Never Let ‘Em See You Sweat

Shelley and her husband Dave dreamt of taking a trip to New Zealand but never could afford to take the time off to go. Between the lack of funds and her being a graduate student, it didn’t look like something that would happen anytime soon. You know how it is, sounds great but just can’t afford it.

Well, Shelley and Dave got pregnant (I guess really it’s all Shelley on the being pregnant part) and they knew if they didn’t find a way to afford it now, the next eighteen years would make it even less affordable.

After eight weeks of planning and saving, Shelley and Dave finally scheduled a two-week vacation to New Zealand. Their flight was scheduled for May 14th. Everything was looking up.

There was only one problem…Shelley had been struggling with plantar fasciitis, excessive pain in the heel of her foot for the last year or so. She got a shot that helped resolve the plantar fasciitis, but after a few months, the pain migrated from the front portion of her heel to the back of her heel and lower leg.

She went to her doctor and was diagnosed with Achilles tendonitis, an overuse injury that causes pain at the back of the leg and foot where the Achilles tendon attaches to the heel bone. Months went by and it got progressively worse.

The pain was debilitating, making it very difficult to walk without hurting…the trip was quickly approaching and the last thing Shelley wanted to do was cancel. But if she couldn’t walk without excruciating pain, the trip would be pointless…their vacation plans involved lots of walking. New Zealand just wouldn’t be as enjoyable if she had to limp along and stop to rest every few steps. What was Shelley to do?

She contacted me on April 24th via email to see if I might be able to help. She wrote:

Hi Jarian,

I’ve been dealing with foot pain for a while – at first it was plantar fasciitis, which eventually got better with a steroid shot, but now I’ve been diagnosed with Achilles tendonitis. It’s just been getting worse all semester. I was using a topical non-steroidal anti-inflammatory gel on it, but had to stop using it when I got pregnant. (I’m currently 8 weeks.) My husband and I have a huge trip we’ve been planning and saving for coming up on May 14th, and I was wondering if you think it’s possible to address the tendonitis and eliminate the pain before the trip? That’s only 3 weeks away though, so it might not be realistic. If you do think it’s possible, what would the time/cost be to address just this issue for now?

Thanks for your help,
Shelley

Did I think it was possible? I know it’s possible. I live for these moments, opportunities to be clutch, like Michael Jordan in the fourth quarter (yes, Jordan…not Lebron, not even Kobe…JORDAN.) This is what I train for…

So I responded:

First of all, congratulations on the pregnancy! I’m excited for you guys!

Concerning your foot pain, I like to treat Achilles tendonitis in four sessions to be completed within one week if possible. We may need to add a follow-up session or two, but I think we can achieve significant pain reduction in seven days. I suggest five sessions initially, four within one week and an additional session one week later. Regular pricing is $120 per session so five sessions would total $600. If you choose to prepay, we can do the initial 4 sessions for $400, and if the follow-up session is needed we can do that for $100.

We can schedule a time to do a free consult or jump right in and begin treatment. Whenever you’re ready, we can get started immediately.

Shelley replied:

Thanks! We’re really excited! It’s been a long time coming.

The doctor that I saw said that if the anti-inflammatory gel didn’t work, he’d have to put me in a boot to give the tendon a rest. I just don’t want to end up paying an additional $500 for a boot if the therapy helps, but then it still just needs to be immobilized to cure it (especially since money is going to be tight now). Do you think that the massage therapy can achieve the same thing as the boot (or better)?

Now please don’t misunderstand me, doctors are very knowledgeable people and are excellent at what they do. If I break my leg, rupture my spleen or ingest poison, don’t take me to a massage therapist…take me to a doctor, STAT! But when it comes to afflictions like plantar fasciitis, Achilles tendonitis or tennis elbow, take me to someone who specializes in the (neuro) musculoskeletal system. Take me to someone like me. In Shelley’s case, she needed to see someone like me…someone who spends countless hours studying, observing and handling the (neuro) musculoskeletal system, that is the system of muscles, bones and the nerves that make them move.

I didn’t take Shelley’s predicament lightly. She had a choice to make and she couldn’t afford to make the wrong one. She also couldn’t afford to simply try everything in hopes that one of them might work. In essence, she was saying I can only afford one approach, one choice. Which one is best? I’m definitely not a stranger to having limited choices but still needing the best outcome possible. So I responded:

I believe the therapy can achieve better results than the boot. The boot is prescribed to immobilize the tendon to provide rest and prevent further irritation. The therapy, on the other hand, is designed to improve functional movement without causing further inflammation, improve flexibility, increase blood flow to the painful area to speed the healing/repair of the tendon and eliminate compensation patterns that contribute to the Achilles tendonitis (and plantar fasciitis.)

After a couple of days, Shelley responded:

Ok, let’s go for it. How long is each appointment, and do I just choose the plantar fasciitis option on your booking page?

I responded:

I ask you to set aside approx. 2 hours per session. The first one will most likely be the longest. You can choose the plantar fasciitis option when booking online.

Shelley was counting on me to get her New Zealand ready and I wasn’t about to let her down.

We started her treatment program on April 30th. I was so eager to get her up and on her way to New Zealand. I did everything I knew to help her achieve the best results. But then…

Shelley sent me this email on May 2nd:

Hi Jarian,

I think we severely underestimated how out of shape that left leg was. I’m having a hard time walking around today because my calf muscle is so sore and does not want to function. Should I go ahead and come in today or should I wait a day for it to heal up?

I wasn’t too surprised, but it’s still not what I wanted to here. I responded:

I would still like you to come in today. We’ll skip the movement and focus on relieving the delayed-onset muscle soreness with massage and gentle stretching. Don’t worry, it’s completely normal to feel soreness after the work we did Monday. We can make adjustments to the protocol until you build up more strength.

She came in that day and we stepped off the gas a bit. She was scheduled to come on May 4th, but she contacted me that morning saying she was still sore and finding it difficult to move around. Oh no…

We delayed the treatment and resumed on May 8th. She was feeling better and I was ready to get to work. The trip was only six days away. It was the fourth quarter. It was time to deliver.

Her pain had decreased slightly by May 10th, but we still hadn’t reached our goal. I could tell she was getting nervous. Did she make the wrong decision? Did I overpromise but under deliver? Just trust the process, I told myself. Trust the body. Do the work, the results will come.

I added a fifth session just to make sure we would achieve the best results. This one was on me I told her, no need to pay more. I had to be sure she could walk when she reached New Zealand.

She came to the clinic on May 12th, just two days before the trip. I asked her to rate her pain on a scale of 0 to 10, 0 being no pain and 10 the worst pain.

“Zero'” she said. She had a little tenderness in her foot, but she could tell the pain was gone and she was on her way to optimal health. By the end of the session, the tenderness n the foot was gone also.

“I never doubted you, but I was kinda worried there for a second,” she said.

“Me too,” I thought to myself. But I would never say that out loud. When it’s the fourth quarter and you got the ball, never let ’em see you sweat.

Click here to see how I helped Melissa reduce foot pain from 8 to 1 on the pain scale in six days!

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Speaking of Amputation…

January 2013 my blood-glucose level was over 550 mg/dl and I was diagnosed “prediabetic.” After spending countless hours in the emergency room waiting to either be seen by a doctor or go into a diabetic coma, I was finally given the “don’t do sugar” lecture along with metformin, the requisite drug for type 2 diabetes, and sent on my way. After a year of taking the medication, I decided enough was enough.

You have to understand, I already know how this all plays out. You take the meds, eat fewer sweets and carbs, do some cardio exercise and check your glucose levels regularly. It works for a while, but then…

The meds stop being as effective so the dosage is increased. Then after another period of time insulin is added to the regimen…then it’s blood pressure meds…and heart meds. Now you’re a walking pharmacy- if you’re fortunate enough not to have your foot amputated, that is.

Speaking of amputation…I had a client, black male, mid 50’s, who had lost protective sensation in his feet due to diabetic peripheral neuropathy and wanted to see if my neuropathy foot massage would help him regain feeling. As I gathered more information from him before the treatment, he told me that his doctor suggested amputation. He had been struggling with diabetes for a while, but his feet were not gangrenous or ulcerated and I saw no reason for the doctor to send him directly to amputation without passing go and collecting $200.

So I asked him if the doctor was just using a scare tactic to convince him to take his health more seriously and implement some necessary lifestyle changes.

“No,” he said, “he (the doctor) just said that it was only going to get worse so I might as well do it (amputation) now.”

Really? Is that the best our healthcare system has to offer? Surely this doctor knows that up to 50% of diabetics die within two years of having a foot or leg amputated. Of course, some of that has to do with old age and comorbidities, but not all.

Maybe this doctor was just giving voice to an (unconscious?) bias that exists in healthcare. Giving voice to the reason why there are Starbucks on every corner in some neighborhoods and dialysis centers on every corner in other neighborhoods. I was angry, disgusted and determined not to go down the same road.

My determination to beat diabetes has been reinforced by watching my younger sister and mother, type 1 and type 2 diabetics respectively, struggle with it for years. My sister has taken the insulin injections and medication and what did it get her? Loss of vision in her left eye and a long wait on the kidney transplant list. There has to be a better way than simply managing the symptoms until the complications pile up. I was determined to find that way.

After a ton of research and answering questions like this from medical professionals,

“What exactly does this massage do for your legs and feet? It’s an irreversible chronic disease. (Diabetic),”

I developed a multidisciplinary approach to do MORE for people who struggle with diabetic peripheral neuropathy. It’s a simple 3-step process:

(1) Manage symptoms (2) Optimize health and wellness (3) Reverse diabetes. With these 3 steps, we can then (4) Eliminate diabetic nerve pain (neuropathy). Manage, Optimize, Reverse, Eliminate- MORE, get it? (I got acronyms for days.) This approach doesn’t just treat the symptoms; it gets to the root cause of type 2 diabetes. If you treat the cause of type 2 diabetes, the symptoms will disappear. High blood sugar is a symptom of diabetes, not the cause. Most treatments and programs for diabetes treat the symptom but not the cause.

I implemented these 3 steps in my own life and stopped taking diabetes medication in 2014. I am no longer considered “prediabetic.” I wish I would have known this earlier, I could have helped my mother and sister avoid numerous medications and complications. But now I know. And knowing is half the battle.

Quick Relief for Plantar Fasciitis

Plantar fasciitis causes the muscles at the bottom of the foot and back of the lower leg to become rigid and “tight.” Conventional wisdom says you should stretch the muscles at the back of the leg, like the calf muscle, along with the soft tissue at the sole of the foot.

In this short clip, I will show you a quicker, more effective way to relieve plantar fasciitis by engaging the muscles in the front of the leg and foot. Check it out!

Evidence-Based Exercise for Plantar Fasciitis

Plantar Fasciitis often causes stabbing pain in the heel and/or arch of the foot, especially upon taking your first steps in the morning or after a long period of rest. The suffix –itis implies inflammation of the fascia (thick bands of connective tissue) located at the plantar surface (sole) of the foot. However, plantar fasciitis is most likely due to degeneration of tendons that attach to the heel rather than inflammation of plantar fascia.

A study of 48 participants with plantar fasciitis compared the effectiveness of plantar stretching exercises to high-load strength training exercises in treating plantar fasciitis. After 3 months, the strength training exercise was shown to be more effective than stretching in reducing pain caused by plantar fasciitis.

1. Make the towel roll large enough so the toes stretch backwards when inserted under the toes. Place only the toes on top of the towel roll, not the balls of the feet.

2. The exercise is to be done every second day until the pain is gone.

3. Wear a backpack and add books to increase resistance once you can do 12 reps easily.

View a summary of the published study here:
https://www.ncbi.nlm.nih.gov/pubmed/25145882