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windlass mechanism plantar fasciitis

Heel pain

Plantar Fasciitis Exercises – a superior new approach

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Heel pain plantar fasciitis exercisesHeel pain is incredibly common and one of those injuries that can take months to years to heal. So the more that you can do to help it at home the better right? Recently there has been a shift in thinking in rehabilitation soft tissue injuries and this has brought with it a new plantar fasciitis exercises that significantly speeds up recovery.

Mechanotherapy has recently been brought back into the limelight and more focus has been put on this. Mechanotherapy is basically looking at how tissue reacts to the forces that are put through it. If you put the right progressive loading through a tissue, it will adapt and change according to that load – The body is an awesome thing and we can use this adaptation to loading to give injuries a push in the right direction to heal pain strong and fast.

A good explanation of mechanotherapy can be found here for more information.

In the past, the treatment for plantar fasciitis (which should really be called plantar fasciopathy) has been quite passive with footwear, stretching and injections being the go-to options. these definitely help, and I have written a post in the past with some great rehab exercises in it, but new research has added another dimension to the treatment of plantar fasciitis that we can add to this.

A recent new study, looking at 48 patients with plantar fasciitis, compared two treatment options which basically had one group stretching the plantar fascia and using shoe inserts and the other group doing plantar fascia specific high load strength training and shoe inserts. The results at the 3-month review mark showed a much better improvement for the patients that were doing the simple progressive exercise every second day.

New findings like this can’t be ignored as who wouldn’t want to be pain-free faster!

So what is this new progressive exercise regimen that you can add to your rehab exercises?

The exercise is a simple single leg heel raise with a towel rolled up and put under the toes to put the plantar fascia on stretch and load up the windlass mechanism.You then do a heel raise, taking 3 seconds to go up, a 2-second pause at the top and then a 3 second lowering down again.

Do 3 sets of 10 reps every second day.

As pain improves and it becomes comfortable to do for after two weeks, you can add weight to the exercise by putting some weight in a backpack (e.g. a few books or a brisk or two) to progress the exercise and progressively add more force.

Note: This exercise needs to be done slowly as described to decrease the risk of flaring up the injury

The main thing is with plantar fasciopathy is to persevere, keep at your treatment and rehab exercises as it does get better.

Thanks for reading, you will also enjoy our new and updated Comprehensive Plantar Fasciitis Rehab Guide

References:

Running-physio


foot pain

The Windlass Mechanism

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The windlass mechanism is an integral function of the foot that is critical to efficient walking and running. I am going to tell you all about how the windlass mechanism works to help you do what you love and how to test it yourself!

What is Windless Mechanism?

The windlass mechanism is simply put, the tightening of the fascia (rope may be the better term) on the bottom of your foot as you push-off. As it tightens it acts to stop your foot collapsing by supporting your arch and helps propel your forward, conserving precious momentum and energy!

Why do we need this mechanism?

It is so incredibly important that this mechanism works. If you want to keep walking or running pain-free – you need this mechanism functioning. If it doesn’t you could end up with one of a number of injuries, including:

Not to mention the undue pressure that gets put through your knees, hips and low back.

So how does the windlass mechanism work?

Your Plantar Fascia (or aponeurosis) is a very strong band of connective tissue that begins at the base of your heel and extends along the bottom of your feet to the toes.

As you walk and run a huge amount of force is put through your feet and so the plantar fascia has a very high tensile strength to hold the foot together and prevent it collapsing.

Because the fascia runs from the heel to the toes, as the foot is put down, the fascia is stretched which stops the toes spreading away from the heel – and so keeping the arch from collapsing.

Without this we would walk with no efficiency and our feet would be continually collapsing in (over-pronating) – Not ideal.

The really fantastic part of the mechanism is at the end of the gait cycle when our heel comes off the ground. As the heel comes up and the big toe stays on the ground getting pushed up, the plantar fascia is put on further stretch.

This winds the fascia around the balls of your feel like a pulley system which shortens the distance between the heel and the balls of your feet to raise and stabilise the arch of your foot.

This means there is no weak point in the foot – it is nice and stable to that you can really push-off and not lose any force.

Check out this clear and concise video that shows the mechanism well.

Achilles Tendon Pitches in As Well

Interestingly the Achilles tendon also helps tension the plantar fascia.

This is because collagen fibers from the Achilles tendon go around the heel to blend in with the outer layer of the plantar fascia.

This is a great example of how the body is connected and really works in synergy and not in isolation. This connection can also have a negative effect on the plantar fascia if the calves are too tight but we will address this in a future post.

Check out Windlass Mechanism in action at home – Test is yourself

Have a buddy standing up, fully weight-bearing and then you lift their big toe (they need to be putting their weight through the foot).

You will see the inside arch lift up as you lift the toe up. This is exactly what happens (or close to anyway) when you step through and push-off your big toe!

This is a really simple test but it can tell you so much. The windlass mechanism could be:

  • Delayed
  • Not happening at all
  • Or needing a lot of force to initiate

And it is also a great test to see if your orthotics do in fact help: Do the test standing on the ground and then standing on your orthotic and see if:

  • It is easier to lift the big toe
  • The arch rises up easier or smoother
  • The arch lifts up quicker or earlier.

Summary

This is another pretty cool example of how our body is an amazing machine! A simple little mechanism and yet it makes us be able to run far, fast and smoothly while absorbing shock and preventing injury. And it’s an important aspect for any health professional to check for any lower limb or back injury.

A good example of an injury where the Windlass mechanism is often not working is Plantar Fasciitis, so if you have arch or heel pain when walking, running and getting up in the morning – check this page out for exercises to rehab it and for your own sake – Don’t wear flip-flops.

Stay tuned in!


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