Once again i stumbled across this seemingly popular treatment for plantar fasciitis, this time, on Dr. Richard Blake's blog (http://www.drblakeshealingsole.com/2010/05/quick-tip-7-rolling-ice-stretch-for.html). This one has got me thinking for a while now....i cant find any RCT's specifically utilising this method as a stand alone treatment, although I know that anecdotally it seems quite effective at reducing symptoms. My question is this, is it effective for the reasons that are described in the above blog or by other means?
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When a tissue is cooled (i.e. through the application of ice) it's load-deformation characteristics are altered. The tissue's ability to strain under load is reduced and therefore will not "stretch" as much. How does this affect the healing process? Does this mean that with the ice bottle less force should be applied than when using a golf/tennis ball that allows greater strain of the PF before reaching its plastic zone? Although more time consuming, wouldn't it be more appropriate to stretch the PF with a warm water bottle to reduce the amount of stress placed on the PF while elongating it to a more functional length. If the plantar fasciitis is in the acute phase or if inflammation still needs addressing then an ice pack could be applied afterwards for 10-20mins.
I came to the conclusion during my exercise science days that you should never stretch "cold" or before warming up the tissue to be stretched, this is probably why I am so confused.
I guess i just want to learn more about HOW this treatment works...
Regards,
Thomas Do Canto (3rd year pod student)
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