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Hi all,

I have a patient presenting with severe tightness, but not pain, in his plantar fascia. He gets frequent cramps in the foot muscles too (takes magnesium). He is 81 years old. Details:
- PFascia palpably tight
- Tightness sensation extends from heel into the arch
- Cavus foot with PF 1st ray
- Reduced AJ ROM
- 1st MPJ ROM restricted
- He also has biceps femoris tendonitis and tib ant mm fatigue on one side

Management so far (over 2 apptmts):
- Daily massage of PFascia
- Spiky ball massage
- Low Dye taping
- AJ mobes
- DTMR calf mm's
- Calf stretches
- Intrinsic control exercises

His 'tightness' sensation has gotten marginally better, but not as better as I would have liked. Is there anything I could be missing here? My main issue is that the pain isn't the main presentation, it's the tightness. Any ideas woulf be appreciated!

WM

 

All I can suggest is to keep doing what you are doing ... it might be a long road given his age.