Archive for the ‘Reader questions’ Category

Reader Questions

Happy new year, everyone. I thought I’d start the year off with some information about my “Target” products. There are a few questions I get on a regular basis, so I’ll try to answer them below.

Q: What is contained in the free mini-course that you give away on the right side of your blog?

A: The mini-course is basically a quick education on plantar fasciitis, plantar fasciosis, and why you should treat them differently. It has some tips on nutrition and treatment, and clears up a lot of the confusion that people have about the two conditions. (The information is also relevant to tendonitis/tendonosis.) If you sign up for it, you’ll get an email every day or two for a couple of weeks, giving you various aspects of the issue. And yes, I’m selling something here, so you’ll also get some information about my ebook+video package. But it’s a pretty soft sell, and you certainly aren’t obligated to buy anything.

Q: I heard that your ebooks have sold in something like thirty countries. Is that really true?

A: Actually, they have sold in more than forty countries worldwide. If you’re interested, here’s a list for just the past month:

The UK, the USA, Cyprus, Switzerland, Australia, Portugal, France, New Zealand, Canada, Singapore, Japan, South Africa, Hong Kong, Turkey and Ireland.

Q: I was looking for Target Plantar Fasciitis on Kindle. I thought I saw it listed, but now I can’t find it.

A: I used to have both the Target Books (Target Plantar Fasciitis and Posterior Tibial Tendonitis, and Target Tendonitis) on Kindle, but I took them down. One reason, frankly, was that I was tired of paying Amazon two-thirds of the cover price, but the more important issue was that there wasn’t any way of getting the videos bundled with the book on the Kindle platform, and without those a lot of people seemed to have a hard time understanding how to perform the exercises I recommend.

Q: I don’t really like ebooks. Can I order a hard- or soft-cover version of TPF?

A: Sorry, but I don’t offer anything other than the PDF version. The reason is the same as the answer to the last question: no way to include the video without adding a lot to the cost. Plus, 99% of the people who buy my books are in fairly severe pain and want to get rid of it as fast as possible. They don’t want to wait 2-3 days (or longer in the case of international sales) for a regular paper book to be shipped.

Q: Do you offer your ebooks in languages other than English?

A: I’m working on it. The Japanese version of Target Tendonitis has been completed and is now on sale. Target Plantar Fasciitis has yet to be translated into another language, but if there is a demand for it, please let me know via the contact form on this website.

Q: Why doesn’t stretching work to get rid of my plantar fascia pain?

A: Stretching is great for preventing pain, but not really effective for getting rid of a problem once you’ve got it. If you have either fasciitis (inflammation of the fascia) or fasciosis (degeneration of the fascia tissue), stretching won’t help much. And in the case of fasciosis, too much stretching may actually cause further damage if the connective tissue has been weakened beyond a certain point.

Q: Is there a quick way to tell which condition I have, plantar fasciitis or plantar fasciosis?

A: Yes. The quickest and easiest way is to just take the test that I’ve put together here. It’s free and only takes about a minute to complete.

Hope this helps. If you have a question that you’d like to have answered, either leave a comment below or use the contact page to get in touch.

The Real Cost of Plantar Fascia Pain

Ever wonder what the actual cost of an ongoing condition like plantar fasciitis is? There are some studies that have attempted to estimate it, but those numbers are probably low. For a better, more visceral idea of what the continued search for relief can cost, check out this post from someone who still hasn’t found the answer:

You ask what people have tried and the cost and effectiveness of those treatments. I’ve taken prescription NSAIDs ($10 per month, thanks to insurance). I’ve tried inexpensive shoe inserts from the store, which didn’t work. The thing that helped most was PT exercises which I found online (free). Unfortunately, that only lasted six months, then things got worse and I talked to my doctor ($20) who ordered an MRI (my share was $315, since I’d already met my insurance deductible). The doctor then referred me to a podiatrist ($20). The podiatrist had me get $50 orthotics and follow up in two months ($20). Those orthotics didn’t help, so the doctor measured me for $400 custom-made orthotics (not covered by insurance) and had me follow-up in another two months ($20), and again a year later ($30). Another four months later ($30). Along with the custom orthotics, I bought three pair of good-quality shoes that the orthotics will fit into ($170, $145, $110). I’d rate the effectiveness of orthotics about 80%, so long as I wear shoes all day every day. This requires extra carpet shampooing since we don’t typically wear shoes in our house. Add to that all the time and fuel required to go to all those appointments, the time to do the exercises, and ongoing pain. Recently the pain has increased, so I have another appt with the podiatrist scheduled, and might be told to try another expensive, ineffective treatment.

The page that the quote comes from is here (the second “reply” down from the top). Note that this person (a) has what appears to be some pretty good insurance and that (b) even though this list still isn’t exhaustive, it totals up to more than twelve hundred dollars (none of which, I’ll bet, came with a money-back guarantee). And the condition still isn’t healed.

Why? Well, I can’t say for sure, but I think I have a pretty good idea. Let me use a completely different example to make a point. Imagine that you have a toothache, and that the only remedy is to pull the tooth. You go to a dentist, lie back in the chair, get shot up with novocain and have your left bicuspid extracted. Now, if the problem was really with your left bicuspid, you’re golden. But if it was really the incisor that was causing the pain, you’re going to be in for an unpleasant surprise when you get home and the novocain wears off.

I’ve said it before, but since the Mayans were wrong and the world is still here I’ll say it again: The reason so many people fail to find relief from “plantar fasciitis” is that they don’t have plantar fasciitis in the first place. If you’re calling a condition by a name that suggests one problem but in fact you actually have a different problem, it stands to reason that no matter how many “cures” you try, you’re not going to get any better.

Here’s the deal: Any kind of “~itis” indicates inflammation, and inflammation by itself is usually pretty short-lived. A week or two at the most. If you’ve had plantar fascia pain for longer than that, the chances are very good (like, 95%) that your condition is plantar fasciosis, not plantar fasciitis. (Of course, you could have both at the same time. But in that case it’s the ~osis that’s causing the ~itis to flare up for so long.)

This is the main question for most people with persistent PF pain, so I created a quick and easy (and free!) plantar fascia test to help them make a more informed judgement on the matter. The test only takes a minute, and as you can see from the above, it might just save you a lot of time and money.

About the author:
Alex Nordach has been involved in the health and fitness industry for over 30 years.  His ebooks, Target Tendonitis and Target Plantar Fasciitis have sold thousands of copies world-wide and been translated into other languages.  If you have had tendonitis or plantar fasciitis for more than two weeks, chances are that your problem isn’t an “itis” but an “osis” – as in tendonosis or plantar fasciosis.  Check out the links above to learn more.

Author: Alex Nordach

Fascia degeneration

I got a really interesting question a few days back from someone who saw one of my videos. He asked: “How can there be a quick recovery for tendonosis, which is tendon degeneration, if it takes collagen (what tendons are made of) 100 days on average to regenerate?” This question was about tendons, but it applies equally well to fascia, since fascia are made up of collagen as well.

This question is great. I love it when someone asks about a topic in an informed and constructive manner. First of all, you have to remember that “degeneration” doesn’t always equate to “destruction”. Degeneration in the context of tendonosis (or fasciosis) can mean several things, one of which is the destruction of the collagen fibers. This is sometimes seen with Levaquin patients, and in those cases recovery normally does take several months, if it happens at all. But most of the time it simply implies a degeneration in function or ease of movement rather than actual damage to the collagen fibers themselves.

What happens is this: in much the same way that adhesions affect muscle tissue, tendons and fascia that are affected by tendonosis or fasciosis develop points or sections along the fibers that begin to bind together. With skeletal muscle fibers, the mechanism is pretty clearly understood: tiny fibers are grouped into bundles to create larger fibers, which are in turn grouped into still larger bundles, until you have a three-tier structure.

Muscle and tendon structure

These bundles slide along each other at every level when a muscle is functioning normally, but when adhesions develop they stick at certain points, which then causes pain during movement. A competent physical therapist can ordinarily find these areas just by feeling along the muscle. Then s/he can use finger pressure to break up the adhesions and get the muscle back into proper working order.

With tendons and fascia, the situation isn’t as clear. One factor is that collagen doesn’t contract…but it does stretch and have some tensile strength. Perhaps because of this, simple finger pressure or massage is typically not enough to break up the adhesions that form. This is partly because collagen isn’t as flexible as muscle fiber, and partly because the location of the tendon or fascia itself can be harder to get at. Also, since tendon and fascia fibers don’t slide along each other the way muscle fibers do, the theory is that the collagen fibers somehow get intertwined, developing what could be pictured as “crosshatches” of collagen. A method of re-aligning the fibers, so that they no longer interfere with each other, is necessary.

Some type of “collagen comb” that could go through the fibers and straighten them out would be ideal. But since that’s not possible, the next best thing is specialized exercises that, over the course of a couple of weeks, will generally accomplish the same effect. You don’t need to go to a lot of expense on this, either. There is a large body of research that indicates that simple collagen strengthening and rehabilitation exercises done at home can be just as effective as platelet-rich plasma, cortisone shots and other such “cutting-edge” treatments.

Nutrition for tendon and fascia pain

I recently received a question from someone who purchased Target Tendonitis. He asked about the advisability of fasting if you have tendonosis.

Although fasting can have some beneficial effects, I do not advise anyone who is suffering from tendon or fascia problems to do it. The reason is simple: your body needs nutrients to heal itself, and if you’re fasting you’re not providing it with the basic “stuff” that’s necessary to do the job. I recommend some nutritional supplements in the book, but these recommendations are based on the assumption that your basic nutritional needs are already being met. If they aren’t, the supplements aren’t going to do you much good by themselves. A diet that is lacking in vitamins, minerals or protein (to say nothing of all three at once!) is going to pose serious, serious problems when it comes to healing your tendons.

Assuming that your basic diet is okay, one thing you can do to help heal yourself if you have tendonosis or fasciosis is get a good kelp supplement and take it regularly. Kelp contains iodine, which is helpful for the formation of collagen, the basic building block of tendons and fasciae. My favorite out of the products listed on Amazon is Icelandic kelp, which is harvested during the cold months and washed in high-mineral fresh water, which adds further minerals to the already good mix that kelp naturally contains.

Author: Alex Nordach