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Dr Zuckerman: question re stretching post treatment

Posted by Helen on 2/27/00 at 00:00 (016480)

Stretch AFTER you start feeling better, ie post Ossatron? Can you clarify? I was told to begin stetching right away.

Helen
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Re: Dr Zuckerman: question re stretching post treatment

Dr. Zuckerman on 2/27/00 at 00:00 (016486)

Start to stretch right away if this is possible. Don't over do it if you are in pain. Only stretch the leg muscles not the foot muscles.
I am going to say something that is going to make alot of people mad that you can't stretch the PF with excerises. I have a hard time cutting this very thick and fibrous material in surgery.. You may be able to stretch other foot muscles but the PF forget it. I don't care what product or what method is used. CAN'T BE DONE. So stretch the achilles tendon with feet in full contact with the ground don't try to lift the foot off of the ground at all. If you do all you will doing is stressing the pf which is already been stress enough

Dr. Zuckerman
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Re: Dr Zuckerman: question re stretching post treatment

Mike W on 3/02/00 at 00:00 (016773)

Hello DR.Z,

I am not mad,however I have several problems with what you posted.
As you know there are 15 extrinsic LL muscles located between the knee and the ankle that have tendons that either attach to or pass through/around the heel or toe bones.

So if you are concerned about the intrinsic foot muscles then what about the extrinsic tendons?

The PF is not a muscle. Tendons are inelastic and therefore do not stretch very well. I agree that you can't and should not stretch the PF. The flexor digitorum and hallcius brevis muscles are enveloped by the PF on the other side of the PF and are what should and can be stretched and strengthened.

As far as stretching the achilles, again you do not want to stretch a tendon you want to stretch the related muscles Gastrox, Soleus. What about the anterior LL muscles?

I also have a problem with standing stretches because the muscles will be contracted prior to the stretch which causes extra tension on tendons that are already painful.

Regards,
Mike W,Physical Therapist, Personal Foot Trainer President, and former chronic PF sufferer, Email (email removed)


posted to the eswt board


Re: Dr Zuckerman: question re stretching post treatment

Dr. Zuckerman on 3/02/00 at 00:00 (016788)

If you can stretch the intrinsic foot muscles on the plantar surface of the foot such as the FHL and FDB, and the rest . This would be great. I just find it very hard to do. If your personal foot trainers can do this then it should be done. Just don't over stretch the PF .

Dr. Zuckerman

posted to the eswt board


Re: Dr Zuckerman: question re stretching post treatment

Dr. Zuckerman on 2/27/00 at 00:00 (016486)

Start to stretch right away if this is possible. Don't over do it if you are in pain. Only stretch the leg muscles not the foot muscles.
I am going to say something that is going to make alot of people mad that you can't stretch the PF with excerises. I have a hard time cutting this very thick and fibrous material in surgery.. You may be able to stretch other foot muscles but the PF forget it. I don't care what product or what method is used. CAN'T BE DONE. So stretch the achilles tendon with feet in full contact with the ground don't try to lift the foot off of the ground at all. If you do all you will doing is stressing the pf which is already been stress enough

Dr. Zuckerman
posted to the eswt board


Re: Dr Zuckerman: question re stretching post treatment

Mike W on 3/02/00 at 00:00 (016773)

Hello DR.Z,

I am not mad,however I have several problems with what you posted.
As you know there are 15 extrinsic LL muscles located between the knee and the ankle that have tendons that either attach to or pass through/around the heel or toe bones.

So if you are concerned about the intrinsic foot muscles then what about the extrinsic tendons?

The PF is not a muscle. Tendons are inelastic and therefore do not stretch very well. I agree that you can't and should not stretch the PF. The flexor digitorum and hallcius brevis muscles are enveloped by the PF on the other side of the PF and are what should and can be stretched and strengthened.

As far as stretching the achilles, again you do not want to stretch a tendon you want to stretch the related muscles Gastrox, Soleus. What about the anterior LL muscles?

I also have a problem with standing stretches because the muscles will be contracted prior to the stretch which causes extra tension on tendons that are already painful.

Regards,
Mike W,Physical Therapist, Personal Foot Trainer President, and former chronic PF sufferer, Email (email removed)


posted to the eswt board


Re: Dr Zuckerman: question re stretching post treatment

Dr. Zuckerman on 3/02/00 at 00:00 (016788)

If you can stretch the intrinsic foot muscles on the plantar surface of the foot such as the FHL and FDB, and the rest . This would be great. I just find it very hard to do. If your personal foot trainers can do this then it should be done. Just don't over stretch the PF .

Dr. Zuckerman

posted to the eswt board