Another BFR Success Story: Healing Heel Pain
One of the themes here at The BFR Pros is that we never look at a patient and think, “How can I use BFR with this person?” Rather, we think, “Can BFR be a tool that can help this person get back to his/her specific goals?” This paradigm was foundational to the treatment of the woman featured in this BFR success story.
Today we have a 51-year-old female with left heel pain. Past medical history includes hypothyroidism (controlled with medication), chronic intermittent low back pain with sciatica, and anxiety (controlled with medication). Recent X-rays of the left heel were negative for fracture and the patient was diagnosed with plantar fasciitis. She recreationally performs a mixture of cardio and weight lifting at a local gym and works as an athletic trainer in a busy physical therapy office, which requires her to stand and walk for 8 hours Monday through Friday. She also was extremely passionate about remodeling her home, performing yard work, and caring for and walking her dog.
Physical examination findings included pain, weakness, decreased walking tolerance, and difficulty with standing after prolonged sitting. Her main goals were to decrease pain, improve standing and walking tolerance, and return to her active lifestyle.
Since this woman was no stranger to exercise, I skipped Pillar 1 (passive BFR) and Pillar 2 (aerobic training) and went right to Pillar 3 (resistance exercise) and implemented 3×10 standing heel raises with a towel roll under her toes at 60% LOP about 3 reps shy of failure. She was instructed to shift her weight to the unaffected side to unload the affected side as needed. We progressed load (reported percentage of bodyweight being put through the affected side) and proximity to failure and added leg presses and squats the following week. All was tolerated extremely well.
After 2 weeks, this particular patient experienced immediate pain reduction and was able to stand and walk at work for ~1 hour before symptom onset. We continued using BFR until she was able to tolerate heavier loads, at which point we transitioned away from BFR training…as we always say at The BFR Pros, BFR training is a bridge to heavy training. After about a month, our patient was able to complete an entire shift at work with only mild discomfort. She experienced mild flare-ups only if she had a particularly physically active day or weekend, but overall, she was back in action!
Was BFR training the reason our rock star ATC did so well? Of course not. Did BFR training play a key role in her ability to accelerate the healing process and improve strength without using heavy loads? You bet!
We can make a difference and we can be leaders in our field, but we need your help! Spread the word! We’re here and won’t stop until our job is done. Who’s with us?
****Remember, the decision to use BFR, or any treatment for that matter, should be based on the pillars of evidence-based practice.
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