It’s no wonder why your clients love pedicures: Every mile we walk puts as much as 60 tons of stress on each foot! Combine this with the fact that most women wear tight, improperly fitting shoes, and it seems baffling that doctors don’t hand out prescriptions for pedicures as often as they prescribe pain relievers. If your client experiences plantar fasciitis, you can make a difference in her comfort level with your services. And because women are much more likely to develop this condition than men, you may come across clients who deal with this problem every day. In this Nail Clinic, we’ll examine the facts behind plantar fasciitis and explain how you can help alleviate some of the symptoms.
The human foot is a complex network of 26 bones, 33 joints and more than 100 tendons, muscles and ligaments. But plantar fasciitis targets one specific tendon: the thick connective tissue that connects the heel bones to the base of the toes called the plantar fascia. “Plantar fasciitis is an inflammation of the plantar fascia,” explains Carol Frey, MD, director of orthopedic foot and ankle surgery at the West Coast Center for Orthopaedic Surgery and Sports Medicine in Manhattan Beach, California. “It can occur if the plantar fascia is being overloaded or as a result of an overly tight plantar fascia, which is less resilient to walking stress.” Other risk factors, she notes, include obesity, pregnancy, poor flexibility and prolonged standing on hard surfaces.
This condition is relatively widespread and may even become more prevalent due to Americans’ tendencies to carry a few extra pounds. “Plantar fasciitis is the most common problem we see in foot and ankle practices,” relates Selene Parekh, MD, MBA, foot and ankle surgeon at the North Carolina Orthopaedic Clinic in Durham, North Carolina. “Often the patients are females, 40 years or older, and slightly overweight, but there are additional risk factors.” He adds that naturally high arches can also cause the condition, and the American Academy of Orthopaedic Surgeons advises that anyone who regularly walks or runs for exercise may also be at risk.
The telltale symptom of plantar fasciitis is heel pain, which is often most noticeable during the first steps one takes in the morning. “The pain is worse in the morning because the fascia tightens up at night when you’re off your feet, and the foot is pointed downward; the plantar is flexed,” says Frey. “So with the first steps, there is increased pain as added stretch and strain is placed on the fascia.” However, warns Parekh, a client who experiences heel pain may also have a variety of other problems, so a physician’s diagnosis is recommended. More severe problems that may cause heel pain include a stress fracture of the heel bone, a tumor in the heel bone, a broken bone, rheumatoid arthritis or lupus. A doctor can easily make a diagnosis based on a brief physical examination and an X-ray.
Prescription for Relief
If your client is diagnosed with plantar fasciitis, she can take several steps to alleviate the problem. Parekh notes that a three-pronged approach is used as the first line of treatment: physical therapy and stretching; a splint worn overnight that prevents the fascia from tightening; and extra cushioning in shoes. Anti-inflammatory medicines such as Tylenol also help. “If conservative care fails, we will try steroid injections. If that fails, we might try platelet rich plasma injections, which injects the healing part of blood into the heel, or ultrasound or shockwave therapy.” A last-ditch effort would involve a surgery in which the plantar fascia is cut, but Parekh finds that less than 10% of clients require this solution (among that 10%, he estimates that 80% to 90% of people receive long-term relief from the surgery).
Unfortunately, plantar fasciitis may require your clients to hang up the stilettos for a period of time. Because ill-fitting shoes can exacerbate the problem, clients should be encouraged to choose function over fashion when selecting everyday footwear. But with this in mind, Frey adds another possible solution for clients with this problem: “It’s not unusual for a patient to say that she feels better in a high heel. It actually can make you feel better, as you throw the weight off the heel and onto the ball of the foot. This isn’t traditionally a recommended treatment, but a small heel can be of help.”
As a nail tech, you can help a client who has been diagnosed with plantar fasciitis. Parekh and Frey both note that massage helps clients feel more comfortable, while warm soaks relieve tension and relax the feet. “I personally have experienced plantar fasciitis. My doctor had me on Motrin and asked me to do stretching exercises with the foot that was in pain,” says Linda Staley, nail technician at Anasa Hair Studio & Spa in Lake Elsinore, California. “Since then, I’ve had a few clients with it and found that with those clients, after the warmth of the pedicure tub and then a gentle massage, the pain subsided.”
All of your clients’ feet take literally tons of pounding throughout the day, which pampering pedicures relieve. But if a client tells you of her problems with plantar fasciitis, take a little time to show her extra attention and care with an additional minute of massage or a few drops of soothing oil in her pedicure bath. These minor tweaks will show your client that you’re especially attentiv e to her needs—leading to an improved feeling for her, and a long-term client for you!
Tracy Morin is a freelance writer and editor based in Oxford, MS.
The American Academy of Family Physicians recommends that a person with plantar fasciitis complete the following stretches at least twice per day. As always, a client should consult her physician before starting any exercise program.
Foot Strengthening Stretch Grab a towel with your toes as if you were going to pick up the towel with your foot. Repeat this exercise several times a day.