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STRETCHING/ORTHOTICS

Posted by JUDY B on 9/06/00 at 12:39 (027384)

Dear Doctors: I think I have injured my heelcords by overstretching.(I am the one who was in the cast boots X 9 weeks ending in June). The heelcords have a burning sensation (this will go away after being off my feet for a while) and numbness in the calf ms. I've been doing plantar/dorsiflexion of the feet lying down. The burning began when I started holding the stretch longer (5-7 seconds). Should I stop all stretching? Will continued stretching permanently damage the heelcord so that walking will always be painful?

Also, I am currently wearing orthotics (semi-rigid) with approx. 1/2' lift. The shoes that they are in has approx. 1/2-3/4' lift for a total of 1 1/4-1/1/2' lift. I'm concerned that this much of a lift will prevent me from wearing a flatter shoe once my feet are healed due to a shortening of the heelcord. Is this true or should I be able to stretch out enough once the feet are healed? This seems like such a viscous circle - you wear a lift to let the foot heal then reinjure stretching out!

Re: STRETCHING/ORTHOTICS

Dr. Biehler on 9/06/00 at 13:03 (027385)

The high lifts take the pressure off the achillies while walking giving it time try to heal itself if it is injured. How much doriflection do you have? 15 degrees is what is normaly needed. If you are no where near this you have to be very carefull when streching. If you foot is in equius,this means you can't get your foot to a 90 degree angle to your leg, then you reinjure youself every time you stand or walk barefoot or in low heels. If you are feeling pain while streching you might be tearing what you are trying to strech. Dr. Biehler

Re: STRETCHING/ORTHOTICS

JUDY B on 9/07/00 at 07:02 (027447)

Dr. B....I can get my foot to a 90 degree angle to my leg before I really start to feel pulling. I could go a little beyond this prior to the burning I am experiencing.
1) Should I wait till the burning is gone before stretching or should I continue to stretch (if so, how far)?
2) Once the achilles is shortened can it be stretched out?
3) Should I try to wean into a shoe with a lower heel lift since the orthotics already have a lift (i.e. using shoes with little/no lift with a progressively lower heel lift put under my orthotic)

I guess my concern is that by continuing to wear a 1 1/2' heel lift I will always have to wear shoes/orthotics with this much lift to avoid reinjury. This doesn't seem great for my ankles/knees/bunions. thanks for your help!!

Re: STRETCHING/ORTHOTICS

Dr. Biehler on 9/07/00 at 10:09 (027462)

If you can get your foot to 90 degrees, see if you can get it higher when your knee is bent. If you can, then your gastrocs are tight. With the 90 degrees you can walk in a shoe that has a rocker bottom. Be very carefull with the streching. This could take alot of time and sometimes surgery to lenghthen the achillies is considered. You have to be sure the motion is not being limited by bony or tendonis blocks around the ankle. If it is just a tight posterior muscle group, use the heel lifts, get rocker bottom shoes ( some people can't use them) and be carefull with the streching. You might need profesional help in the streching department. It sounds like you are over doing it with the streching. Dr. Biehler

Re: STRETCHING/ORTHOTICS

judy b on 9/08/00 at 11:17 (027557)

Dr. B...Do shoes with a roller bottom (where the bottom of the shoe is made rigid and the toe is curved up) accomplish the same thing as the rocker bottom (where the sole has a sharp angle at the toe) to accomodate for my lack of dorsiflexion?

Re: STRETCHING/ORTHOTICS

Dr. Biehler on 9/08/00 at 12:01 (027562)

Yes

Re: STRETCHING/ORTHOTICS

Dr. Biehler on 9/06/00 at 13:03 (027385)

The high lifts take the pressure off the achillies while walking giving it time try to heal itself if it is injured. How much doriflection do you have? 15 degrees is what is normaly needed. If you are no where near this you have to be very carefull when streching. If you foot is in equius,this means you can't get your foot to a 90 degree angle to your leg, then you reinjure youself every time you stand or walk barefoot or in low heels. If you are feeling pain while streching you might be tearing what you are trying to strech. Dr. Biehler

Re: STRETCHING/ORTHOTICS

JUDY B on 9/07/00 at 07:02 (027447)

Dr. B....I can get my foot to a 90 degree angle to my leg before I really start to feel pulling. I could go a little beyond this prior to the burning I am experiencing.
1) Should I wait till the burning is gone before stretching or should I continue to stretch (if so, how far)?
2) Once the achilles is shortened can it be stretched out?
3) Should I try to wean into a shoe with a lower heel lift since the orthotics already have a lift (i.e. using shoes with little/no lift with a progressively lower heel lift put under my orthotic)

I guess my concern is that by continuing to wear a 1 1/2' heel lift I will always have to wear shoes/orthotics with this much lift to avoid reinjury. This doesn't seem great for my ankles/knees/bunions. thanks for your help!!

Re: STRETCHING/ORTHOTICS

Dr. Biehler on 9/07/00 at 10:09 (027462)

If you can get your foot to 90 degrees, see if you can get it higher when your knee is bent. If you can, then your gastrocs are tight. With the 90 degrees you can walk in a shoe that has a rocker bottom. Be very carefull with the streching. This could take alot of time and sometimes surgery to lenghthen the achillies is considered. You have to be sure the motion is not being limited by bony or tendonis blocks around the ankle. If it is just a tight posterior muscle group, use the heel lifts, get rocker bottom shoes ( some people can't use them) and be carefull with the streching. You might need profesional help in the streching department. It sounds like you are over doing it with the streching. Dr. Biehler

Re: STRETCHING/ORTHOTICS

judy b on 9/08/00 at 11:17 (027557)

Dr. B...Do shoes with a roller bottom (where the bottom of the shoe is made rigid and the toe is curved up) accomplish the same thing as the rocker bottom (where the sole has a sharp angle at the toe) to accomodate for my lack of dorsiflexion?

Re: STRETCHING/ORTHOTICS

Dr. Biehler on 9/08/00 at 12:01 (027562)

Yes