Plantar Fasciitis and turning knees out

[Doodlemom]

I've done the first instructional tape twice and am finding that when I turn my knees out over my toes, I cannot keep my feet flat on the floor and by the end of the workout, the bottom of my feet are very sore. I am prone to plantar fasciitis and have had several bouts of physical therapy because of flare-ups. Am I supposed to be basically standing on the outer edges of my feet? Will this trigger a flare-up? I don't wear orthotics and the shoes I wear for the workouts are good, mid-ankle Rykas. I have fairly weak ankles from sprains over the years and I tore my left medial meniscus about 7 years ago.

[monica213]

Here is a post from Teresa:

KLT positioning automatically creates a subtle NBT aka "arch lift" by creating weight shift to outside of foot. This is coming from strength at point of knee which will initially be greater than at outside of ankle due to natural weight bearing of the body as well as increased gravitational pull (ie: the closer to the ground, the greater weight intensity per square inch within muscle tissue)

To better explain this, it's probably a good idea that I explain what plantar fasciitis is and why KLT works to improve PF condition vs. NBT.

The plantar fascia is a broad band of fibrous tissue that runs along the bottom of the foot - from heel to toes. It is just below the skin and subcutaneous fat. It helps to secure the arch. Excessive flattening of the arch on weight bearing as well as excessive load on foot due to obesity and over-pronation of the foot (a complex motion that involves outward rotation of the heel and inward rotation of the ankle.

Therefore, NBT technique done by lifting the big toe (which is the beginner's application until neuro-kinetic application of hip/knee roll out and metatarsal strength to "lift" the arch of foot can be applied)actually intensifies tightness of the plantar fascia. This further increases tension/ inflammation at lateral tibia and fibula attachments as well as the heel...all of which complicate plantar fasciitis. Initial strength/flexibility developed within metatarsal muscle attachments by KLT offset this tension as well as initial strength/flexibility developed within ankle muscle attachments by KLT lateral positioning.

Walking with NBT is actually a conservative approach of KLT. Working out with NBT during T-Tapp workouts (Basic, Total, Tempo and More)is actually progressive to intensify full fiber activation, isometric strength as well as joint strength with flexibility at all points of attachment.

Using NBT with regular walking and with Stepping Away the Inches is to create focus of keeping one's weight off the big ball joint. Weight should be mid to lateral - primarily on last two toes ...AND optimal NBT focus should be with weight transfer during full knee extension whereby knee tracks to middle of foot and ball joint and big toe touch without full weight shift.

Hope this better explains my reasoning behind NBT, KLT and their varied applications.

Best wishes, Teresa

[monica213]

So therefore, one should not try to keep the foot flat on the floor, you actually do want to shift your weight to the outer edge of your foot to rehab your PF.

[Excelsior]

I also have plantar fasciitis and knee problems. I do use inserts for my shoes (from Foot Solutions--and have 3 different levels of support for different activities). My fasciitis is related to pronation from having flat feet. Now that I have correct inserts and wear shoes at all times, I've had no more flare ups. I use the BWO+, TTAPP walking tapes, and the occasional Ladybug workout with no problems.

Perhaps some of the trainers on the site can give you more specific form techniques.

[just7]

I also have PF. Since T-Tapping, I have no pain from it at all. To the best of my ability I followed Teresa's direction that Michelle shared. I also took the insoles that I had bought from WalMart out of my shoes. They were the only thing that used to bring me some measure of support. Couldn't afford to go the more expensive route. With T-Tapp, I haven't needed to! :clappinghands:

[Doodlemom]

I have to admit Teresa's explanation makes absolutely no sense to me. It would also help if the abbreviations she uses were explained. What is NBT?

I wore orthotics for years (from my chiropractor) but discovered about a year ago that my feet - and my plantar fasciitis - improved when I took them out. This is after spending about $500 on new orthotics from my podiatrist. I stretch my feet and calves out every morning and that has keep the plantar fasciitis at bay. I also have flat feet.

So the pain I feel in my feet after the workout is supposed to be a good thing? Are you trying to tell me that eventually the muscles in my feet will stretch out enough that I won't be standing on the outer part of my foot? The arch the stance creates isn't subtle at all. It's like having your feet curled sideways while you stand.

The fear that my plantar fasciitis will return because of the T-tapp stances makes me unsure about this workout.

[monica213]

I actually rehabbed my PF using T-Tapp technique. Took a few weeks, but I no longer suffer the pain.

There is a list of acronyms stickied to the top of this forum and in the must read threads list on the general forum. <but NBT = No Big Toe> And no, for T-Tapp purpose only, you should not use orthotics to give the muscles in your feet a chanve to strengthen and lengthen

[lotsakids]

I think a good summary would be, just aim the knees out to little toe without lifting the big toe for now--phase 1 of rehab. Because of the anatomy of the lower leg, aiming the knee out will lift the arch of the foot a little, but not too much.
Also:
Be careful not to let your ankles roll out.
It is helpful to know:
Do you still have the excercises from your physical therapist?
Do you do them?
I hope this helps!