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questions about tts (sorry for so many)

Posted by alan k on 12/14/99 at 00:00 (013753)

I now am %95 convinced I have tts, though maybe also pf.
I don't feel good about it, but wendyn is right, I have to adjust to the situation by accepting it, while also holding out hope. I madethe adjustment when I thought I had pf, and so I can do it again.

I still don't understand how it works-- like how entrapment up the nerve causes burning feet (I get that part actually) but why does icing the bottom of the feet make it better, since the cause is in the ankle part?

I have tapped all over for tinnels sign for a long time with mixed results, but only in the last week have I had a clear sign that I can reproduce any time. It is not due to a discovery, but something has changed. I wonder if it is nightsplints or stretching (I was being more responsible about stretching lately) that could be aggravating the nerve. My pod says this wouldn't be so (so I guess that settles the question!).

Also, why would message of the feet help people with tts if the feet aren't the thing, it's the nerve on the ankle?
Also, why would pressure on the sole hurt the feet (such as I get from wearing sneakers or shoes too long) if there is no standing pressure on the nerve in the ankle, just the sole? I guess it must be that the nerve pinch makes the sole ends of the nerves sensitive too? But that doesn't make sense.

Also, I don't get how anyone with tts, or pf for that matter, could exersize on a bike. Pushing on the pedals must put pressure on the ankle/nerve. I will buy a bike if someone can answer that. Also, if I find some money.

Sorry about all the posts , but I am learning a lot and I hope maybe the on-lookers are too. Seems like alot of people posting know about tts, so it's really helpful for me.

thanks, alan k


Re: questions about tts (sorry for so many)

Alan K on 12/15/99 at 00:00 (013754)

Alan -- where exactly do you tap to elicit this pain? What do you use to tap? I'd like to see if I could replicate this on myself. I would also suggest you get a nerve conduction test to say for sure this is TTS.

Since I have had this, I have been a pretty avid biker. Biking doesn't bother me. Try it out on a friend's bike to see how it feels before you buy one.

Of all the treatments I have tried, only intense massage to the feet makes it feel better. I'm not sure why this is, but perhaps the breaking up of scar tissue reduces pressure on that nerve? Maybe it's not just a matter of the nerve being pinched up at the ankle, but maybe it being irritated down in the arch -- like that Baxter nerve that John talks about.


Re: questions about tts (sorry for so many)

wendyn on 12/15/99 at 00:00 (013761)

Ummmm.....where do we start?

I have a binder full of information on TTS that I've printed off on the internet, but I'm posting from work..so we'll wing it...have you ever whacked your elbow? If you smack your elbow it can cause intense weird pain not only in your elbow but right down your arm (it's been a while since I've done it but I recall it can cause some pretty bizarre sensations). I think TTS works the same way. Despite the fact the actual problem is in your ankle, the nerves being supplied from there all respond to the compression. Also, I read that because the blood supply to the nerves in the bottom of your feet is restricted (there is an artery that runs through the tarasl tunnel too), they react by creating pain from lack of oxygen. Sounds pretty reasonable to me.

Ice reduces inflammation and can help with pain. Try icing the tarsal tunnel area instead of just the bottom of your foot, or soak your feet in ice water for 15 or 20 minutes, with the water up a few inches above your ankle. This can take some getting used to, but it is effective if your pain is bad. No, it won't hurt you (wouldn't do it if I was diabetic or had circulation problems) - I've checked out out with the PT and the doctors and none of them thought it could cause frotst bite or anything - but it is REALLY COLD!

Massage is a mystery to me, but I know that it seems to work on all kinds of things. My uneducated theory is that anything that causes an increase in blood flow is helpful for healing....maybe it's positive energy that makes your feet think they feel better? Who knows? I only recently started trying to gently massage my feet - before they hurt too much to look at let alone actually touch.

My PT and two sports med doctors insist that I should be able to bike. My past experience was that the constant stretching and ankle movement aggravated not only my foot, but my sciatic nerve up the back of my leg (this is connected to the nerve that goes to your Tarsal Tunnel). I have recently started using a 'recumbent' bike, you're kind of sitting down with back support. I move the seat up as far as I can so my legs aren't stretched out too far. I'm up to 2 or 3 minutes of very very slow rotations. (Look like a complete loser at the gym, I'm sure people wonder why I bother at all) I am not going to rush this.

I don't know exactly how TTS works, but I think that the longer you stand, the more inflammation and swelling you cause in the Tarsal tunnel, this compresses the nerve and then causes the pain in your foot. I do have a number of sites that I can send you to take a look at - or I can post them if you want. Let me know.....



Re: questions about tts (sorry for so many)

alan k on 12/15/99 at 00:00 (013763)

Thanks for your usual generousity wendyn

I would be interested in any info. I can't seem to find much online. Don't know why I keep getting the same things.

Do you message the tarsal area itself? It seems like that might make it worse. Or do you message the soles?


alan k


Re: questions about tts (sorry for so many)

alan k on 12/15/99 at 00:00 (013764)

Interesting. The region to tap is around the ankle, on the inside side of the leg, running in the corridor between the ankle and the heel, and also under the ankle. You need to tap all over for a long time to be sure you hit every millimeter of it.
If you get any sensation you should post a description of it, and any tts'er will be able to say whther its positive tinnel sign. More tests are necessary for a real diagnosis. I am getting the electric conduction test soon.

Note that I was negative for a long time on tinnel test, even when my feet were at their worst. I don't know what this means, but it can't be good for making us feel certain about these matters.

alan k


More


Re: questions about tts (sorry for so many)

john h on 12/15/99 at 00:00 (013766)

on a stationary bike you can set the level of resistance. if you set it rather low (level 3) you are putting very little pressure on the bottom of the feet and still getting aerobic benefits.you should also put feet well into the foot holders so you are not peddling with your toes. iceing numbs the feet and nerves. any movement of foot an ankle can cause movement of nerves in ankle or something that is touching nerve.

Re: questions about tts (sorry for so many)

john h on 12/15/99 at 00:00 (013767)

forgot to mention what wendy says and that the recumbent bike is the way to go. for wendy: i sort of move back some on the bike rather than sit real close so as to get some stretch in the calves and hamstrings?

Re: questions about tts (sorry for so many)

john h on 12/15/99 at 00:00 (013768)

doctor told me to be very careful about massaging the tarsal tunnel area as you can aggrevate the problem. i let a reflexologist work the area over about a year ago in a real aggressive manner and it really set me back.

Re: questions about tts (sorry for so many)

john h on 12/15/99 at 00:00 (013769)

for a long time i tried to press real hard on the bottom of my foot and heel to reproduce pain. i could never do it. recently a massage thearpist was pressing real hard and indeed produce pain direct over the site of the baxter nerve. this point would be just forward of the heel on the inside EDGE of the foot. about where the big fascia band from the big toe connects to the heel. this is the point where a small section of fascia is removed using the baxter procedure. she could only produce the pain in one foot and that was the foot that was not operated on.

Re: questions about tts (sorry for so many)

john h on 12/15/99 at 00:00 (013770)

even with a positive electric conduction test it does not mean that you need surgery or that is the cause of your pain. the test results are usually very subjective as my surgeon told me. the test is not just positive or negative but an infinite range in between.

Re: questions about tts (sorry for so many)

wendyn on 12/15/99 at 00:00 (013778)

No, I don't really touch the tunnel area at all, except with ice packs. I gently massage the bottom of my foot and my toes - whenever they hurt. I don't really know if it does anything than provide some temporary 'feel better'



Re: questions about tts (sorry for so many)

Alan K on 12/15/99 at 00:00 (013754)

Alan -- where exactly do you tap to elicit this pain? What do you use to tap? I'd like to see if I could replicate this on myself. I would also suggest you get a nerve conduction test to say for sure this is TTS.

Since I have had this, I have been a pretty avid biker. Biking doesn't bother me. Try it out on a friend's bike to see how it feels before you buy one.

Of all the treatments I have tried, only intense massage to the feet makes it feel better. I'm not sure why this is, but perhaps the breaking up of scar tissue reduces pressure on that nerve? Maybe it's not just a matter of the nerve being pinched up at the ankle, but maybe it being irritated down in the arch -- like that Baxter nerve that John talks about.


Re: questions about tts (sorry for so many)

wendyn on 12/15/99 at 00:00 (013761)

Ummmm.....where do we start?

I have a binder full of information on TTS that I've printed off on the internet, but I'm posting from work..so we'll wing it...have you ever whacked your elbow? If you smack your elbow it can cause intense weird pain not only in your elbow but right down your arm (it's been a while since I've done it but I recall it can cause some pretty bizarre sensations). I think TTS works the same way. Despite the fact the actual problem is in your ankle, the nerves being supplied from there all respond to the compression. Also, I read that because the blood supply to the nerves in the bottom of your feet is restricted (there is an artery that runs through the tarasl tunnel too), they react by creating pain from lack of oxygen. Sounds pretty reasonable to me.

Ice reduces inflammation and can help with pain. Try icing the tarsal tunnel area instead of just the bottom of your foot, or soak your feet in ice water for 15 or 20 minutes, with the water up a few inches above your ankle. This can take some getting used to, but it is effective if your pain is bad. No, it won't hurt you (wouldn't do it if I was diabetic or had circulation problems) - I've checked out out with the PT and the doctors and none of them thought it could cause frotst bite or anything - but it is REALLY COLD!

Massage is a mystery to me, but I know that it seems to work on all kinds of things. My uneducated theory is that anything that causes an increase in blood flow is helpful for healing....maybe it's positive energy that makes your feet think they feel better? Who knows? I only recently started trying to gently massage my feet - before they hurt too much to look at let alone actually touch.

My PT and two sports med doctors insist that I should be able to bike. My past experience was that the constant stretching and ankle movement aggravated not only my foot, but my sciatic nerve up the back of my leg (this is connected to the nerve that goes to your Tarsal Tunnel). I have recently started using a 'recumbent' bike, you're kind of sitting down with back support. I move the seat up as far as I can so my legs aren't stretched out too far. I'm up to 2 or 3 minutes of very very slow rotations. (Look like a complete loser at the gym, I'm sure people wonder why I bother at all) I am not going to rush this.

I don't know exactly how TTS works, but I think that the longer you stand, the more inflammation and swelling you cause in the Tarsal tunnel, this compresses the nerve and then causes the pain in your foot. I do have a number of sites that I can send you to take a look at - or I can post them if you want. Let me know.....



Re: questions about tts (sorry for so many)

alan k on 12/15/99 at 00:00 (013763)

Thanks for your usual generousity wendyn

I would be interested in any info. I can't seem to find much online. Don't know why I keep getting the same things.

Do you message the tarsal area itself? It seems like that might make it worse. Or do you message the soles?


alan k


Re: questions about tts (sorry for so many)

alan k on 12/15/99 at 00:00 (013764)

Interesting. The region to tap is around the ankle, on the inside side of the leg, running in the corridor between the ankle and the heel, and also under the ankle. You need to tap all over for a long time to be sure you hit every millimeter of it.
If you get any sensation you should post a description of it, and any tts'er will be able to say whther its positive tinnel sign. More tests are necessary for a real diagnosis. I am getting the electric conduction test soon.

Note that I was negative for a long time on tinnel test, even when my feet were at their worst. I don't know what this means, but it can't be good for making us feel certain about these matters.

alan k


More


Re: questions about tts (sorry for so many)

john h on 12/15/99 at 00:00 (013766)

on a stationary bike you can set the level of resistance. if you set it rather low (level 3) you are putting very little pressure on the bottom of the feet and still getting aerobic benefits.you should also put feet well into the foot holders so you are not peddling with your toes. iceing numbs the feet and nerves. any movement of foot an ankle can cause movement of nerves in ankle or something that is touching nerve.

Re: questions about tts (sorry for so many)

john h on 12/15/99 at 00:00 (013767)

forgot to mention what wendy says and that the recumbent bike is the way to go. for wendy: i sort of move back some on the bike rather than sit real close so as to get some stretch in the calves and hamstrings?

Re: questions about tts (sorry for so many)

john h on 12/15/99 at 00:00 (013768)

doctor told me to be very careful about massaging the tarsal tunnel area as you can aggrevate the problem. i let a reflexologist work the area over about a year ago in a real aggressive manner and it really set me back.

Re: questions about tts (sorry for so many)

john h on 12/15/99 at 00:00 (013769)

for a long time i tried to press real hard on the bottom of my foot and heel to reproduce pain. i could never do it. recently a massage thearpist was pressing real hard and indeed produce pain direct over the site of the baxter nerve. this point would be just forward of the heel on the inside EDGE of the foot. about where the big fascia band from the big toe connects to the heel. this is the point where a small section of fascia is removed using the baxter procedure. she could only produce the pain in one foot and that was the foot that was not operated on.

Re: questions about tts (sorry for so many)

john h on 12/15/99 at 00:00 (013770)

even with a positive electric conduction test it does not mean that you need surgery or that is the cause of your pain. the test results are usually very subjective as my surgeon told me. the test is not just positive or negative but an infinite range in between.

Re: questions about tts (sorry for so many)

wendyn on 12/15/99 at 00:00 (013778)

No, I don't really touch the tunnel area at all, except with ice packs. I gently massage the bottom of my foot and my toes - whenever they hurt. I don't really know if it does anything than provide some temporary 'feel better'