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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.

There are certain aches and pains that arise over time due to repetitive movements that can occur on the job, at the gym, or even at home. And whether we realize it or not, these aches and pains can be the result of a multitude of micro-tears to muscle, fascia, or tendon. These soft tissue structures become comprised from over use and eventually lead to inflammation. Let’s take a look at some of the contributing factors involved in this syndrome.

A lot of overuse injuries occur on the job. They can affect just about anyone from a manual laborer to an office worker. Whenever we perform repetitive actions such as in typing at the keyboard, lifting heavy objects, standing or sitting for prolonged periods, we run risk of overtaxing the soft tissue structures involved in those actions. Carpal tunnel syndrome for example can be the result of faulty mechanics, such as in prolonged extension of the wrist and hands while at the keyboard. It can also occur from micro-trauma due to repetitive movements done over time, such as in those who use power tools, paint, play an instrument or racquet sports — the list can be extensive. The median nerve which passes through the carpal tunnel of the wrist becomes compressed and inflamed, which can then lead to tingling, numbness, weakness and pain in the finger and wrists.

Another place where over use injuries can occur is at the gym or while playing sports. Athletes are notorious for developing tendonitis and stress fractures due to repetitive movements and over use. Runners for example are prone to developing conditions such as Achilles tendonitis, plantar fasciitis, and shin splints, especially in those who are poorly conditioned. People who play racquet sports or golf are susceptible to developing shoulder tendonitis in any of the rotator cuff muscles, golfer’s elbow (which is tendonitis of the forearm flexors attaching on the inner part of the elbow), or tennis elbow (which is tendonitis of the forearm extensors attaching on the outer part of the elbow). People who play soccer, basketball, volleyball, or any sport that requires starting and stopping, cutting movements, sprinting, or jumping can see overuse injuries ranging from patellar tendonitis (i.e. jumper’s knee, runner’s knee), to ITB friction syndrome which is caused by a tight iliotibial band frictioning the outer part of the knee. Chondromalacia Patella or Patellofemoral Syndrome occurs when the patella does not track properly in the patellar groove when the knee is extended under load. Think of doing squats or climbing stairs. The articular cartilage eventually gets worn away, resulting in pain and inflammation along the inner part of the knee.

These types of repetitive use injuries are not limited to the job or the gym. Most of us have hobbies that involve repetitive movements. Playing an instrument is a good example. Think of the muscles involved in playing the piano or the violin. Hours and hours of practice can eventually lead to pain and inflammation of the fingers, wrists, elbows and shoulders. How about gardening? Pulling up weeds or potting flowers can require us to maintain certain positions which can stress our knees, hips and low back. There’s even a condition known as blackberry thumb or gamer’s thumb. De Quervain’s syndrome, its clinical nomenclature, is a tenosynovitis (a tendon sheath inflammation) and repetitive use injury (RSI) of two key tendons attaching on the thumb. It usually results from an over use of the thumb and wrist while texting or playing video games.

Now that we’re familiar with some of the most common manifestations of repetitive use injuries, here are some of things we should consider as part of a preventative care plan:

  • Most over use injuries stem from muscle imbalances. Are we pushing ourselves too far, too fast in our training before we’re properly conditioned? Are we using good form when performing certain movements?
  • Certain jobs may require us to perform repetitive movements at work. If this is the case, are we taking periodic breaks? Can we switch sides so we’re not using the same hand, arm, or shoulder? Are we using faulty equipment to perform these tasks? Developing an awareness of these mitigating factors can go a long way in preventing an injury.
  • Warm ups and stretches. Whether we’re going out for a run or getting ready to play an instrument, a little warming up goes a long way. Gentle range of motion of the joints and targeted stretching of key muscles will help reduce the likelihood of a strain by increasing blood flow and oxygen to the area.

Signs and Symptoms:

If you think you may be dealing with a repetitive use injury, here are some common signs and symptoms:

Localized pain: Whether its Achilles pain, knee pain or shoulder pain, you’ll feel it acutely at the site of inflammation. The pain may be brought on from use of the inflamed muscle or tendon, as in an isometric contraction. It can result from stretching the inflamed tissue. And in advanced cases, the pain may be constant even while at rest.

Tenderness: Minimal pressure to the area can often induce pain. In cases of acute tendonitis, the whole muscle may feel sore to the touch.

Limited ROM: Your mobility of the affected area may be limited and painful. Lifting your arm above your head for example may be hard to do in certain cases of shoulder tendonitis.

Swelling: Inflammation can lead to swelling and heat in the affected area.

Crepitus: Clicking or creaking sounds may be heard during certain movements of the affected area.

Treating over use injuries can require several approaches, not least of which is time to heal.

Treatments:

R.I.C.E.: If you’re not familiar with this acronym, then it maybe one of the only things you should remember when dealing with acute injuries.

  • Rest: In some cases as much two weeks may be indicated. The body needs time to mend the damaged tissue.
  • Ice: applying ice is a great way to reduce inflammation.
  • Compression: wrapping the injured area with and ACE bandage or brace will provide added support and help keep you mobilized.
  • Elevation: In cases of acute trauma and inflammation, elevating the area will help to reduce the swelling.

Proximal massage: Massaging the area directly above the injured site, for example the calf muscles in cases of Achilles tendonitis, will help to increase circulation and drainage to the injured site.

Range of motion exercises: Moving the affect area in a pain free and gentle way after the acute phase has passed, will prevent muscles and tendons from tightening up from under use.

Ice massage/Contrast bathing: Depending on where you are in the healing process, ice massage to the affected area will help reduce pain by decreasing inflammation. Later on in the healing process, heat can be introduced in conjunction with cold applications to create a pumping affect. This is excellent for removing waste byproduct trapped in the affected area.


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.

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