Why ART or Graston did not work for you arch pain, plantar fasciitis, Achilles tendonitis….

Almost every endurance athlete knows about the soft tissue techniques of Active Release Technique and Graston. These are great techniques to help free the body of adhesions that have developed through repeated micro traumas to muscles, ligaments, and tendons. ART and Graston are used by thousands of practitioners worldwide because they work really well, but what happens when ART and Graston do not work?  The answer is found by looking for the inhibited or weak muscle rather than the tight muscle. A basic tenant of Applied Kinesiology is that when a muscle is weak any opposing muscle will become tight.  If this muscle imbalance continues to exist, exercise or even normal daily movements will result in tendonitis of the tight muscle.

Using Applied Kinesiology’s idea of looking for the weak muscle that is creating the dysfunction we can test the muscles of the foot and ankle and see which ones are firing correctly. The most common foot/ankle conditions patients seek care for in my office are arch pain, plantar fasciitis, and Achilles tendonitis. Many patients have already done some kind of therapy, such as ART and Graston, that helped, but only temporarily. The most commonly weak or inhibited muscle in these conditions is the tibialis posterior.  One of the main functions of the tibialis posterior is to help hold up the arch.  If the tibialis posterior does not fire when it is supposed to the foot will over pronate.  This over pronation can result in excessive stretching of the plantar fascia and arch which over time causes the plantar fasciitis and arch pain.  The same over pronation caused by the weak tibialis posterior will cause the ankle to flex forward over stretching the achilles tendon repeatedly resulting in tendonitis. These as just two examples of over-pronation resulting,  from a weak tibialis posterior. An exhaustive list could fill pages. A foot problem can also be more complicated than just a weak tibialis posterior but for now we are just keeping it simple.

The next questions should be, What caused the tibialis posterior to become weak? An injury is a very common cause and is easily managed by time and proper care. However, many patients say the pain “came from nowhere” and there was “no injury”.  Often the patient is not even an athlete and arch, plantar, or Achilles pain still develops.  Here the idea of overuse completely goes out the window.  In Applied Kinesiology there exists a muscle-organ relationship where stresses in the body’s organs will manifest as a weakness of specific muscles.  Improvement in the organ results in better muscle function. This is often the reason for the weakened tibialis posterior. It is so common is because the tibialis posterior is related to the adrenal glands.  The adrenals help the body cope with stress, manage blood sugar, make anti-inflammatory hormones and conserve electrolytes.  If the demand on the adrenals is greater than their ability to manage the different stressors often the associated muscles will become weak. The weakened tibialis posterior then leads to the arch pain, plantar fasciitis, or Achilles tendonitis.

Managing stress becomes the treatment of choice before and during treatment to the arches, plantars, and Achilles.  There is more likely to be a successful outcome with foot and ankle exercise, soft tissue techniques and taping.  I have even had patients do no therapy and get better just by managing their diets.  Here is a typical case that was not far gone when they came to the office.

A mother brought her 9 year old daughter in for bilateral Achilles tendonitis that started about one month before while playing basketball. It seemed to really only be sore after she played or ran. They tried changing the shoes but it didn’t seem to help. Testing the muscles of her feet showed weakness in the tibialis posterior and calf muscles (another adrenal muscle) on both sides. When questioned about diet the patient’s mother admitted she may have been having more sugar since the Christmas holidays. I made some adjustments to help turn the tibialis posterior and the calves back on, taped her feet (to support the arches while the tibialis posterior turned on) and sent her home with instructions to avoid all added sugar and skip basketball for one week. When she returned one week later all the muscles in her foot and ankle worked better and she did not have any pain just walking around in her daily life. We returned her to basketball which she was able to do pain free.  In this case changing her diet made all the difference and if they had not made those changes treatment could have gone on for weeks or longer.

What can you do on your own to help your adrenal glands and your feet and ankles?

Stress-look at what is going on in your life. Are you over committed? Working too much? Exercising too much? (could be too high an intensity as well as too much time).  Not getting enough sleep or to bed on a regular schedule? Relationship trouble that needs to be resolved? This means family, friends and work. Find a way to resolve or at least address the biggest stress in you life.

Caffeine-it directly stimulates your adrenal glands. Energy drinks, forget it. You want to save the adrenals for when you really need them. Try to limit it to one cup in the morning.

Sugar-too much sugar leads to a rollercoaster with your blood sugar levels calling the adrenal glands into action time and time again wearing them out over time.  I find sugar to be the number one issue with kids and teenagers that have arch pain.  Not only can reducing sugar help their arches but it can set them up for improved health for the rest of their lives.

All stresses in the body are cumulative. They pile on top of each other until an individual’s threshold for stress is crossed and the body starts to break down.  Just one of the ways the body manifests going beyond this threshold is with weakened muscles resulting in structural problems. There are other manifestations of stress in the body that we will not discuss here.  In the office when I make adjustments, rub reflexes, tap acupuncture points and give nutritional supplements I am helping to bring that person below their threshold again.  If they do not do their homework of managing stress, reducing caffeine and sugar then it is always an uphill battle and they can expect their condition to recur.

If your feet are still bothering you, and you have made all these changes already, your problem may be coming from somewhere else.  You may need adjustments, specific muscle work, supplementation or some other therapy. I can work with you to diagnose and resolve the issue. Figuring out which is the best therapy for you is my job after all.

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