Body shop: Cool your heels - Military Off Duty, Army Health, military fitness, army physical fitness - Army Times

Body shop: Cool your heels

Plantar fasciitis and ankle sprains are the last things you want to worry about when you’re deployed downrange.

The most common course of treatment, when possible, is rest, ice, compression and elevation, or RICE. But that doesn’t fix the underlying injuries.

Troops “need to look beyond RICE for plantar fasciitis and ankle-sprain injuries,” says Air Force Lt. Col. (Dr.) Anthony Beutler, assistant professor in the family medicine department at the Uniformed Services University of the Health Sciences. “Those steps certainly help to alleviate the immediate pain, but strengthening exercises need to be incorporated to prevent re-injury.”

Lt. Cmdr. (Dr.) Trey Wilson, primary care sports medicine fellow at USUHS, realized the importance of self-help exercises while deployed on an aircraft carrier.

“With one physical therapist for 5,000 people, it’s important to know what to do to help yourself,” he says.

While it’s always best to seek treatment by a qualified medical professional if you’re injured, the following exercises can keep you going and get you in better shape for your next mission.

Plantar fasciitis

According to Beutler, plantar fasciitis is the most common cause of heel pain, affecting about 10 percent of all runners in any given year. The pain is usually worst in the morning, with the first step out of bed.

High or low arches, tight heel cords, weak foot muscles, tight calves, overpronation and improper footwear are all common reasons for PF.

“PF occurs most commonly in runners with high or low arches,” Beutler says. “It’s actually not an inflammatory condition but micro-tears of the plantar fascia.”

Calf stretches and plantar fascia stretches loosen tight muscles and strengthen weak ones. When done regularly, they can have you running pain-free in six to eight weeks. If pain persists, a doctor may recommend orthotics or other courses of treatment.

Calf/heel cord stretches: This involves stretching two muscles, the gastrocnemius and the soleus. For best results, each should be stretched individually.

• Place the leg to be stretched behind the other and lean forward onto a wall.

• Keep your knee straight and your heel on the ground until you feel pull in the upper calf (the gastrocnemius).

• Hold for 30 seconds. The muscle begins to lengthen after 20 seconds, so the final 10 are the most essential.

• Lean forward again, but bend the knee on your back leg, still keeping your heel on the ground. Visualize trying to kneel while keeping your heel on the ground.

• Continue to kneel and lean until you feel pull in your lower calf (the soleus).

• Hold for 30 seconds, then repeat on opposite leg.

Stretch each leg three times in one session. To improve heel cord flexibility, do three stretching sessions per day. To maintain flexibility, one per day is enough.

Plantar fascia stretch:

• Hold your toes and pull them back toward your shin — this may be done by putting a belt around the ball of your foot and gently pulling toward the shin or, while in a seated position, crossing the foot to be stretched over the opposite thigh and gently pulling the toes toward the shin.

• Hold the stretch for 30 seconds. Stretch each foot three times, two to three times a day, to improve flexibility and once a day for maintenance.

Ankle sprain

“In the military and in emergency rooms nationwide, ankle sprains are the most common musculoskeletal injury, period,” Beutler says.

A rehabilitation plan focused on range of motion, strengthening and proprioception “can make ankles stronger than before a sprain,” he says.

“Proprioception” is your ankle’s ability to sense its position in space. When injured, it loses this ability. Regaining it is imperative to prevent re-injury, according to both Beutler and Wilson.

Beutler also recommends wearing a semirigid brace during athletic activities for six to 12 months after injury.

Toe alphabet: This improves range of motion. While sitting in a chair, “write” each letter of the alphabet from A to Z on the floor with your toes. Move only the ankle, not your knee and hip. Repeat with the other foot. These exercises can be done immediately after being diagnosed with an ankle sprain.

Single-leg balance: Begin these exercises as soon as you can stand on your injured leg with minimal discomfort.

“Depending how far you are from an aid station, single leg balancing exercises are the best thing you can do to strengthen an injured ankle,” says Wilson.

Practice standing on one leg, barefoot on a hard floor. Do several repetitions at least twice a day on each foot.

After you can stand on one foot and feel somewhat balanced, try doing it with eyes closed. When you can do that for 20 seconds, make the task harder by:

• Brushing your teeth while standing on one foot with eyes closed.

• Standing on a pillow, scrunched-up sleeping bag or sleeping pad.

• Standing on one leg and playing catch. Ask your buddy to throw the ball so that you have to bend to catch it.

Wilson also recommends mixing single-leg squats into your routine.

Most ankle sprains take four to six weeks to feel better. If your ankle remains sore after six weeks of treatment, you need to see a doctor.

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Allison Patillo writes about fitness for OFFDuty.