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How to treat common triathlon injuries-Plantar Fasciitis

According to self proclaimed rehab geek, James Dunne and Leigh Boyle, from Athletes Treating Athletes, the 10 most common triathlon injuries are:

1 – Plantar Fasciitis

2 – Achilles TendonitisPosterior Tibialis-you'll know you're on it bc it hurts

3 – Shin Splints (Tibial Stress Syndrome)

4 – Hamstring Strains

5 – Patellofemoral Syndrome (PFS)

6 – Iliotibial Band Syndrome (ITBS)

7 – Hip Flexor Strains

8 – Low Back Strain

9 – Shoulder Impingement

10 – Neck Strains

So we’ll take it week by week. Im going to discuss SPECIFICALLY how massage supports recovery from both of these conditions. I’m not going to write about using tennis balls or kinesio tape or other very legitimate helpful accessories. I’m going to focus on massage.

#1 and #2 are caused by the same problem, but manifest pain differently. As Massage Therapists (MTs) we treat the symptom and the cause. You know how to treat the symptoms. Lets talk about the cause.

The two muscles that cause Plantar Fasciitis and Achilles Tendonitis are the posterior tibialis and the soleus. Im not a rocket scientist. I learned this from someone over the last 20 years. I really wish I could give whoever it is credit, but I’ve taught this over 100x to MTs who use this technique, as I have, with great success.

Palpate your own tibialis posterior by finding your shin bone and sticking your finger, medially, behind the tibia. Its going to be sore. All we need to do as MTs is to stimulate some blood flow thru out that muscle. It runs behind the medial aspect of the knee at the superior aspect and attaches at the medial arch of the foot. Often the attachment point on the arch is painful. You can warm the tissue with palm friction. You will definitely need to use some specific friction and thumb walking down the entire front of the leg. Find and follow the tibia. Stay behind it. Lower on the leg will be more painful on most people. Duration? 3-5 minutes is plenty of attention to this area once you are comfortable with the work. I like to evert the foot (not invert, evert) to add a little passive stretch as well. Of course you can do some work to the Plantar tendons and soften the tissue on bottom of the feet.
Moving on…posterior compartment. You will need to treat the soleus. Find the Achilles tendon. Give it a gentle pinch. Ask your client, “Is this sore?” That’s a classic ‘pinch test’ to determine inflamation in the Achilles. Hopefully its not too painful. I like to bend the knee, sit on the table and work the middle muscle of the lower leg. The Achilles tendon turns into the soleus-so just follow it on up. Give it a little extra pressure. Most athletes do a standing straight leg calf stretch. Unless the knee is bent your athlete isn’t stretching the soleus. Which can lead to overuse; which can lead to chronic tightness. So demonstrate the bent knee stretch for self care.

So there you have it. A quick “how to” eliminate Plantar Fasciitis and Achilles Tendonitis using massage therapy.

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