Have you ever taken a step first thing in the morning and felt like you had a sharp knife stabbing you in the heel? Have you gone on a long walk to find hours later you have a burning or aching pain along the bottom or backside of your heel? Heel pain is by far the most common foot problem we see in the clinic. It can be debilitating and can greatly affect your quality of life. Differential diagnosis of heel pain is essential, as treating the correct tissue is incredibly important to ensure proper healing and faster results.
More often than not, patients with heel pain come into the clinic with a diagnosis of “plantar fasciitis.” However, this is not the only cause of heel pain. The plantar fascia is a fibrous tissue that runs along the bottom of your foot, originating at the inferior surface of the heel and ending at the toes. Typically, when this tissue is involved, the pain is sharp and intense, located directly at the bottom of the heel and sometimes into the arch of the foot. Pain is usually only present when weight-bearing through the foot and almost always painful with the first few steps in the morning.
The inferior calcaneal nerve (ICN), otherwise known as “Baxter’s Nerve,” also runs in the same area as the plantar fascia. Baxter’s nerve can cause burning, aching, or numbness and tingle in the heel or foot. Initially, this pain is present hours after activity, but when highly aggravated, the pain can be constant. Baxter’s nerve will also be painful at rest, unlike the plantar fascia, which will be painful only when the foot is in use.
If you have heel pain, call Austin Manual Therapy Associates to make an appointment today. Our expert physical therapists are fellowship trained and can help correctly diagnose the underlying cause of your heel pain.
The Science Behind Pain
Pain is a common occurrence. Except for those rare individuals who have no sense of pain, everyone else will experience some sort of physical discomfort in their lifetime. According to data synthesized from information provided by The Manual Therapy Institute and Physiotherapist David Butler, the simple concept that tissues must be injured to cause pain is the most commonly held belief as to its source and has been around for centuries. But recent research shows that the source of pain may be from a multitude of other factors, rather than automatically associating it with tissue injury.
Sure, tissue injury in the body causes physical pain, but it is hardly the entire spectrum. When information is sent from the injured area of the body to the brain, it is simply received as “danger”, or “no danger”. It is not necessarily perceived as what we think is “pain”. The brain analyzes the significance of the signal and then “decides” if it warrants further attention, or if the signal can be dismissed.
Prolonged and repetitive pain experience over time causes the spinal cord to get more efficient at sending this “danger” signal to the brain, instead of simple sensory information. This means the “threat” message is more easily and frequently delivered, even if there is no threat. If this process goes on long enough, without being checked, any type of touch stimulus may eventually be perceived as a danger, even if the stimulus is intended to be comforting and soothing.
The brain then has a hard time keeping up with the demand for more and more endorphins to be released to control this ever-increasing “threat” surplus. The brain is overrun by this constant influx of nociception. This phenomenon can be part of the clinical picture of many physical disorders such as Fibromyalgia, Complex Regional Pain Syndrome, and other autoimmune disorders. The vague pain distribution (sometime subtle and sometimes intense) is characteristic of what is now identified as Central Sensitization Syndrome.
As Fellowship-trained Manual Therapists, we at Austin Manual Therapy have the training and skill to help most everyone manage these often intrusive and unrelenting pain symptoms. Give us a call at (512) 832-9411 to discuss ways we may be able to help anyone whose life is interrupted by any type of pain experience.
Crossfit and Manual Therapy
How can Manual Therapy benefit Crossfit City Limits’ members in their quest for “ultimate fitness”? And what is Manual Therapy? These are sample questions many people have about our physical therapy practice at Austin Manual Therapy, and why we show up at Crossfit City Limits every few weeks with a table set up for injury screening.
In principle, Manual Therapy is a philosophy inasmuch as it is a set of manual techniques. According to the American Physical Therapy Association, the definition of Manual Therapy is the skilled passive movement of joints (joint mobilization/manipulation) and soft tissues (soft tissue mobilization/specific localized massage). This also includes movement analysis and restoration of appropriate movement patterns. OMPT (Orthopedic Manual Physical Therapy) is currently the only certified therapy recognized by the American Medical Association. The training for Manual Therapy specialization is very similar in nature with didactic and residency training for a Medical Doctor specializing in a particular medical domain.
In essence, Manual Therapy is a treatment philosophy which treats the whole patient, utilizing the most advanced cutting-edge techniques with the highest order of orthopedic physical therapy problem-solving. Simply stated, it is the most effective holistic approach to Orthopedic Physical Therapy. What does this mean to Crossfit City Limits? It means that our training and attention to detail mirror that with which you strive in every workout.
Crossfit City Limits fundamentally is focused on generating exceptional fitness, while at the same time improving efficiency of movement with every front squat lift, muscle-up, and power clean, etc. To that end, it is evident that you must perfect your form before progression in workout volume and intensity can be achieved, most especially to avoid injury. But we all know that, even in the best of attempts, injuries are part of the process. Usually, these injuries are related to lapses in small details of particular dynamic movement, not a weakness in the larger muscle groups. Learning from the mistakes that lead to these particular injuries is what ensures progress more consistently.
We at Austin Manual Therapy strive for the same movement mastery you do with your Crossfit program, beginning with establishing a strong base of stabilization control and aerobic capacity of the working tissues, then progressing to more challenging dynamic movements to more closely mimic and correct the activities in patient’s lives which caused the breakdown and injury in the first place. Ultimately, we at Austin Manual Therapy are after the same things that you at Crossfit City Limits pursue. Everyone needs a little help and coaching along the way, and that is the help that we provide with our injury screenings and subsequent treatment approaches. We would assert that asking for help is a sign of strength. Ask yourself if you are strong enough to ask for this help.
We are always ready to answer your questions and provide relief of your symptoms. Contact our office at (512) 832-9411, or simply stop by to speak to us at our exam table during the next Saturday morning open-gym workout. Your health will thank you!
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