How many times have we been in the office of a <Doctor/Chriopractor/Physical Therapist> for a running injury and they’ve said those words? Before today the number of times for me was 0. But that is what happened at today’s PT appointment.
A couple of days ago my frustration level with this lingering heel pain reached a point where I decided to go see my Podiatrist. He said the Plantar Fascia on that foot is really tight. (I’d noticed when I massaged it with a tennis ball I could hear it “pop”.) He strongly recommended I see a PT he works with who does ASTYM and dry needling. ASTYM has gotten a lot of positive talk on the forums, so when he mentioned it I was quite enthused. Dry needling I’d heard of – but I was not as familiar with it.
The goal of ASTYM is to break down the problem tissue so the body will rebuild it. This is done by breaking up scar tissue (using plastic tools that are scraped over the skin) and causing the body to go into a healing response. These micro injuries are what cause the body to launch efforts to rebuild and repair the tissue. In between appointments (the “scraping” sessions) the patient is given a regimen of stretching and strengthening exercises. Apparently by using the tissue while the rebuilding is going on the body does it in a way to make it stronger and more effective. This is one of the positive aspects of ASTYM: You’re supposed to be active – at least to some degree; within the scope of what the Physical Therapist recommends.
Dry needling uses Accupuncture needles to (Release? Relax? Break up?) trigger points that can be found in muscles. The similarity between dry needling and Accupuncture is only in the needle. The concepts and premise for the treatments are totally different.
Today was the first appointment. Cocoa butter was put on the skin to aid the tool in gliding over the skin. The PT and I could both feel the things in the foot that needed to be treated. On the lateral side of the foot the Plantar Fascia was nice and smooth. On the medial side it was quite bumpy. He also found two trigger points in the foot and at least one in the calf. He also said the heel pain was not coming from the classic location for PF pain. He thinks there may be a fat pad issue or irritation. Lastly, I have some hip weakness on the side with the bad foot. That, too, could be contributing to the foot issues.
The ASTYM treatment itself was not that difficult to get through. It wasn’t trivial – but it wasn’t as bad as some reports I’d read. (I’d found reports that ranged from “No pain.” to “It really hurts a lot.”) “Intense” would be a good word to use. And it wasn’t intense the whole time – just sometimes.
As we were wrapping up he said the words that about made me fall on the floor: “I’m going to have you increase your running.” Yowsa. This is going to be interesting………………….
Jim
Jim,
ReplyDeleteLook forward to your progress as you increase your running. Right light and easy.
In friendship and on the run,
Ozzie
Jim,
ReplyDeleteI check in on you once in awhile, see? :)
I was wondering if you've still ruled out cortisone. My PF was very very tight (they called it plantar fasciosis by that point) and the cortisone shot released it... I was really resistant to the cortisone shot method, but in the end it worked for me. (No recurrence since August of last year...) Just wondering...
Steve
Steve:
ReplyDeleteThanks for checking in. The cortisone shot, as of now, is ruled out. Neither my doc nor the PT think it would help, and if they did, I don't know that I'd have the stomach for it. I've heard they hurt A LOT! What was your experience? It's fantastic it did the trick for you. Who knows what tomorrow will bring - but as of now - it's not on the radar.
It's good hearing from you.
Jim
Jim:
ReplyDeleteI had absolutely no pain from the cortisone shot. They did local anesthetic and I didn't feel a thing.
Steve
Steve:
ReplyDeleteThat's outstanding and great to hear. I've heard some stories about how those shots aren't particularly comfortable. Like all things, I guess, you gotta find the doc that is really good at what they do - and it sure sounds like you did.
Jim