You are currently browsing the tag archive for the ‘Foot Pain’ tag.

It’s been widely speculated that the origins of reflexology date as far back as 5000 years to China. As part of Traditional Chinese Medicine (TCM), some form of hand and foot therapy was being practiced alongside herbal therapy, acupuncture and qigong. Its roots have also been traced back to ancient Egypt through pictographs dating to 2330 B.C. Commonly referred to as the “Physician’s Tomb” for its depiction of several medical procedures, the pictographs were found at the burial site of a high ranking official named Ankhmahor. One of the images depicts two practitioners applying pressure to the hands and feet of two other people, with the inscription loosely translating to “Do not let me feel pain” and the response, “I will act as you please.”

Other cultures such as those of India, Japan and the Native Americans, have also used some form of pressure therapy to the feet as part of their tradition. The Native Americans for example believe that because our feet make contact with the earth, that we are connected to the whole of the universe through the energies that pass through them. In Europe, a form of pressure therapy known as “zone therapy” was being practice as far back as the 14th century.

In 1898, an English Neurologist by the name of Sir Henry Head discovered what are now known as “zones of hyperalgesia” or “Head’s Zones.” In a series of experiments, Head was able to demonstrate a link between diseased organs connected to a specific “zone” of skin by nerves and a hypersensitivity to pressure in that zone of the skin. Around this same time the work of two notable Russians: Ivan Pavlov – a physiologist, and Vladimir Bekhterev – a neurologist & psychiatrist, made their contribution through what are known as “conditioned reflexes”. Pavlov and his work with classical conditioning were able to demonstrate a causal link between a stimulus and a response. Bekhterev’s work was very similar in nature to Pavlov’s, although he referred to this link as an “association reflex.” Bekhterev however has the unique distinction of coining the term reflexology in 1917.

The first instance of a “reflex action” being attribute to massage occurred in Germany in the late 1890’s. What the Germans referred to as reflex massage was being widely practiced as a way of treating various diseases. A German doctor by the name of Alfons Cornelius had experienced first hand the therapeutic effects of a reflex action while recovering from an illness. He noted that during his massages, focusing on the tender and painful areas helped to significantly reduce his pain levels and speed up his recovery time.

It wasn’t until the work of an American physician named Dr. William Fitzgerald, that the reflexology that we know and practice today took form. Fitzgerald was the head of the Nose and Throat Department at St. Francis Hospital in Hartford, Ct in the early 1900’s. Commonly regarded as the father of zone therapy, Fitzgerald discovered the anesthetic effects created through the application of pressure to the fingers and toes. A series of ten longitudinal zones for the hands and feet, where found to run the length of the body from the fingers and toes all the way up to the head. Through the use of clamps, pins and rubber bands which he used to apply pressure to the digits, Fitzgerald was able to map out the distinct areas on the body where the anesthetic effect took place. He soon realized that could relieve pain and the underlying causes of the pain using this technique. Fitzgerald became so skilled at this that he was able to perform small surgeries using his technique, which he referred to as zone analgesia. Along with colleague Dr. Edwin Bowers, Fitzgerald co-wrote the book “Zone Therapy” in 1917. In it they discuss the general principles behind this therapy. The idea being that areas of the body found along specific zones will be linked to one another through energy that flows through that zone. The zone therapy that’s used today in reflexology is largely based on Dr. Fitzgerald’s pioneering work.

Another physician by the name of Dr. Joseph Shelby Riley was so fascinated by Dr. Fitzgerald’s work with zone therapy, that he went on to refine and use his techniques in his own practice. Riley was the first to create detailed diagrams of reflex points on the feet. He also discovered the eight horizontal divisions governing the body. It was his assistant however, a physical therapist by the name of Eunice Ingham, that finally charted the reflexes we use today in reflexology. Ingham has been called the “Mother of Modern Reflexology”. It was Ingham who focused on the feet as a means of treatment. By applying the techniques used in zone therapy, she meticulously checked and rechecked the reflexes until she had created a detailed map of the body on the feet. After writing her first book, “Stories The Feet Can Tell” in 1938, she tireless promoted the practice of reflexology throughout the general public. Along with her nephew Dwight Byers, which she often practiced on, the two of them helped bring the modern practice of foot reflexology to the forefront.

Another key contribution worth noting came around the mid 1960’s. In 1965, Ronald Melzack and Patrick Wall published an article in the journal of “Science” entitled, “Pain Mechanisms: A New Theory”. In it they describe how the body transmits and inhibits pain signals through a gate response found in the spinal cord. This theory would go on to explain one of the possible ways that this anesthetic affect was being created in the body. The theory was called the “Gate Control Theory” of pain.

The body’s normal response to pain is to inhibit it through the use of endorphins; the body’s natural pain relievers. Endorphins are endogenous opioid compounds produced by the pituitary gland and the hypothalamus in response to strenuous exercise, excitement and trauma. And they are as strong as any opiate out there, including morphine. As a matter of fact, the word endorphin is actually an abbreviated version of “endogenous morphine”. When you stub your toe for example, pain signals are sent to the brain where they are processed by the thalamus. During this time, the first wave of endorphins is released into your system. But there’s a curious thing that happens along side this. Our immediate reaction is often to reach for the area in pain to try and soothe it. Ever wonder why that is? Somehow it helps to diminish the pain and the gate control theory can explain why.

The gate control theory states that a competing signal can essentially block pain signals from reaching the brain. Nociceptive pathways or pain pathways, have two different types of nerve fibers. A-Delta fibers are myelinated pathways that conduct pain signals to the spinal cord at approximately 40mph (fast, acute, sharp pain). C-fibers are unmyelinated pathways that carry signals at approximately 3mph, (slow, continuous, throbbing pain). Sensory neural pathways however, are myelinated but also larger in diameter, which essentially means they can transmit signals faster than both pain pathways. Basically, sensory information reaches the spinal cord faster and takes precedent over pain signals. This explains why rubbing your toe seems to miraculously help ease the pain. When the sensory input reaches the spinal cord it stimulates inhibitory inter-neurons, which act as gates that can close and suppress the pain signals. It’s a complex interplay and not an all or nothing phenomenon, which is why we still feel some pain. Interestingly enough, the theory goes a step further. Melzack and Wall also state that “the psychological condition and cognitive content of the mind” can affect our experience of pain. This includes emotions, thoughts and our overall outlook! This could explain why pain is such a subjective experience.

This last theory has wide implications for the therapeutic effects of touch therapy such as massage, Reiki and in particular, reflexology. Firstly, the sensory input created when pressure and movement are applied to the feet and hands help to close the gates, lessening the effects of pain. Secondly, the psychological effects of stress reduction can help generate feelings of ease and comfort, and ultimately give us hope that relief is within sight.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist, ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.

In some cases, the affects of heel pain may have a different source. As previously mentioned, tight calf muscles can often predispose you to developing plantar fasciitis. A byproduct of this are trigger points. Trigger points are tiny contractions in the muscle fiber which form as a result of over-use, strain, trauma, or shortened and tight muscles. Trigger points refer pain to other areas of the body. In the case of the lower leg, there are several muscles which could be referring pain to the heel and long arch of the foot – the same area where plantar fasciitis pain occurs. Let’s take a look at the first image below.

Soleus TP

This image depicts a trigger point in the middle of the soleus muscle. The soleus is a large calf muscle that plays a major role in plantar flexing your foot. The muscle is accessible half way down your lower leg and attaches itself to the foot via the Achilles tendon. If the muscle is tight, it will keep your foot plantar flexed (toes pointing down) and limit the amount of dorsiflexion (toes pointing up) available. This limitation will invariably put a strain on the muscles and fascia of the foot.

Quadratus Plantae TP

This second image shows a trigger point in the quadratus plantae muscle — a deep intrinsic foot muscle. Pain from a trigger point in this muscle can be a sharp, stabbing pain preventing you from putting your full weight down on your heel.

Gastrocnemius TP

And lastly, another common site of plantar fasciitis pain is along the medial arch of the foot. A trigger point in the medial head of the gastrconemius muscle can often refer pain to this area. Your gastrocnemius muscles are the superficial muscles found on the upper part of the lower leg. These muscles are very strong, powerful muscles which also attach to the foot via the Achilles tendon. They are often recruited in activities such as sprinting and jumping due to their capacity to lift your entire body weight.

It’s important to remember that while true plantar fascitiis takes time to heal, the effects of trigger points in these muscles could perpetuate pain in the area long after the condition has resolved itself. Along with treating the symptoms of referred pain, trigger point therapy has the added benefit of addressing tight calf muscles, which could be contributing to the condition. So whether you’ve been diagnosed with plantar fasciitis or are dealing with foot pain of some kind, in addition to your conventional treatments, trigger point therapy in combination with reflexology should be a part of your recovery plan.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist, ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.

We rely on our feet to take us just about everywhere. So if heel pain is causing you to curtail your daily activities, this can be a huge problem. In the first half of this article, we’ll look at the most common form of heel pain — plantar fasciitis.  In the second half, we’ll consider how the effects of trigger points in the lower leg muscles can be a contributing factor and/or the cause of your heel pain!

Plantar fasciitis is a fairly common condition that causes pain and inflammation in the fascia which cover the bottoms of your feet. These tough bands of connective tissue run from your heel bone to your metatarsals and provide a good amount of arch support. Micro-ruptures can form due to repeated pulling, stress, and/or trauma to the area. If not treated properly, the condition can become chronic and lead to the formation of a heel spur, which can then cause further irritation and pain.

Plantar fasciitis typically affects those who have relatively: high arches (pes cavus), flat feet (pes planus), tight calf muscles, or tight, ill-fitting shoes. It can also occur in people who spend most of their day on their feet, those who are overweight, and runners who suddenly increase their activity level. Excessive pronation of the foot, running on sand or uneven surfaces, and inadequate arch support from worn out shoes can also be contributing factors.

The major signs and symptoms include:

– Pain at the heel when weight bearing

– Morning stiffness and pain that decreases with activity

– Tenderness along the medial arch when pressure is applied

– Pain when standing on your toes and /or walking on your heels

– Numbness along the outside of the foot

– Occasional swelling over the heel

– X-rays that reveal bone spurs where the fascia attaches on the heel bone

If you’ve been diagnosed with plantar fasciitis, chances are that most conservative methods should help alleviate the condition in a majority of cases. Such remedies may include:

– Rest, along with an over the counter NSAID to help with pain and inflammation

– Ice and myofascial massage to the affected area

– Orthotics and/or new shoes with good arch support

– Stretches for lower leg and foot muscles

– Night splints

In severe cases when the condition is particularly chronic and debilitating, your doctor may prescribe cortisone shots. While the shots may help to manage the condition, they are not a cure. It is crucial to be proactive and stave off any possible long-term effects by doing your homework. This will help speed up the recovery time significantly.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist,  ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.

In part one of Anatomy of the Foot, we covered the basic structure of the foot — from the three sections and three arches, to the bones and their ligaments. In part two, we’ll get into the muscles and tendons that make the foot move.

Tendons

Like the ligaments of the foot, there are numerous tendons that attach the muscles of the lower leg to the foot. Tendons are the cord-like structures that attach muscle to bone. Here are a few key tendons along with some common forms of tendonitis.

Achilles Tendon: One of the most recognizable tendons of the body, the Achilles tendon is located at the back of the heel and attaches the calf muscles of the lower leg to the calcaneous. This tendon helps to flex the foot downward and propel you forward. Achilles tendonitis can result from overuse of the tendon while running or jumping or from a tight shoe, which can put pressure on the back of the heel.

Peroneal Tendons: There are two peroneal tendons which attach the lateral muscles of the lower leg to the foot. These tendons run underneath the lateral malleolus (the boney knob on the outer ankle) and when overused, can often times lead to peroneal tendonitis. The pain is usually felt along the lateral malleolus and heel, and can also be related to a high arch or a supinated (rolled in) foot.

Tibialis Posterior Tendon: This tendon attaches one of the deeper lower leg muscles to the foot. The tendon runs underneath the medial malleolus (the boney knob on the inner ankle) and when overused can lead to posterior tibial tendonitis. Common amongst runners or people with hyper mobile or pronated feet, pain and swelling can occur along the inner part of the ankle.

Anterior Tibial Tendon: The tendon of the anterior tibialis muscle, located in the front of the lower leg, runs over the top of the ankle to attach itself to the bottom of the inside of the foot. Pain and swelling along the top of the ankle and foot could be a sign of anterior tibialis tendonitis. This can result from excessive downhill running.

Bursa and Bursitis: Bursitis is an inflammation of the bursa sacs which lie under tendonous joints and are designed to reduce the friction against bone. One of the most common sites for bursitis on the foot is just behind your heel under the Achilles tendon. Often referred to as a “pump bump,” this bursa lies underneath the Achilles tendon and can be irritated from a tight shoe. Retrocalcaneal bursitis, as it’s called, usually develops over time and is often more acute and localized than the pain associated with Achilles tendonitis.

Muscles

Of the twenty intrinsic muscles found on the foot, only two are located on the dorsal (top) part of the foot. Seven muscles are found on the plantar (bottom) part of the foot. And the other eleven (the interosseous and lumbricals) are found between the metatarsal bones.

Dorsal foot muscles: The extensor digitorum brevis and the extensor hallucis brevis are short toe extensors. The latter extends the big toe and the former extends the other four toes.  The interosseous muscles lie between the metatarsal bones and help to move the toes from side to side and also aid in flexion and extension. There are actually two set of these interosseous muscles. The dorsal component has four muscles and the plantar component has three. Technically these muscles lie between the metatarsals, but because they’re most easily accessible from the top of the foot, they’re usually considered dorsal muscles.

Plantar foot muscles: The plantar surface of the foot is home to three layers of muscle.

First Layer: The first and most superficial layer contains three muscles. First on the list is the flexor digitorum brevis muscle which lies directly in the middle of the foot and attaches the heel to the toes. This muscles aids in flexing (curling) the four smaller toes. The abductor hallucis muscle lies along the medial longitudinal arch and helps to abduct or rather, move the big toe away from the other toes. The abductor digiti minimi muscle, found along the lateral longitudinal arch, helps to move the little toe away from the other toes. These last two toe abductor muscles are crucial in making the minor adjustments necessary to keep your balance.

Second Layer: This layer contains five muscles. The quadratus plantae muscle attaches the heel bone to the tendons of a long flexor muscle. This configuration makes it a strong aid in flexing the toes. The deeper lying lumbricals, of which there are four, lie parallel to the metatarsal bones. These tiny muscles help to flex the 2nd-5th toes.

Third Layer: This third and deepest layer has two big toe muscles and one little toe muscle. The two big two muscles are the adductor hallucis and the flexor hallucis brevis muscles. The adductor muscle moves the big toe closer to the other four toes and the flexor muscle bends the big toe downward. The last muscle in this layer, the flexor digiti minimi brevis muscle, helps to flex the little toe.

Covering all these layers of muscle are two bands of fascia that run for the heel to the ball of the foot. When irritated, it can lead to a fairly common condition called plantar fasciitis – an inflammation of the fascia.

Movements of the Foot

Finally, let’s discuss the four major planes of movement of the ankle and foot. The foot is capable of making numerous adjustments along its 33 joints, all of which are necessary for maintaining balance. For the sake of simplicity, we’ll consider the movements of the ankle joint, which move the foot.

The four major planes of movement are: dorsiflexion, plantarflexion, inversion and eversion. Each of these planes has a degree of movement that is considered part of the normal range of motion (ROM) found at the ankle.

Dorsiflexion: When you lift your foot so that your toes are pointed upward, this is called dorsiflexion. About 20 degrees of dorsiflexion is considered normal.

Plantarflexion: Flexing your foot so that your toes point downward is considered plantarflexion. Typically, 50 degrees of plantarflexion is about average.

Inversion/Supination: When your foot rolls inward so that your toes are pointed toward the midline of the body, this is referred to as a supinated or inverted foot. There tends to be more variability in this plane of movement than the previous two, so a normal range is usually between 45-60 degrees.

Eversion/Pronation: This occurs when your ankle rolls outward and your toes point away from the midline of the body. Similar to inversion, pronation of the foot falls within a normal range, which is typically 15-30 degrees. This is notably less than inversion/supination.

As one can see, there’s quite a bit to consider when discussing the feet. Hopefully this short anatomy lesson will give you some working knowledge and better equip you in making informed decisions about the care of your feet.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist, ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.

Zone therapy is often considered the foundation for the theoretical and practical application of reflexology. In the late 1800’s, an English neurologist by the name of Sir Henry Head discovered through a series of experiments that there was a link between a diseased organ and specific areas of skin on the body. These areas often displayed a heightened sensitivity to pressure and touch that other areas did not. Twenty to thirty years later, an American doctor by the name of Dr. William Fitzgerald would take these findings and refine them into the practice of zone therapy used by reflexologists today.

Fitzgerald discovered that there were ten longitudinal zones on the feet and hands, which ran the length of the body. Five zones on either side of the body, with each zone corresponding to a section of the foot and hand that lead up to each toe and finger. See the diagram below. By applying pressure to these zones, Fitzgerald was able to create and observe an anesthetic effect in that part of the body. He became so adept at doing this, that he was able to perform small surgeries using his techniques.

zone therapy

Over the years reflexology has evolved into a finer application of these findings, but the underpinning of it has always been zone therapy. The practical application of zone therapy in a reflexology session can serve several purposes. If an area of the foot displays a heightened sensitivity to pressure, zone therapy can be used as a diagnostic tool for the organs and systems in that region of the body. Someone who is prone to chronic neck and shoulder tension for example may find that the toes, base of the big toe, and 5th metatarsal joint (pinky toe joint) are particularly sensitive. The good news is that applying systematic pressure to these zones will create an analgesic effect in the part of the body, essentially reducing tension and pain levels.

In addition, visual cues can provide a wealth of valuable information for what’s occurring in an area of the body. Bunions, calluses, and dry skin are just a few examples of these cues, which could ultimately signify a longstanding condition in a particular part of the body. The use of zone therapy can therefore help reflexologists ‘zone’ in on specific reflexes that may need extra attention. Having an open dialogue between the therapist and the client is also an integral part of the therapy. The simple reason fort this is that reflexology, or any form of bodywork for that matter, does not have to be painful experience to be effective. Research has shown that touch alone helps to release a flood of endorphins which the body uses to relieve pain. Staying within an individual’s pain threshold helps to relax the body while still creating the desired effect. The feet truly are mirrors of the body. And if we listen to them carefully and treat them accordingly, the health benefits could be immeasurable.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist, ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.

How does one know they’re getting a reflexology session and not just a foot massage?

In some cases it can be quite obvious. Even if you’ve never experienced a professional reflexology session before, if you’re getting the same three techniques for the entirety of your treatment, chances are you’re just getting a foot rub. And although there is some overlap with massage, a reflexology session typically includes a fair amount of detailed work aimed at targeting the ‘reflexes’ on the feet. This is usually done with a technique called ‘thumb walking.’ Reflexologists use their thumbs to outline and work along specific areas of the body represented on the feet via their reflexes.

One of the first things you should inquire about is the therapist’s qualifications. Are they ARCB certified? The American Reflexology Certification Board (ARCB) is the national governing board that oversees the certification of professional reflexologists. Although massage therapists are qualified to do reflexology, the training in most massage therapy programs is limited in scope and practice. The ARCB requires an additional 200 hours of training in order to become a nationally certified reflexologist.

Since one of the aims in a reflexology session is to target specific areas of the body via their reflex zones, your therapist should speak with you before your session to determine which areas are in need of attention. Just about every part of the foot corresponds to a specific organ, gland or body part. And in most cases the reflex zone is very much a circumscribed area on the foot. For example, if you’re having digestive issues and need specific work along your descending colon reflex, the corresponding reflex is about 1” – 1.5” on lateral aspect along the bottom of your left foot. Or if you’re having sinus congestion and could benefit from having those reflexes worked on, the toes should be given particular attention during the course of your treatment.

Of course it always helps to have a rudimentary understanding of the reflexes and where they are located on the feet. But even if you don’t know or are uncertain, ask your therapist. A knowledgeable therapist won’t hesitate to answer your questions and help provide you with a safe and effective reflexology treatment.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist, ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.

Feet come in all shapes and sizes. Some have well balanced arches with minimal callusing and a healthy appearance, while others deal with chronic foot pain due flat feet, high arches, and bunions – just to name a few. While most of us fall somewhere in the middle, it’s been reported that 80% of all adults will suffer some foot disorder during the course of their lives. Heredity can be a significant predictor of your overall foot health, but so can factors such as — the types of shoes you wear, the amount of time you spend on your feet, and whether or not you’re overweight. Add to this your mental and physical health and well being, and we start to get a clearer of picture of what your feet are saying about you.

The feet are the mirrors of the body. And since every part of the body is represented on the feet via its reflex, the appearance and sensitivity of those reflexes can hold a wealth of information about our health. Calluses and corns for example, tend to develop in areas of high friction – it’s the body’s way of protecting itself by adding more cushioning. But they could also be an indication of congestion or some other imbalance in that part of the body. Where it appears and to what extent can be of significant importance.

Bunions for example, form around the first metatarsal joint, just below the big toe. It’s true that some people inherit them from their parents, but it’s equally as true that tight, uncomfortable shoes can lead to bunion formation. When we consider the area where bunions form, we have the upper thoracic spine and neck reflexes. Could our choice in footwear be contributing to upper back and neck issues…? Whether the imbalance starts in the body or whether it starts on the feet, no one can truly say. What can be said is that there appears to be a strong connection between the two.

Flat feet and high arches are other fairly common foot conditions. The relative height of your medial arches can have a significant impact on how your weight is distributed on your feet. Most people with flat feet will have their weight shifted to the insides of their feet, while people with high arches bear their weight along the outer parts of their feet. This could have an impact on your posture and the proper functioning of the spine. People with low back pain should start with a pair of comfortable shoes with good arch support.

The tips of the toes represent the head and brain reflexes and the sides correlate to the sinuses. Issues such as hammertoe, claw toe, rigid toe, or any deformity of the toes, could create congestion in those areas but could also be representative of some imbalance that’s already present. People with high arches and those that wear open toed shoes such as sandals, are more likely to develop hammertoe.

Skin conditions such as plantar’s warts, athlete’s foot, eczema, or even just dry skin, could be used as an indicator for that part of the body’s overall health. Again, the placement and extent of the condition is key. Toenail problems such as ingrown toenails, thickened toenails, or fungal infections, could be an indicator of a poor diet or vitamin deficiency.

Pain anywhere on the foot is of significant importance and should be attended to with care. Whether it’s pain resulting from arthritis, gout, bunions, heel spurs, neuromas, or plantar fasciitis, any painful areas on the feet should be considered in relation to the whole body. The feet are our first and primary contact with the earth and the ground beneath us. Establishing a firm and secure foundation should be a top priority in our lives.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist, ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.

By Appointment Only

917-514-3175

Location

116 Clinton St, Brooklyn Heights
October 2020
M T W T F S S
 1234
567891011
12131415161718
19202122232425
262728293031  

Reflexology Map