Excess tension on the underside of the foot prohibits correct function required for forefoot running. The condition distorts the foot structure, pulling the foot apart internally downward, causing impingement at top of foot and a failure point at the heel area connection.
Specific lengthening of the underside tissues so as to allow them to operate and align correctly with the foot body as the toes dorsiflex. Restore normal ROM allowing the toes to flex without causing excess tension under the foot. Re-balance and strengthen foot.
At the PT last week she diagnosed PF in my left heel. She tested my calf ROM and my left had more flex than my right (which I knew). She was obviously looking for a tight calf. She taped my foot, applied ultrasound, lent me some foot mini-wobble boards, etc and said no running or walking (swim bike only) & come back in three weeks.
I have one good foot, one bad foot. I am pretty sure I know the causal factors, but what is the mechanical difference between my feet? That I found out.
1. I clamped my right foot with this massage tool I made a while back . Flexed my toes all the way back, and felt some "good" pressure. I clamped my left foot, pulled my toes back and I hit the roof! Classic tissue in distress. Went to work using my jig to loosen things up. A good hour working on it. The key here is under no-load, the top of the foot must be supported when you pressure in the bottom. Big difference.
2. I always kneel using my right knee down, right foot flexed. This weekend I tried the opposite while changing out some snow tires = almost impossible!. My left foot toes would not bend enough to allow me to drop down on that leg. I kept working at that and was able to execute, uncomfortably mind you.
3. I made a small foam EVA bar to put sideways inside my shoe. Hurt like heck initially, but that's good news. Used it all day long, including a few hours cycling. Cycling was curious because the bar engaged my arch more heavily than I expected during climbs or when pushing it. Repeated heavy and static loading of the foot is the reason for dysfunction.
4. My heel pain is gone, but I am certainly not expecting the tissue back @ the heel to be healed enough to run.
At least until tomorrow :)
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