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Hi
My Tae kwon do Instructor has just admitted to me, that he's had unilateral plantar fasciitis for the past 2/12, whilst he is improving, it is recurrent. He has had the usual [calfstretches, RICE, NSAIDs, foot stretches & deep massage before standing after resting, and has bought some generic heel gel pads].

Tae kwon do is a martial art practiced with bare feet, dynamic movement during sparring and kicking are it's distinctive features. Occaisionally light shoes are worn [a littlebit like a ballet pump].

A quick gait observation shows mid tarsal joint pronation at mid-stance phase. Though he's flexible [no equinus], i don't think he's hyper mobile. 1st ray [and everything else] hasn't been checked.

Whilst I'm familiar with PF and it's differentials, and traditional treatments, orthoses might not be relevant as he clearly spends most of his active time barefoot.

Before steroid injections are suggested, has anyone had any succes with intrinsic foot muscle exercises [I remember Simon Costain - Uk Sports podiatrist, describe how he treated various olympic athletes with this regime]? If so what's your protocol? any advice sheets?

Any other bright ideas folks?

Charlie

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I would suggest standard tx icing, stretching, tennis ball massage.

Just because he has 10 degrees of dorsiflexion of the ankle does not mean that the triceps surea is loading up the PF especially if he is bouncing on his toes while training.

Orthotics for normal wear ie when not training. He will still be stressing the area thus adding to his symptoms.

Taping for training low dye or high dye which may include padding to help facilite windlass.

Foot mobilisation Ted has just put a video on mobilisation for stj pronation on the PA channel on you tube might be worth looking at.

hope that helps

__________________
Mike Weber.



Crazy Mary

I developed PF when training for my Black Belt a few years ago.

I found that wearing a tensor ankle wrap helped the most when sparring and doing Kata/forms. The tensor leaves the heel and forefoot exposed and doesn't interfear with the activity.

__________________
Graham Curryer

None of us know what we are doing, but some of us know more about what we are not doing than others!::

Charlie:

I would suggest using a low-Dye strap and on instructing the patient how to put this on before every workout. This generally works quite well for martial arts athletes for plantar fasciitis.

__________________
Sincerely,

Kevin

**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College

e-mail: kevinakirby@comcast.net

Private Practice:
107 Scripps Drive, Suite 200
Sacramento, CA 95825 USA
My location

Voice: (916) 925-8111 Fax: (916) 925-8136
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Charlie,

Sadly we in the UK can't claim Simon Costain as one of our own; I'm pretty sure he's an Aussie. Shame... as he's an absolute legend and easily in my top 5 of Podiatrists who I feel we should all strive to be like.

Ian.

IGNORE me - I'm being a tool - I'm talking about Bartold...

Hi Charlie

I treated my thai boxing instructor a few years back for the same problem.
I used manipulation very successfully in that case and he has had no reoccurance.
kevins advice of low dye is also sensible.

hope this helps

Dave

Charlie,
The key is going to be in supporting his midfoot.
You need to find a way to wrap his midfoor and orevent (as much as possible) pronation.
You may want to suggest that he use custom orthotics with a strong medial arch when he is wearing shoes.
Good Luck,
Michael

Hi Charlie,

I became a Sports Pod due to my Taekwondo injuries.
Back in 1990's leading up to Sydney Olympics, I was in the Olympic Squad for TKD, had a scholarship to the AIS (Aust Institute Sport), and treated nearly all of the Australian Olympians over many years.

Obviously extremely common injury; however simple measures will make all the difference to enable training to continue;

1. TKD/Bag shoes to be worn during training with Orthoses- FFO or NCIs.
2. Orthoses worn daily footwear.
3. Low dye taping when barefoot (competition/sparring); restrict as possible.
4. Training drill modification - resticted bouncing, footwork, pads/bagwork, running.
5. Plantar Golf Ball Massage / soft tissue therapy; multiple daily.

Are you really considering injection? Esp prior to conservative Tx...

Cheers,

Paul

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Paul Dowie

Hi Paul,
Thanks for a great reply, i'll pass this on directly. Your background will add a different level of credibility, and hopefully, compliance!
No injection suggestions, might be one for emergencies, but i can't see that it would be approprate for many reasons.
Best wishes
Charlie