, this seated stretch is a good alternative.

Seated towel or belt stretch

Sit with your affected foot in front of you. Place a belt at the base of your toes and pull back, stretching the long plantar ligament.
Repeat 3 Times
Hold 1 Minute
Complete 1 Set
Perform 2 Time(s) a Day

Plantar Fascia-Self Stretch

Grasp foot and pull big toe towards you as far as you can while fully dorsiflexing ankle simultaneously.
Repeat 2 Times
Hold 30 Seconds
Complete 1 Set
Perform 2 Time(s) a Day

Plantar Fascia-Self Stretch

Grasp foot and pull big toe towards you as far as you can while fully dorsiflexing ankle simultaneously.
Repeat 2 Times
Hold 30 Seconds
Complete 1 Set
Perform 2 Time(s) a Day

Sit on the edge of a bench or a chair. Place a tennis ball on the ground and place your involved foot on the ball. Apply pressure and run your foot back and forth over then ball, massaging the underside of your foot. Don’t press so hard that you are in pain.

Repeat 20 Times
Hold 2 Seconds
Complete 2 Sets
Perform 2 Time(s) a Day

I think I may have Plantar Fasciitis. What can I do?

  • The first step is to see your physical therapist for an evaluation to diagnose the problem.  She will take a thorough history and perform an assessment to ensure that your symptoms are not caused by other conditions
  • If you indeed have Plantar Fasciitis, your therapist will teach you exercises to improve flexibility of the ankle and plantar fascia
  • She may also perform some myofascial work to speed up restoration of flexibility
  • Other components of treatment may be instruction in ice massage, instruction in exercise program modification, education re footwear selection, assessment for need of orthotics, use of night splints, or taping

Of course, the best thing is to prevent Plantar Fasciitis in the first place, but if you have developed this condition, it is worthwhile to get it checked out promptly.  Most of the time symptoms can be resolved with conservative measures, so that you feel better and can get back to the activities you enjoy.


Physical Therapy, Uncategorized
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