The Feet
Feet are more important to us than we realize, and especially so to the runner. When I worked with the University of North Carolina-Chapel Hill runners in the late 1980s, the program had a $10,000 a year shoe budget (sad to say they did not have a massage therapist budget, so runners had to pay for my services out of their own pocket). Good shoes are very important in running, but few runners go beyond a "good shoe" in taking care of their feet.
Heel Spur
One of the more common injuries in older runners is a heel spur. Hell spurs occur due to repetitive overuse of the feet, and especially if most of the running occurs over a prolonged period of time on a hard surface (such as road running).
Goals, Objectives and Treatment
The main goal of Russian Neuromuscular Re-Education treatment is to produce enough direct heat in the area of calcified deposit to dissolve it. Other goals include increasing tissue elasticity in the heel and foot area, and increasing arterial flow to the area so the tissue can heal.
These goals are accomplished through 10-15 minute pressure stretching of the area. You should begin by placing the patient prone, with his feet resting on a support at least 6 inches high. This will allow you to work deep. Use only a small amount of lubricant -- too much oil won't allow you to go deep. Begin to work in the arch area using the heel of your hand. Press down and move your heel in a rubbing motion, back and forth and in circles. This will activate arterial circulation and increase tissue elasticity.
Form your hand in a fist, and by using the medial phalanges, perform the same motion as before. This change in hand position will allow you to go deeper. As the tissue heats up, you may use the knuckles of your fist to penetrate even deeper. Once the arch area is sufficiently pliable, move on to the heel itself. Begin the treatment by palpating on the calcaneus in order to establish the size of the calcification, as well as its location. I have to warn you, the area of calcification is usually very tender to the touch so you may have to take some time when increasing the depth of your touch.
After establishing the location of the spur, begin the same procedure as described for the arch area. This is necessary in order to increase the circulation and the elasticity of the soft tissue. By increasing circulation and tissue elasticity, you accomplish two things: your touch will penetrate deeper with the soft tissue being more pliable; and increased pliability and circulation will allow the calcified deposit to be carried away as it starts dissolving.
(Read more about treatment of Hell Spur)
Fallen Arches
Another foot condition I often see in my practice is fallen arches. Like heel spur, this can also be caused by bad foot gear, as well as continuous overuse. Arches fall with age, and they also can fall if the client has increased their weight without increasing their arch support during running. The only solution for a fallen arch is to correct it with an arch support. This is not quite as simple as it sounds.
Arch supports available at drugstores are not as effective as one would hope to see. Yet, there are a few routes to explore when looking for a good support. A podiatrist (foot doctor) is very specialized in this area, and I often refer my clients to them. A problem arises in the type of support each podiatrist uses. Most podiatrists use plastic molded supports. I find most clients have a problem with a hard, plastic support.
I prefer the cork-and-leather supports built by several companies throughout the country. I find that these custom-built arch supports are not only effective, but also comfortable enough for the clients to wear regularly.
I send clients to be measured for the support after one week of treatments. It takes 2-3 weeks for the supports to be built, so when my treatment is finished, the client can maintain the arch we re-created in treatment.
Goals, Objectives and Treatments
The main goal here is to increase tissue elasticity in the arch area, and to increase arterial flow to the area so the tissue can heal. These goals are accomplished through 10-15 minute pressure stretching of the arch area.
