Tuesday, October 12, 2010

Foot Problems-Resources and Treatment

Both the foot and ankle are comprised of a complex array of bones, tendons, joints, muscles, soft tissues, ligaments, nerves, blood and lymph vessels, and skin. Any of these tissues may be damaged or affected by disease, resulting in foot and/or ankle problems such as plantar fasciitis, tarsal tunnel syndrome, and myofascial trigger points.

Many FM patients, me included, complain of burning, neuropathic like pain. This certainly could be due excessive sensitivity related to the centralization of FM, but it feedback to the brain from myofascial trigger points (TrPs) in the calf muscles can cause similar symptoms. So before you assume that you have to “learn to live” with these symptoms, be sure you check out possible trigger points.

Many perpetuating factors of foot problems can be changed; but some, such as blood sugar problems and neurotransmitter imbalances, and structural deformities such as hammertoes or having one leg shorter than the other cannot, but they can be controlled. Manage metabolic problems and lessen the stress put on skeletal deformities by using orthotics. Not addressing structural deformities can cause a myriad of other problems, such as undue stress on the spinal column, knees, and hips.

If conventional treatments for plantar fasciitis and tarsal tunnel syndrome fail, be sure to check for myofasical TrPs. Trigger points in muscles that refer pain or other symptoms, such as numbness and tingling, to the foot may include: tibialis anterior, extensor digitorum longus, extensor hallucis longus, peroneus longus, peroneus brevis, peroneus tertius, gastrocnemius, soleus, tibialis posterior, flexor digitorum longus, flexor hallucis longus, extensor digitorum brevis, interosseous, abductor hallucis, adductor digiti minimi, flexor digitorum brevis, quadratus plantae, adductor hallucis, flexor hallucis brevis, and flexor digiti minimi brevis.

Here is a great diagram of leg and foot muscles http://www.foottrainer.com/foot/

Plantar Fasciitis

Plantar Fasciitis is inflammation of the thick, fibrous band of tissue that extends from the heel of the foot to the toes, supporting the muscles of the bottom of the foot and helping the foot to function properly and is usually due to injury of the plantar (sole) fascia (connective tissue).


Tarsal Tunnel Syndrome

Tarsal tunnel syndrome results from compression of the posterior tibial or plantar nerves in the tarsal (foot bone) tunnel, which provides passage for the nerves, tendons, and vessels that supply the foot. Symptoms are pain, numbness, and tingling on the bottom of the foot and can also be caused or aggravated by untreated myofascial trigger points, especially in the FM patient.


Manuals for self-care manual for lay readers.

The Trigger Point Therapy Workbook, 2nd ed. by Clair Davies. Oakland, Calif: New Harbinger Publications, 2004

Trigger Point Self-Care Manual: For Pain-Free Movement by Donna Finando, L.Ac., L.M.T. Rochester, Vt.: Healing Arts Press, 2005.

Harmony and Hope, Celeste


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