How to treat and beat your plantar fasciitis- By Melissa Biffi, Biokineticists

The plantar fascia is a thick band of ligaments connecting the heel bone to the toes. It works with the Achilles tendon to store and return energy during specific movements and supports the arch of your foot. For most of you runners suffering from this acute, sometimes chronic heel pain, you’d wonder what the need for your plantar fascia is, if it just causes pain! It does in fact have an important function, to stabilize the forefoot as the force during push off increases.

So if it’s there to help you, why would it cause pain? Often pain results due to strain of the plantar fascia thus causing inflammation, weakness and swelling, making it hard to get around. Why would this happen? Many plantar fasciitis cases are the cause from factors such as tight calves and repetitive hill workouts, however the largest factor is owing to fallen or collapsed arches. Flat footed individuals are more likely to develop and suffer from this condition as collapsed arches places more tension on the fascial ligament thus overloading the attachment at the heel bone.

The most common sort after treatment is to mash your foot out with a ball or an iced bottle. Yes this may help relieve the tension and loosen up the ligament; however this is only temporary, providing an invitation for the pain to return at a later stage. So why deal with the chronic pain when Biokinetics and exercise therapy can completely stomp out that plantar fasciitis. Biokinetics aims to find the cause and deal with it using an individualized and specific exercise intervention. Often enough, the flexor digitorum brevis muscle, or more simply put, the muscle in the sole of your foot is weak, allowing for collapsing in the arch. This may also be combined with overall weakness in the lower limbs and general tightness that needs to be dealt with appropriately and conservatively to prevent further aggravation and even possible heel spurs (bony outgrowths on the heel).

As for you runners looking for a quick fix, it is important not to rush the process and seek proper medical advice and initial supervision when it comes to rehabilitative exercise, whilst trying your best to avoid those corticosteroid injections and surgery to relieve the pain. As biokineticist’s it is our job to treat conservatively and to determine faults in your running technique that may be contributing to your pain. Since foot strike patterns significantly increase tension in the plantar fascia, it is important to avoid mid or forefoot strike. While recovering from the condition, it is recommended that you decrease your stride length and increase your cadence and to wear appropriate shoes with enough support for shock absorption.

With correction in form and general activity and the combination of a rehabilitative exercise program, you may just be able to stomp out your plantar fasciitis and enjoy the open roads and trail runs pain-free. 

Scoliosis... we've got your back! - Melissa Biffi (Paladin Biokineticists)

What is Scoliosis?

Scoliosis is an abnormal, curvature of the spine.  Viewed from the back, a typical spine is straight. When scoliosis occurs the spine can curve in two different ways, the spine can curve to one side, either the left or right side (shaped like a C) or the spine has two curves (shaped like the letter S) normally occurring at the cervical and lumbar spine region.

There are two types of scoliosis. Structural scoliosis which is characterised by permanent structural changes in the bone and usually caused by congenital abnormalities. Non-structural or functional scoliosis is generally caused by a problem elsewhere in the body, such as a leg length discrepancy or muscle spasm. 70-90% of all cases are idiopathic (unknown). Idiopathic scoliosis can be seen at any age, but is most commonly diagnosed between the ages of 10 and 13 years, and is more common in females. Degenerative scoliosis is more likely to develop in adults, where degeneration in the spine and surrounding musculature can result in abnormal curvature. 

How do you know you might have scoliosis?

The most common symptom of scoliosis is an abnormal curve of the spine. Often this is a mild change and may be first noticed by friends or family. The change in the curve of the spine typically occurs very slowly and over a long period of time and so it is easy to miss until it becomes more severe. Pain is a symptom of scoliosis .When back pain is present with scoliosis; it may be because the curve in the spine is causing stress and pressure on the spinal discs, nerves, muscles, ligaments, or facet joints. It is not usually caused by the curve itself. 

Scoliosis may cause the head to appear slightly tilted to one side or one hip or shoulder to be higher than the other side and can also cause one leg to appear shorter than the other. If the scoliosis is more severe, it can make it more difficult for the heart and lungs to work properly as severe scoliosis can cause a rotation of the rib cage, which will cause shortness of breath.

How can Biokinetics help scoliosis?

Mild cases of scoliosis generally have minimal deformity. Such cases can therefore be treated with appropriate stretching and strenghening exercises. A biokineticist will assess what functional aspects may be contributing to the scoliosis, so that appropriate stretching and strengthening exercises can then be prescribed to manage the  scoliosis and prevent further deterioration.

Biokineticists can prevent the progression of curvatures in adolescents with scoliosis and in some cases even improve their curvature. Biokinetics will focus on prescribing a specific individualised exercise regimen according to the need of each person. The program will consist of isometric and other muscle strengthening and stretching exercises in order to strengthen the spine causing it to straighten out. Treatment will also focus on posture correction and stabilising the corrected muscles so that posture will be improved in activities of daily living. It is very important that the correct exercises be prescribed and done obediently, as incorrect exercises; a lack of effective management of the scoliosis and to poor compliance of the individual can lead to progression of the curvature. 

Melissa Biffi obtained her BCom Sports Management Degree at the University of Johannesburg and completed her Honours in Biokinetics at the University of Witwatersrand.

She has a special interest in dancing and other sports such as soccer and hockey, which lead to her interest in orthopaedic rehabilitation, particularly knee rehabilitation.

Melissa is also very passionate about working with children in specific areas such as rehabilitation and development of individuals from very young ages all the way through to adolescents.

Melissa can be contacted on 082 822 9677 or melissabiffi@kinetics.co.za