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In the first installment of this two-part series, we looked at a group of common soft- tissue disorders of the foot. Unfortunately, clients can ignore foot pain until it creates a functional disability. Yet, massage therapy and addressing biomechanical function early can resolve pain and prevent dysfunction. Understanding foot pathologies and recognizing their key signs and symptoms allows us to intervene earlier. For 30 years, I have stressed how important it is to match the physiology of the condition with the physiology of the treatment. With foot pain, choosing the most appropriate treatment strategy for that particular condition is necessary. In this installment, we explore a few techniques to address these conditions. In creating a treatment plan, it is essential to consider the condition's degree of severity and stage of development (for example: recent versus chronic). How treatments are applied also depends on these factors. There is far more to understand about foot pain than this overview can provide. But the following will get you started. First, I cover the basic soft-tissue treatments, numbered for quick reference. Next, I provide guidelines for which techniques to use with particular conditions. TREATMENTS 1. Deep Gliding with Broad Contact Surface (Plantar Surface) Use the back side of the fist, palm, or forearm to perform a slow, broad, gliding stroke on the foot's plantar surface. The client may be more comfortable with the treatment applied in one direction versus the other. Your work will not have the force to pull the plantar fascia farther from the calcaneal attachment. 2. Deep Gliding with Small Contact Surface (Plantar Surface) Similar to the technique above, except a small contact surface is used. Use the fingertips, thumb, knuckle, or pressure tool to apply a long, slow, gliding technique to the soft tissues on the plantar surface of the foot (Image 1). 3. Active Engagement Lengthening: Deep Compartment Muscles This method employs massage along with active muscle contraction. It's an effective way to access the leg's deep compartment muscles, which have tendons that extend into the foot. Use a small contact surface such as a fingertip or thumb to apply a slow, gradual stripping along the medial border of the tibia. The client is instructed to move the foot back and forth in dorsiflexion and plantar flexion. The stripping technique is applied 20 m a s s a g e & b o d y wo r k m a rc h /a p r i l 2 0 2 3 Treating Plantar Foot Pain, Part 2 TECHNIQUE By Whitney Lowe CLINICAL EXPLORATIONS KEY POINTS • The feet and legs are sometimes ignored in massage treatment. Yet, lower-extremity massage has resounding effects throughout the kinetic chain of our body. • With foot pain, choosing the most appropriate treatment strategy for that particular condition is necessary. Plantar Foot Pain Series To read the first part of this two- part installment on plantar foot pain, check out "Exploring Plantar Foot Pain, Part 1," page 22, in the January/February 2023 issue of Massage & Bodywork magazine. 1

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