Massage Therapists and the TCS NYC Marathon

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Massage Therapists and the TCS NYC Marathon

Introduction to the New York City Marathon and Massage

Every year we take part in the NYC Marathon by supporting runners in their health care journeys. We see runners of all kinds, new runners, experienced marathon runners, runners with disabilities who all have one thing in common, they think massage would be a benefit to their marathon training.

This year we were lucky enough to have one of our therapists Emanuel participate. Take a look at what he had to say about the experience.

The role of Massage therapists at the TCS NYC Marathon

Body Mechanics Sports Therapists Emanuel Gomez headshot
Emanuel Gomez

Hello there, my name is Emanuel Gomez, and I am a Licensed Massage Therapist and a Personal Trainer. I specialize in Sports Massage. I volunteered as a medical staff member for the 50th anniversary of the NYC marathon. This was a great opportunity to work alongside other medical professionals to help runners get back on their feet after running 26.2 miles. The kind of training you must have as a Licensed Massage Therapist for this particular event is how to treat an athlete post-competition. A lot of the athletes needed to be treated for muscle cramping and/ or muscular aches after the race. My job at the event was to assess the athletes to see whether the athlete was cramping due to dehydration, which was the case for many of them or if they experienced any muscular injuries throughout the race such as a tear for example, which can be treated through massage. From there you apply the appropriate massage treatment according to their condition. 

Why The Marathon Needs Volunteer Healthcare Workers

Emanuel at the Marathon

The volunteer experience was great and a bit intense since our tent was the medical tent where the more severe of cases were. The cases ranged from a mild muscle strain or cramping to complete dehydration and hypo/hyperthermia. One particular runner that we received was suffering from dehydration and hyperthermia and had a core temperature of 103 degrees. He had to be submitted to the ICU immediately.

In his case he seemed moderate upon arrival until he settled down. At first he felt cold and his legs were cramping. We gave him salt packages and Gatorade to alleviate the cramping and we provided gentle stretching and massage. But he then started to shiver aggressively. Our team applied heavy blankets on him and provided him with soup but he still wasn’t warming up. Our Captain Physician decided to take his rectal temperature and read 103. A more extreme treatment approach was needed. He was sent to the ICU where we monitored his heart rate and blood pressure. We applied ice packs to his axillary areas and groin to bring down his core temperature. An IV was inserted into his arm to continue to rehydrate him and eventually he recovered. This case was one of the more severe ones that we encountered.

          However, not all cases were like this. Depending on the degree of the runner’s condition we provided the appropriate treatment. If it’s muscle cramping or a strain, then that’s when LMT and PT get involved. We made sure we ran down a check list of conditions to an incoming subject to get a picture of what treatment the runner will receive. LMTs and PTs were amongst the busiest since we had to deal with the mildest of cases like muscle cramping and strains which were the more common of complaints.

Summing Up the Massage Therapist Role in the Marathon

After such a demanding event like the marathon, I recommend a post-event recovery massage approximately 24 to 48hrs after to mitigate DOMS (delayed onset muscle soreness) which can be debilitating especially for newer runners. I conclude by saying that this was a fantastic experience, to see all the disciplines from Physicians, to Podiatrists, to ER emergency workers, to PT and LMT to even Psychologists working together and performing their specialty in helping the athletes get better was very inspiring. Every medical staff member had a job to do in the marathon.

      This experience is great for old and new therapists who would like to work in a sports environment with a team of other disciplines. If you do decide to participate as a volunteer in future marathons, prepare to be on your feet all day and moving around as you will be going from station to station helping runners. Typically, the day will be long, we are talking from 8 30 to about 6 30pm.

Body Mechanics Orthopedic Massage

1 W 34th St
#204,
New York, NY 10001
Phone: 212-600-4808
Email: info@bodymechanicsnyc.com

Sports Massage Therapist Profile – Emanuel

Body Mechanics welcomes new Sports Massage Therapist Emanuel to the team! With experience in martial arts, sports, and training, Emanuel has many sources of knowledge to pull from when taking on a client! We spoke with him to get to know him a little better.

What is your background in sports? Do you train? Participate? Watch?

Emanuel – My background in sports is a diverse one. I have played football for years, was on my high school track team, and I practice several forms of martial arts. I am not competing in anything as of yet but never say never! There may be a future where I step up my training and can join another team, but for now my focus is on sports massage.

How long have you been training?

Emanuel – I’ve been training my body in one way or another since I was a teen. Practice between games, runs in the morning before school and on the weekend, with regular gym days in between. as well. Exercise is very much an important part of me. I make sure I train no less than 3 times a week keep my mind and my body sharp.

Keeping his training schedule helped keep Emanuel sane during quarintine

Can you share one experience, as a person who knows their body, that has greatly impacted  the way you approach  massage?

Emanuel – One experience I have gone through that has impacted the way I approach  sports massage therapy was being treated by a massage therapist after a pretty bad back injury. I was sparring and was tossed by my partner. I took the fall pretty bad and I knew something was wrong. I saw several doctors but there was nothing to operate on, so all they did was give me painkillers. Finally the 3rd doctor I saw recomended a massage therapist. During the assesment she saw that I was limping and that my hips were uneven and went to work on me. I was sore aftetwards but after a couple of days I was limping or feeling the same pain in my back.

From then on I saw massage therapy as something that everyone could benefit from. I think it should be normal as going to the dentist.

How did you get into sports massage? 

Emanuel – I got into sports massage because as a personal trainer I wanted to further help people. I would often see similar injuries among my clients and sometimes I’d even be there when the injury happened! I wanted to be able to give them more help than telling them to ice it. Thanks to my training I know the anatomy even better. So now when I am treating a client who is active at the gym a lot or plays sports, I am in a better position to understand their injury and how to treat it. 

What is your best uh oh story? A time you really messed something up with your body.

Emanuel – I wouldn’t say “best” but my most memorable “uh oh” story was when I broke my ankle in football practice back in High School. I thought I had just sprained it at first, so I got up to walk off and ice it. When I tried to take a step I said to myself “UH OH!” realized I couldn’t walk and had to be assisted off the field.

What sets your sports massage apart from anyone else?

Emanuel – What sets my sports massage apart is my ability to pay attention to detail and communication. I believe if I’m in tune with what the patient is experiencing they will receive the best treatment.

If you could try any sport/or amazing physical activity what would it be?

Emanuel – One sport I would love to try is Gymnastics. It takes a TON of strength, coordination and stamina to pull off those routines.

What are your favorite kinds of people to treat and why?

Emanuel – I like treating athletes and other active people, especially people training for a game or competition. They usually want a very specific muscle group or body part to be worked on and I can focus on maximizing their results. I feel extra accomplished when they are satisfied with my work.

Is there anything we do not know about you we should?

Emanuel – I’m a huge video game fan, particularly fighting games like Mortal Kombat. 

If you had a super power what would it be?

Emanuel – It’s gotta be flight! Especially in New York City; I’d never have to wait for the train again!

If you want check out more of our therapists head over to our Massage Therapist Page and check them out!

Body Mechanics Orthopedic Massage

1 W 34th St
#204,
New York, NY 10001
Phone: 212-600-4808
Email: info@bodymechanicsnyc.com

Plantar Fasciitis and Massage Therapy

Many years ago – in what seems like the Dark Ages, I was in school to become a registered massage therapist (RMT) in Ontario, Cananada and was taught a standard massage treatment for plantar fasciitis and runners. 

The massage therapy mostly focused on the foot. It involved stretching the plantar aspect of the client’s foot by cranking the toes into extension forcefully and pulling the bottom of the foot tight. Then while your client was face down and you had this position achieved, you were to take your thumbs or even an elbow and dig away at the tissue until you had eradicated all of the ‘granular’ scar tissue. 

I quite clearly remember my teacher saying that we needed to then ice the bottom of the foot immediately, as he slapped an ice pack on my friend who was a runner and triathlete. I remember her gingerly limping off post-treatment. I can’t remember how long it was before she ran again after that. Who knows?  No explaination was ever given for the method of treatment. They never explained that the purpose was to break down tissue and re-injure the site to facilitate healing. But it surely stank of that mode of treatment, and it did not make sense. 

Why do we need to hurt someone to make a massage work? 

Now let me ask you a question, a question that I will likely repeat in multiple blog posts: If you come to me, as a medical practitioner, and you complain of a black eye, and I punch you in the same eye and tell you it will facilitate healing, does that make sense? No! So why is it acceptable in massage? Certainly it applys to plantar fasciitis and massage. 

Massaging the leg for runners
Photo by Adam Ninyo

Years later, I now teach a very different method to address runner’s issues to the therapists at Body Mechanics. It is far more gentle, treats the entire lower leg as well as upper (depending on time constraints), engages the brain by moving the body, and involves a referral to PT or exercise depending on the level of experience the runner or athlete has. 

The Plantar Fasciitis Massage Treatment

When assessing, we are looking at a far wider spectrum of dysfunction than simply plantar fasciitis. Indicators that there might be an issue or impending problem include heel pain, pain in the bottom of the foot, and sometimes calf pain. Of course with any assessment, we screen to rule out red flags as well. The symptoms listed above can also correlate with a recent increase in mileage or speed work for runners, or a weight change, plyometrics or recent changes in health. If there is no connection to the assessment you’re probably going to want to refer out regardless to check for bone Spurs and tendon issues. 

For the purposes of this blog let’s focus on the lower leg. I generally combine in-prone, general massage with gentle pin and stretch. Having the patient flex and extend the ankle as well as pronate and supinate. I am looking to see a full articulation of the foot and ankle. Often you will see that those with foot pain also have poor articulation. Resistance in these areas can be added to help cue the body into moving better. Once we have warmed the area with massage and movement, adding resistance to those movements is helpful. While many massages focus on the muscles, at Body Mechanics Orthopedic Massage I like to include tendon work, like “bowing,” as well. We want soft supple moving parts so practicing flexibility is helpful. 

When treating the bottom of the foot, I no longer use that awful stripping technique that requires an ice pack. Instead, I use a hot towel to warm the foot and then use a deeper gliding technique across the sole, while I have the patient flex and extend the toes, or spread them and let them fall to neutral. Here, if things are still not moving well we would add in some mobilizations between the tarsals and resisted exercises for the toes. 

As for home care, if the problem persists, we will refer you to a physical therapist and if it does not, then we would advise you to a program of foot and calf strengthening as injury prevention. As a massage therapist, I am not rehabbing you.  My job is to get you more comfortable while your body does what it does and what it was designed to do. It is adaptive. It will adapt, with or without me.

Summing up…

A warm towel? Simple exercises? No digging thumbs or elbows into the client’s foot? This is a far cry from the painful techniques that I was taught! No one is limping painfully off our tables before a run. The clinical outcomes seem just as effective and I’d say are more beneficial. If you are looking for a therapist who will not hurt you to help you, ask questions before you book. Look for someone who listens well and has a wide variety of techniques at their disposal. It would be a shame to miss your next run due to foot pain… especially if it was caused by the person trying to help you.

Check out more on plantar issues

 

Body Mechanics Orthopedic Massage

1 W 34th St
#204,
New York, NY 10001
Phone: 212-600-4808
Email: info@bodymechanicsnyc.com

Sports Massage Therapist Profile – Alex

Body Mechanics NYC is proud to add Alex to our wonderful team. Anytime we hire a new therapist, we like to provide a little profile so you can get the 411 on getting to know them! You can check out a more formal Massage Therapist bio for Alex here.

If you have any questions please reach out to reception and they can answer additional questions! Want to know more about our programs? You can read up on our Sports Massage and Sports Injury programs or check out some of our other offerings such as prenatal massage or our tmd program.

What is your background in sports? (do you train in, participate in, or watch…. give us the 411)

Alex– I grew up as a big skier, tennis player, and dancer.  Now I love being active in various ways to keep it interesting.  I love weightlifting, hiking, and yoga.

How long have you been training or working at it?

Alex– I started teaching yoga about 8 years ago and got big into strength training about 6 years ago.

Can you share one experience as someone who uses their body that has greatly impacted your massage?

Alex – My first “real” massage.  I had an aching pain in my hip that prevented me from squatting.  I went to a professional LMT and she had me feeling great after one session.  That’s when I realized massage is not just to feel good and relax (although that is a bonus), it actually has amazing effects on your mobility and can be used to aid in your training.

What is your best uh oh story? (time you really F-d it doing something with your body)

Alex– After many years of dancing and having TOO much flexibility, my hips were super wonky.  I tore my labrum many years ago, but I still notice it every once a while during certain movements.  I focus on diligent strengthening and consistent sports massage to keep myself feeling my best.

If you could try any sport/or amazing physical activity what would it be?

Alex – I would love to do more climbing and hiking.  South America is on my list and Teton!

How did you get into sports massage?

Alex – I needed it myself!  I realized how much massage is an important piece of the puzzle to keep both your mind and body healthy.  I have also surrounded myself with so many athletes and clients who use their body so much and needed a massage, I decided “Hey, who understands what you’re feeling more than me?  Let me help fix you!”  From there I decided to get my massage license.

What are your favorite kinds of people to work on?

Alex – Athletes and active people. I can speak their language.

Are there any athletes you particularly admire? Who?

Alex – Any professional athlete because I understand how it really needs to become your entire life.  Fitness, diet, rehabbing, injuries, there is so much more to it than just playing the sport.  It takes so much determination and diligence to do it all.  You make sacrifices that I would struggle making (especially when it comes to diet) and I admire their focus and hard work.

What sets your sports massage apart from anyone else?

Alex – I feel like I can really understand my clients because Ive been there.  I’ve seen it all, whether it was me personally, a client or a friend.

Is there anything we do not know about you we should? (odd ball facts) If you had a superpower what would it be?

Alex -I spent New Years a few years ago climbing Mt Kilimanjaro in Tanzania

Want to read up on more of our therapists?

Sports Massage LMT Interview – Crystal

Crystal Massage TherapistFor each of our Massage Therapists, we do a little interview when we hire them so that everyone can get to know them better and see a little about why they got into the Sports/Medical Massage field.

This month we are focusing on our Sports/Medical massage therapist Crystal and her massage therapy skills.

What is your background in sports? Have you ever trained or participated in a sports program? 

Yep, I ran track in both middle school and high school so I am familiar with training programs and running.

Can you share an experience that you have had in the past that has changed or impacted they way you work with massage as a tool today?

I once worked with a professional body builder who wanted an entire 90 minute massage session on his injured shoulder, it ended up being the most informative fun session I have ever had.

How did you get into Sports and Medical Massage Therapy

I have been fascinated in the study of the body ever since I visited an Orthopedic Doctor for a knee injury I had when I was running track. I found the process very interesting.

What are your favorite kinds of people to massage?

Anyone who uses their body for a living, I have worked with many pro and semi pro athletes. I like how tuned into their bodies they are.

Okay, give us an odd ball fact about yourself, something we do not know about you but we should.

I have a horrible sense of direction.

And last but not least, if you could have any super power, what would it be?

Oh my super power would totally be extreme strength and agility!

And that sums up our ‘get to know you’ sports massage interview. If you want to learn more about Crystal or her massage therapy you can head over to our Massage Specialists profile page or book an appointment with her on our booking site.

Body Mechanics Orthopedic Massage

1 W 34th St
#204,
New York, NY 10001
United States (US)
Phone: 212-600-4808
Email: info@bodymechanicsnyc.com

Sports Massage Therapist Profile Interview

Check Out Our Sports Massage Therapist Sharon!

sport massage therapist Sharon

We do this profile for our therapists now and again so that you can get to know them and get a little more information on who they are and what they do. Many of our therapists not only work in sports massage but also are athletes themselves. So here we go!

What is your background in sports?

Sharon: I have always enjoyed movement and have tried different kind of sports, even field hockey at one point, but lately I am really into yoga. I specifically train in arial yoga, circus, and silks. 

How long have you been training at your sport?

Sharon: I took my first arial class in 2013, but really started to get serious about it in 2015. I am now teaching arial yoga.

Can your share one experience as someone who uses their body that has greatly impacted your sports massage?

Sharon: Training in aerial can sometimes contribute to some weird imbalances. Especially if you are training for a performance sequence. However, I am a big fan of movement variability. Because of this I try and make sure BOTH sides of the body are worked in a sports massage, not just the side that has the issue. 

How long have you been training at your sport of choice?

Sharon: 5-6 years

What is your best uh oh story?

Sharon: One of the most significant injuries I have had is pretty recent. I inured my right shoulder so badly that it took me out of any regular movement practice. It gave me a deep appreciation of shoulder injury.  

How did you get into sports massage?

Sharon: When deciding our final semester practical, I decided to train as an LMT at the Joffery Ballet School. It was after that experience that I realized I really wanted to work with athletes and dancers. 

Are there any athletes you admire?

Sharon: Misty Copeland is pretty cool and inspiring!

Other than sports massage is there anything else you really enjoy working on?

Sharon: I LOVE working with the prenatal population. 

Is there anything else about you we should know? (odd ball facts and such?)

Sharon: Oh, I can hula hoop, play the ukelele while singing at the same time.

Sharon has now been on our staff for 1 year! Congratulations Sharon, you have grown leaps and bounds and worked hard for it. If you want to book a session with Sharon for sports massage, medical massage or prenatal massage you can find us online on our booking page!

You can also find more about Sharon in her therapist profile here.

Body Mechanics Orthopedic Massage

1 W 34th St
#204,
New York, NY 10001
United States (US)
Phone: 212-600-4808
Email: info@bodymechanicsnyc.com

 

 

 

 

Sports Massage Profile Gerry

Get to know our sports massage therapist Gerry!

We asked our sportsports massage therapist nyc gerrys massage therapist, Gerry, a few questions so you can get to know him a little better. Here is what he had to say!

What is your background in sports, since you are working in sports massage currently?

Gerry: I used to race and I was a bike messenger, back when that was a thing in New York.  I also spent some time snow boarding.

If you could try any sport what would it be?

Gerry: Motorcycle racing!

How did you get into sports massage as a thing?

Gerry: I have a curiosity about the way people move and want to help them.

Are there any athletes your particularly admire? 

Gerry: Peter Sagan, he is a professional road bicycle racer.

Is there anything that sets your massage apart from anyone else?

Gerry: I hope it is my sensitivity

Do you have any specialized training that you are really drawn to?

Gerry: While I love working with athletes, I also work with geriatric paitents and that work is really inspiring. 

Is there any special skills or hobbies you want us to know about, something people would be surprised to know?

Gerry: I am really good at backgammon and swing dancing.

Last but not least, if you could have a super power, what would it be?

Gerry: I would want to fly of course!

 

If you want more information on Gerry you can find it on our therapist profile page.

To book an appointment see our prices page.

Body Mechanics Orthopedic Massage

1 W 34th St
#204,
New York, NY 10001
United States (US)
Phone: 212-600-4808
Email: info@bodymechanicsnyc.com

 

 

 

 

 

Sports Massage Therapy Profile -Laura F.

Get to Know One of Our Sports Massage Therapists, Laura!

We are asking our sports massage therapists for a little extra information so that you can get to know them and their experience in sports massage.

 

So here it goes!

First off Laura, What is your background in Sports?

Laura: I have been working in the field of sports massage for 30 years.  I am not just a massage therapist but I am also a personal trainer, and I train myself.  I have played a number of sports… including boxing, running, and lifting.  If you are coming in for these things, I have a pretty good understanding of what is going on. 

What is your best “uh oh” story in regard to injury?

Laura: When I moved from LA to NYC, I (bleeping) fell on some black ice and I tore my left medial meniscus.  That was awful and it was a long recovery. 

If you could try any sport now, without limitations, what sport would it be? 

Laura: Krav Maga!

How did you get into sports massage?

Laura: When I was at Swedish Institute in NYC, I was bored with the relaxation massage and energy work I was learning.   I had an an instructor who taught sports massage and she was incredible.  That’s when I knew that was what I wanted to do. 

What are your favorite kinds of ‘sport’ people to work on now?

Laura: I love to work with dancers, but I also just love people who are active and want to take care of their bodies. 

Are there any athletes that you particularly admire?

Laura: Manny Pacquiao and Michael Jordan.  They are my favorites!

What sets your sports massage apart from everyone else’s sports massage?

Laura: (laughs) Honestly, I do not compare myself.  I just studied hard and took advanced courses.   I truly care about helping people in pain, and teaching them how to learn about their bodies.  As a trainer, I can also suggest some ways they might prevent hurting themselves. 

And last but not least, are there any other things we should know about you?

Laura: I am also a certified life coach.

To book with Laura, you can book online at this location, or you can read more about her Massage therapy and Sports massage there.

 

Body Mechanics Orthopedic Massage, 1 W 34th St, #204, , New York, NY 10001, United States (US) - Phone: 212-600-4808 Email: info@bodymechanicsnyc.com URL: https://www.bodymechanicsnyc.com/

 

 

Strengthening and Conditioning for a Marathon

The right strengthening and stretching program is important when preparing for a marathon. Strength training has been shown to improve running economy, prevent injuries, and improve body composition and resting metabolic rates. Strength training is particularly important for older runners. Endurance exercise, like running, does less to protect against age related loss of lean muscle tissue than strength training.

When training for a race runners should perform one to two full-body strength sessions per week. Your workouts should be staggered around your key running workouts for the week. Avoid combining your strength workout with a hard speed session or long run on the same day. Research shows it could compromise your running workout and recovery[1]

Your strengthening routine should focus on two goals. First you must focus on correcting any imbalances in your movement patterns like over-pronation or over-supination. Read my last blog post on Plantar Fasciitis for the right exercises and stretches. Research has shown that a 1:1 strength ratio between your hamstrings and quadriceps is related to optimal running economy[2]. When performing leg exercises you can compare how much weight you can lift on the leg extension exercise versus leg curls. You need to strengthen the weaker of the two muscles. Most people have stronger quadriceps than hamstrings and will usually do only the leg curl, instead of both leg curl and leg extension exercises in a workout.

In addition to corrective exercises, your workout should aim at overall strengthening throughout the body to improve running economy and endurance muscle fibers. The following is a sample workout that incorporates both :

Lower Body

If you over-pronate during running do:
-Ankle Inversions with dorsiflexion using resistance tubing,
If you over-supinate, during running do
-Ankle Eversions with plantarflexion using resistance tubing

If your Quadriceps are stronger than your hamstrings do
-Leg Curls

If your Hamstrings are stronger than your Quadriceps do
-Leg Extensions
-Hip Adduction
-Hip Abduction
-Dumbbell Front Squat
-Barbell Deadlift

Upper Body

-Bench Press
-Dumbbell rows
-Dumbbell press
-Barbell Curls
– Planks(hold 30-60 seconds)
-Side Planks (hold 30-60 seconds)
-Do 2 sets of each exercise of 8-12 repetitions

For each upper and lower body exercise start with a weight heavy enough to allow you to reach 8 repetitions per set. Try to increase the reps every week. Once you can perform 12 repetitions with a certain weight, you can increase the load enough to allow you to do 8 repetitions again. Use the routine alongside your running training 1 to 2 days a week.

Provided by Ivan Garay LMT CPT
References

Eur J Sport Sci. 2014;14(2):107-15. doi: 10.1080/17461391.2012.726653. Epub 2012 Oct 3.
The acute effects intensity and volume of strength training on running performance.
Doma K1, Deakin GB.

Journal of Strength & Conditioning Research:
doi: 10.1519/JSC.0000000000000376,
Post Acceptance: January 28, 2014
Relationship Between Functional Hamstring: Quadriceps Ratios and Running Economy in Highly Trained and Recreational Female Runners.
Sundby, Øyvind Heiberg; Gorelick, Mark

[1] http://www.ncbi.nlm.nih.gov/pubmed/24533516
See references for specific citation information

[2] http://journals.lww.com/nsca-jscr/Abstract/publishahead/Relationship_Between_Functional_Hamstring_.97501.aspx
See References for specific citation information

Running Season and Treating Plantar Fasciitis

Exercises for Plantar Fasciitis

Plantar Fasciitis is one of the most common foot complaints. Technically what is happening is the plantar fascia is being over stretched or over taxed
Beret Kirkeby, “Treating Plantar Fasciitis”

plantar

Exercise for plantar fasciitis should reduce excessive strain on the plantar fascia and correct biomechanical faults that contribute to plantar fasciitis. Common biomechanical faults include over-pronation, flat feet, a tight Achilles tendon (especially from tight soleus muscles), excessive weight, and a high-arched foot. These imbalances are corrected with the right mix of stretching and strengthening exercises that bring the foot and ankle into correct functional alignment and movement. First, a general exercise routine for all people suffering from plantar fasciitis will be explained; followed by corrective exercise routines for specific common biomechanical imbalances.

General Routine

Before discussing targeted corrective exercises, most everyone with plantar fasciitis will benefit from relieving the strain from a tight Achilles tendon.  But because the body works as a whole, it’s important to not only stretch/work the muscle that directly attach to the Achilles tendon, but also the rest of the posterior chain muscles. (please see link for graphic) Treatment would start at the gluteal muscles, hamstrings, and then the calf. The figure below is the posterior chain of muscles that connect to the Achilles tendon. If you are seeking treatment for plantar fasciitis, it is important to note that it it begins in the hips. It is a common misunderstanding that it is the feet causing the issue. While the feet clearly play a role, the focus of treatment is not specifically the feet unless you are utilizing orthotics or working on foot mobility.

achilles-tendon

Imbalance or dysfunction in any segment of the posterior chain can produce excessive tightening of the Achilles tendon, so it is important to stretch each segment individually first and than end with a full posterior chain stretch like the Downward Dog yoga pose.
The following exercises are recommended in this order:

First, Stretch the Soleus (lower calve)soleus

Second, Stretch the Gastrocniemius (upper calve)
upper-calve

Third, Stretch the Hamstrings
hamstrings
Fourth, Stretch the Erector Spinae
erector-spinae

End with the Downward Dog Pose (will also treat the gluteus muscles)
downward-dog-pose

It’s best to use the Active-Isolated Stretching technique on each segment and end with holding the Downward Dog pose for 30-60 seconds. If you are unfamiliar with Active-Isolated Stretching, visit: http://www.stretchingusa.com/active-isolated-stretching

Exercises for Specific Biomechanical Faults

To understand biomechanical faults, let’s first look at the walking cycle. In a perfect walking stride, the person’s arch elevator muscles of the leg (tibias anterior, peroneus longus and tibialis posterior) work in perfect harmony with the plantar-flexors (gastric, soleus, etc.) to absorb, distribute and release stored kinetic energy. On heel strike, the arch elevators must fire eccentrically to decelerate and dissipate ground reaction forces via foot pronation and internal tibial rotation.

As the foot transitions from midstance into push-off, the toes begin to dorsiflex causing activation of the plantar fascia and associated muscles.

But if the muscles of the leg and ankle are imbalanced, the forces acting on the foot and ankle are not evenly distributed. This often results in excessive strain to the plantar fascia. Over pronation, a common problem causes excessive strain on the plantar fascia and often leads to flat feet.

Over Pronation and Flat Feet
pronation

If you are over pronating your plantar flexor muscles are often stronger and tighter than your arch elevator muscles. The arch elevator muscles of the leg (tibias anterior, peroneus longus and tibialis posterior) need to be strengthened. The following two exercises help to strengthen these weaker muscles.

ankle-inversion

An elastic band, rubber tubing, or cable machine are all good choices to provide resistance. Start the ankle inversion exercise in neutral and fully invert your foot slowly. Do 3 sets of 20 to 30 reps. The second exercise is for flat feet:

excersice-pronation

Sit on a chair so that your knees are at an approximate 90-degree angle with your feet on the ground. You’ll need a smooth floor so that the towel will glide easily. Spread the length of the towel in front of you and sit with your back straight and bare foot flat on the edge of the towel. The short end of the towel should be against the legs of the chair. Without moving your heel, contract your toes to bunch up the towel and draw it toward you (as shown) until you have done 2 sets of 10-20 repetitions of toe contractions or run out of towel. As the exercise becomes easier over time, begin adding a light weight to the end of the towel.

Excessive Supination and High Arch

ankle-eversion

Like the inversion exercise, a Thera-Band, tubing or cable machine will work well. Do 3 sets of 20 to 30 reps and move slowly throughout the range of motion. The second exercise for high arches involves a tennis or golf ball to release the muscles on the plantar surface of the foot.

ball-stretch

Place the ball under your foot and move the ball back and forth 20-40 times. Repeat on other foot (Note: roll only on the non-painful part of the arch, if the entire surface of foot is painful, avoid this exercise).

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Fitness information provided by Ivan Garay, a personal trainer. To book an appoinment for personal training, please contact his website: http://ivangaray.massagetherapy.com/