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Endurance Athlete Consulting covers a broad range of topics regarding human performance in sport, sport related injuries, and rehabilitation. If there is something specific you would like to inquire about, please feel free to email me at:

I am available for speaking engagements and in services regarding aspects about injury, injury prevention, training for specific competitive events, injury treatment protocols, and workplace ergonomic assessments for a healthier work environment.

Monday, March 12, 2012

Be Patient With Your Plantar Fasciitis and Tibialis Posterior Tendonitis!

I've talked quite a bit about the different symptoms of plantar fasciitis and tibialis posterior tendonitis.  I've not talked much about other injuries that have similarities such as even a knee replacement or hip replacement, ACL reconstruction, etc.  What I want to tell you is very important!  There are rookie mistakes that are made consistently across injuries.  When guided by a professional, these mistakes can be avoided and your recovery made shorter and your return to normal activity and sports quicker.  So, here we go...

Patience is absolutely necessary!  Staying focused on the fundamentals of your rehab or recovery protocol is imperative!  I work in a setting in which many of our patients are very active with running, golf, tennis, cycling, scuba diving, horse back riding, etc.  These activities are their daily diversions and pleasures.  Patients are very anxious to get back to these activities.  Besides just being a fun activity, these activities are a great social outlet where friends meet up, enjoy time together, and bond, and share life's joys together.  And for many, these activities are a time of some friendly competition.  Therefore there is often an urgency in getting back to your prior level of fitness.  I'm prefacing this in detail for a reason.  Every patient that comes into the clinic wants a quick speedy recovery.  Here's the facts!  Your body dictates the rate at which it will recover.  Yes, you do have some input into your recovery but you do not have the final say to which day you will be back to 100% of your prior level of activity.  So here are some very important elements in a speedy but thorough recovery:

  • Be patient and control your urges to do too much at one time or too soon!  Doing more isn't necessarily going to improve your rate of healing.  Doing more or too much too soon can keep your injury unnecessarily and excessively inflamed and sore.  The longer your injury stays inflamed, then the more stasis of unwanted chemicals remain in the involved tissue, joint, or injured area.  This stasis of damaging chemicals called bradykinins, (chemicals that cause pain), mast cells, and histamines can cause unwanted scarring and malformed tissue remodeling.
  • Be consistent with your assigned exercises.  When your physical therapist says for you to perform your home exercises 3 times a day then perform them 3 times a day.  Perform all of the exercises together instead of doing one or two now and then 20 minutes later you do the next 2 or 3 exercises. The spreading out of your workout doesn't allow for the proper muscle recruitment appropriate for healing and strengthening.  Nor does this type of workout allow for the muscle core temperature to raise enough to be therapeutic and allow for the right type of tissue remodeling.  When your therapist says to do the whole workout together, then do them together.  There's a reason for it!
  • Don't be afraid of pain.  Pain can be your friend.  If something hurts, this doesn't mean it's time to forego your exercises or prescribed therapy and lay down on the couch and tell yourself that you're recovering.  Pain is simply a sensation that tells you what is happening inside your body, joints, or muscle tissue.  There are certain types of pain that are not ok to work through though.  A pain that is common is the lactic acid build up pain in the muscle belly that is being exercised.  This pain is your friend. It's letting you know that your body is attenuating new forces and causing your muscle to build strength.  Pains that should be of concern are pains that do not go away with rest or pains that come on during the night and do not respond to the usual remedies such as taking anti-inflammatories or prescribed pain medications.  These type of pains should be discussed immediately with your doctor or physical therapist.  Sometimes these pains can be normal especially if the occur close to a surgical procedure.  So remember, pain is not always bad.  Pain is a sensation that is telling you that you are attenuating new forces and these forces are making you stronger, in body and in mind.
So, with this in mind, be at ease, be patient, and be methodical about your recovery.  Don't try to speed your recovery be being over zealous with your rehab.  It just may slow you down.  Follow instructions from your therapist.  These instructions are for a specific reason.  And finally, just use common sense.  When in doubt, ask your therapist!

Happy Recovery!

Brad Senska, PT, DPT, BS, ASTYM.