The Agony of DeFeet

By

Victoria L. Magown, CMTPT, LMT and George S. Pellegrino, LMT, CMTPT

  Linda, a veterinarian, suffered with unrelenting foot pain for five years.  Her profession required long hours of standing which was very difficult.  The foot pain was particularly distracting while performing long surgical procedures.

  Linda tried just about everything to relieve her pain including medications, injections, insoles and special shoes.  Although these helped, the pain continued.  At one point Linda even considered early retirement.

  When she came to MyoRehab, we discovered she had a long history of injuries to her calves.  Once, when helping to clear trees from the area around her vacation cabin, her calves were hit by a log hard enough to leave a “dent” in her right calf.

  As a child, when horseback riding, she was thrown from her horse with one foot getting caught in the stirrup.  Spooked, the horse continued to run, ignoring the screaming child.  When the horse was finally stopped and Linda was rescued, her left ankle was badly sprained.

  Our evaluation of Linda’s calves showed Myofascial Trigger Point activity in both the gastrocnemius and soleus muscles.  (Illustrations A & B)  A Trigger Point is a hypersensitive spot in a muscle that when stimulated, produces pain that is referred in a predictable pattern usually away from the Trigger Point.

  In Linda’s case, her pain was nearly identical to the pain patterns typically produced by Trigger Points in the gastrocnemius and soleus muscles.  When we began treating Linda by addressing Trigger Points in these muscles, she was surprised.

  She commented that all of her previous treatments had focused on her feet, the site of the pain.  When treating pain caused by Myofascial Trigger Points, addressing the site of the pain rather than the cause will have you treating the wrong place more than 75% of the time.

  The result of inactivating these Trigger Points was dramatic.  In the past, Linda said that by the end of her work day she could barely apply pressure to the accelerator to drive home.  In just a few treatments, she was not only able to drive home at the end of a long day but also was able to resume jogging with her husband.

  Karen’s case was different from Linda’s.  Her pain began gradually without a clear incident.  She was a serious runner and would grimace when someone referred to her as a “jogger”.  She loved to talk about the many marathon races in which she participated.  Early this past summer, she cut back on her running. The culprit, she said, was the dreaded “Plantar Fascitis” or so she was told by her fellow runners.

  When she came to MyoRehab for help, she told us about all the different shoe inserts and folk remedies she tried to no avail.  Although Karen’s pain was similar to Linda’s, different muscles were involved.

  Trigger Points in the tibialis posterior muscle produces a pain pattern similar to the gastrocnemius pain pattern at the arch of the foot and also at the achilles tendon similar to the soleus. (Illustration C & D)  The tibialis posterior is referred to as the “Runner’s Nemesis” which it surely was for Karen.

  Trigger Points in the quadratus plantae, a muscle deep in the bottom of the foot, produces pain at the heel similar to the soleus.

  When Karen’s feet were examined, we discovered a common foot structure known as Morton’s Foot.  This is described as a short first toe and long second toe.  When a person has this foot structure, the weight of the body is distributed between the long second toe and the heel, instead of the fifth and first toes together with the heel which forms a more stable “tripod”.

  The instability caused by this structure is like walking on a knife edge which keeps the muscles of the calf and feet constantly active, stabilizing the foot.  When Karen was fitted with the correct insole, Morton’s Foot Structure was no longer a problem.

  After treating both Karen and Linda, they were each given individualized Home Exercise Programs to stretch the muscles of the calves and feet.  This program retrains the muscles to stay at their normal resting length in a pain-free state.  In Karen’s case, we also suggested she stretch the quadratus plantae by rolling her foot on a golf ball.

  Are you experiencing “The Agony of De-Feet”? Give us a call at MyoRehab OR click here to set up your thirty minute consultation