Stand Up and Workout

A new University of British Columbia study is exploring alternatives to traditional plantar fasciitis treatments. Led by Jack Taunton, a professor of sports medicine, the study touts prevention rather than reactive treatments.

Jack Taunton knows all about sore feet. Since the ‘70s Jack has run 62 marathons, or roughly 200,000 kilometres. Jack has experienced the intense pain and discomfort associated with plantar fasciitis. “I had burning pain in the middle part of my back heel,” he recalls.

His own experiences with plantar fasciitis have heightened his desire to learn more about the debilitating condition. His research aims to not only focus on those who run marathons, but anyone who spends long periods of time standing. Teachers, nurses and construction workers are especially vulnerable to plantar fasciitis.

Plantar fasciitis affects the plantar fascia; the thick connective tissue that supports the arch on the bottom of the foot. It extends from the heel to the bottom of the foot. The plantar fascia contributes to support of arch of the foot by acting as a sort of rubber band, where it undergoes tension when the foot bears weight. 

Through accumulative abuse the fascia can become inflamed, which makes a simple task like walking difficult and painful. According to the New England Journal of Medicine, plantar fasciitis accounts for 15 percent of all adult foot complaints.

Jack is midway through the WorkSafe BC funded study, which is testing a multi-element exercise program as a preferred early method of treatment for plantar fasciitis and the more advanced plantar fasciopathy. Plantar fasciitis refers to the foot pain caused by ligament inflammation, while plantar fasciopathy refers to deterioration of the ligament itself. Plantar fasciitis generally last for three to four weeks, at which point it becomes plantar fasciopathy.

As part of the study, Jack is working with 320 individuals whose plantar fasciitis was triggered from standing for long periods of time at work. “We are very interested in whether chronic plantar fasciopathy could be improved with an exercise program,” he comments. The idea is to strengthen the ligament itself, reduce overall pain and prevent the condition from worsening over time.

Currently the standard treatment comes in the form of cortisone injections. These injections can lead to downtime in the workplace and high claim costs for employers. Jack believes exercise may be a viable alternative treatment, which may negate the need for injections in some cases. Once micro-tears start forming in the fascia, injections are not effective. “Cortisone inhibits inflammatory response but cannot repair degeneration,” Jack explains.

“Can exercise help heal those micro-tears? If we heal the tear, will function improve and go away?”

These are questions Jack wishes to answer with the WorkSafe study. Previous research from a smaller study Jack performed in 2009 suggests that exercise can significantly reduce pain associated with plantar fasciitis.

Jack suggests an exercise routine consisting of dynamic and static stretches as well as balancing exercises. It is his hope to show that the use of a pragmatic exercise regimen can be as effective as or better than a cortisone injection at relieving pain.

Dynamic and static stretching.

The findings could affect a variety of industries, especially health care workers who tend to stand on their feet for twelve- hour shifts or more. “If workers can experience a significant reduction in pain while at the workplace, they will be more productive, easier to work with, and, of course, happier,” says Jack.

As an employer of EMS personnel, Global Medical Services is interested in plantar fasciitis and potential remedies of the condition. At times, Global paramedics can be on their feet without rest for many hours. Recently, we profiled plantar fasciitis in our quarterly paramedic newsletter. It is our hope we can bring more light to this condition within our workforce. We encourage our employees to stretch, as it can not only reduce pain, but also prevent it.

At the workstation, or on the job, a few minutes of stretching every day can help relieve stress, relax tense muscles and re-energize your day. 

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