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My cure: stretching and night splints

Posted by Jana on 10/23/00 at 12:08 (031070)

I have suffered for a year and a half. I could not even take out my own trash a month ago. I'm finally improving and I can absolutely pin point one combination, night splints and ham string stretching, as the 'cure'. I'm writing to help any who have not yet tried this.

I have tried all of the following (non of which worked): rest, wheelchair, 3 months in a walking boot(removable cast), 12.5 mg vioxx (2 a day), 2000 mg Relaphan a day, ice, deep tissue massage, electro stim (two types), ultra sound with anit-inflam cream, 2 types of orthotics, and every type of supplement you can imagine.
I have tried all of these for several months at a time. I noticed no improvement from any of them (some made me worse).

I have been stretching and wearing splints for 3 weeks and have noticed a HUGE improvement. Yesterday I took out the trash, changed the bed sheets, went to the market and walked the dog (all in the same day)....and, I wasn't sore when I went to bed or this morning.
The trick: Stretch all day and between every activity.
I wear the splints for as many hours as I can stand at night (yes, it's hard to sleep) and at work. I have a foot stool under my desk to increase my dors-flexion throughout the day.

I also do ham string stretches. The stretches are non-weight bearing: sit on the floor with your legs straight out in front of you and flex your feet. If your are able, bring your toes towards you and lean your chest towards your knees.

Yes, it hurts. Don't stretch to tearing, stretch till you feel tension.
When I started, I could not straighten my legs or flex my feet. I had to work up to it. I spend 1/2 hour in the morning, at lunch, and at night in this position. I also do it every our to keep everything from getting stiff.
If you haven't tried it....DO! It seems to be my cure and it's fairly quick. First, you'll notice less pain in your morning walking. Then you'll notice you're able to stand for a few more minutes in a row...Before you know it, you'll be doing small little tasks you haven't done in months.

My phys therapist, said I'll be grocery shopping again within 2 months. I didn't believe him at first (having given up hope) but I'm starting to now....

Please give this a try (and you HAVE to be consistant, like everything else, but it's worth it.)

Feel free to email me directly if you have questions.

Re: My cure: stretching and night splints

Pat C. on 10/23/00 at 16:17 (031080)

Did you have PF in one foot or both & what did your symtoms feel like?? Was your pain in the heel only or different parts of the foot??? Thanks for your help!

Re: My cure: stretching and night splints

Julie F on 10/23/00 at 17:01 (031082)

Jana, I'm glad this stretch has helped you so much, but
please be careful, folks, with this exercise, or with any forward bend with the legs straight. Just sitting upright on the floor with the legs straight is a strong exercise. if you aren't used to it, and you add forward bending to it, you can easily damage your back, and the last thing you want is to add back problems to the ones you already have.

If you want to stretch the hamstrings a safer way is to lie on the floor on your back with both knees bent. Bring one knee up towards the abdomen, keeping the other foot on the floor, and straighten the leg upwards. Do it with your foot dorsiflexed, if you can without pain; otherwise keep the foot relaxed. Don't straighten the leg completely if you cannot do so while keeping it at a right angle to the body. If it has to go forward of the hip to straighten fully, its weight will pull on your lower back. Don't force it - gently does it with hamstrings.

Re: My cure: stretching and night splints

Beverly on 10/23/00 at 18:35 (031087)

My PT has me doing the laying down version of the hamstring stretch - much like what Julie described. I still can't do it with my FootFlexed but I'm working towards that.

It is always wonderful to hear about someone getting better.
Congradulations.
Beverly

Re: My cure: stretching and night splints/hamstring stretch

Julie F on 10/24/00 at 02:33 (031115)

I posted my hamstring message late last night (late for me - it's 5 hours later here in England than on the East Coast) and re-reading it this morning see that it isn't complete.

The exercise is done with the breath. Stretch the leg up on the inbreath, and bend the knee on the outbreath. Practise 3-5 times and repeat with the other leg. Keep the lower back in good contact with the floor throughout (use your lower abdominal muscles). After stretching your legs individually, you can stretch both together, but be careful with this if you have lower back problems: hold round the backs of the thighs with your hands for support. If you can't dorsiflex the foot, don't worry: the dorsiflexion works the calf muscles, and in this exercise you're mainly targeting the hamstrings, which will stretch without dorsiflexion.

You're aiming for a right angle between the leg and the trunk. But if your hamstrings are tight, the leg won't straighten fully to this position, so just take it as far as it goes. Don't force it, and don't be tempted to straighten it if you have to send it forward to do so (i.e. forming a wider-than-90 degree angle). Once the leg leaves the perpendicular-to-the-trunk position, it starts to pull on the lower back: not good news for the back, as the legs constitute about 40% of the body weight and the pull is enormous. So make sure the upper leg between the hip and knee is at a right angle to the trunk: even if the knee remains slightly bent, you'll still feel the stretch in the hamstrings.

Here is why I really would not recommend the exercise that Jana described for anyone who isn't adept in yoga. The hamstring muscles connect the backs of the knees with the lower back. Therefore, in sitting and standing forward bends, if the legs are kept straight there is a pull on the lower back: the tighter the hamstrings the stronger the pull. This prevents optimum, **safe** stretching of the spine and the muscles that support it, and is why I think these postures should be taught with the knees bent. Once the back has been stretched optimally/safely the knees can be slowly straightened. The hamstrings will be stretched even if the legs don't straighten fully. The straightening of the legs can be gradually increased, over a period of time. And all the while, the lower back is being protected.

But if we aren't concerned with stretching the back, and want specifically to target the hamstrings, the stretch lying on the floor is just as effective, and safer because the back is fully supported by the floor.

Sorry for all this theory, but I know we're all keen to try whatever has helped someone else, and it worried me that someone might do themselves a mischief. It's great, and I'm very glad, that it's helped you, Jana, so much, but you possibly have nice long hamstrings and a healthy lower back, so although it may be safe for you, it would not be for everyone - everyone is built differently, and body structure and limitations should always be taken into account.

All the best, Julie

Re: Vary above exercise, for a great calf stretch

Lynn S. on 10/24/00 at 02:49 (031117)

I started physical therapy again, (Last time was about 6 months ago), because I had a big flare up few weeks ago, but this time I went to a new PT. She showed me the same stretch , but if you sit on a PT table, or on the edge of your bed at home, and put one leg straight out in front of you, and keep the other leg on the floor (bend the knee), and then lean forward there is no pull on your back. Only lean forward as much as is comfortable for you. Then bring your foot foward. Try to bring it forward gently from the heel, not so much from the toes. This gives an incredible calf stretch without irritaing the fascia. Just hold it for a few seconds at a time at first.
I also got night splints around a week ago, and noticed a drastic difference in morning pain, and stiffness today, and it dissapeared within a few minutes, after I got up. I can't wait to see what happens a few months from now. (The Royce medical night splint is very comfortable, even though it doesn't look it.) The PT also did deep tissue massage on the calves, and on my peroneal tendons, which were very sore. I hadn't even noticed, that before, until she touched that area. She also messaged the tissue around the shins. The last few days I've been able to stand for a good few hours with very little discomfort. If you are getting PT asked them to check for tightness in either the achilles area, or peroneals. I have peroneal tendonitis, because I have a high arch and supinate. Most people with PF will more than likely have tight achilles tendons, so ask them to check that area, and massage there too. I'm also getting ultra sound on the peroneals, and the fascia again, and that also has helped.

Re: Vary above exercise, for a great calf stretch

Julie F on 10/24/00 at 05:11 (031125)

Lynn, that's better, because the other foot is on the floor, but the weight of the extended straight leg extended can still pull on the back. Your PT gave that particular exercise to you because she assessed you as being able to take it. Not everyone would be. The bottom line is that an exercise has to be right, by which I mean safe as well as effective, for the person performing it. Of course that goes for the floor exercise I described - lots of people cannot work both legs at the same time.

My prime concern in all practice and teaching is safety, particularly in this community where everyone is equally and understandably eager to share what has helped them, and to try anything that might conceivably help.

All the best, Julie

Re: My cure: stretching and night splints

Pat C. on 10/23/00 at 16:17 (031080)

Did you have PF in one foot or both & what did your symtoms feel like?? Was your pain in the heel only or different parts of the foot??? Thanks for your help!

Re: My cure: stretching and night splints

Julie F on 10/23/00 at 17:01 (031082)

Jana, I'm glad this stretch has helped you so much, but
please be careful, folks, with this exercise, or with any forward bend with the legs straight. Just sitting upright on the floor with the legs straight is a strong exercise. if you aren't used to it, and you add forward bending to it, you can easily damage your back, and the last thing you want is to add back problems to the ones you already have.

If you want to stretch the hamstrings a safer way is to lie on the floor on your back with both knees bent. Bring one knee up towards the abdomen, keeping the other foot on the floor, and straighten the leg upwards. Do it with your foot dorsiflexed, if you can without pain; otherwise keep the foot relaxed. Don't straighten the leg completely if you cannot do so while keeping it at a right angle to the body. If it has to go forward of the hip to straighten fully, its weight will pull on your lower back. Don't force it - gently does it with hamstrings.

Re: My cure: stretching and night splints

Beverly on 10/23/00 at 18:35 (031087)

My PT has me doing the laying down version of the hamstring stretch - much like what Julie described. I still can't do it with my FootFlexed but I'm working towards that.

It is always wonderful to hear about someone getting better.
Congradulations.
Beverly

Re: My cure: stretching and night splints/hamstring stretch

Julie F on 10/24/00 at 02:33 (031115)

I posted my hamstring message late last night (late for me - it's 5 hours later here in England than on the East Coast) and re-reading it this morning see that it isn't complete.

The exercise is done with the breath. Stretch the leg up on the inbreath, and bend the knee on the outbreath. Practise 3-5 times and repeat with the other leg. Keep the lower back in good contact with the floor throughout (use your lower abdominal muscles). After stretching your legs individually, you can stretch both together, but be careful with this if you have lower back problems: hold round the backs of the thighs with your hands for support. If you can't dorsiflex the foot, don't worry: the dorsiflexion works the calf muscles, and in this exercise you're mainly targeting the hamstrings, which will stretch without dorsiflexion.

You're aiming for a right angle between the leg and the trunk. But if your hamstrings are tight, the leg won't straighten fully to this position, so just take it as far as it goes. Don't force it, and don't be tempted to straighten it if you have to send it forward to do so (i.e. forming a wider-than-90 degree angle). Once the leg leaves the perpendicular-to-the-trunk position, it starts to pull on the lower back: not good news for the back, as the legs constitute about 40% of the body weight and the pull is enormous. So make sure the upper leg between the hip and knee is at a right angle to the trunk: even if the knee remains slightly bent, you'll still feel the stretch in the hamstrings.

Here is why I really would not recommend the exercise that Jana described for anyone who isn't adept in yoga. The hamstring muscles connect the backs of the knees with the lower back. Therefore, in sitting and standing forward bends, if the legs are kept straight there is a pull on the lower back: the tighter the hamstrings the stronger the pull. This prevents optimum, **safe** stretching of the spine and the muscles that support it, and is why I think these postures should be taught with the knees bent. Once the back has been stretched optimally/safely the knees can be slowly straightened. The hamstrings will be stretched even if the legs don't straighten fully. The straightening of the legs can be gradually increased, over a period of time. And all the while, the lower back is being protected.

But if we aren't concerned with stretching the back, and want specifically to target the hamstrings, the stretch lying on the floor is just as effective, and safer because the back is fully supported by the floor.

Sorry for all this theory, but I know we're all keen to try whatever has helped someone else, and it worried me that someone might do themselves a mischief. It's great, and I'm very glad, that it's helped you, Jana, so much, but you possibly have nice long hamstrings and a healthy lower back, so although it may be safe for you, it would not be for everyone - everyone is built differently, and body structure and limitations should always be taken into account.

All the best, Julie

Re: Vary above exercise, for a great calf stretch

Lynn S. on 10/24/00 at 02:49 (031117)

I started physical therapy again, (Last time was about 6 months ago), because I had a big flare up few weeks ago, but this time I went to a new PT. She showed me the same stretch , but if you sit on a PT table, or on the edge of your bed at home, and put one leg straight out in front of you, and keep the other leg on the floor (bend the knee), and then lean forward there is no pull on your back. Only lean forward as much as is comfortable for you. Then bring your foot foward. Try to bring it forward gently from the heel, not so much from the toes. This gives an incredible calf stretch without irritaing the fascia. Just hold it for a few seconds at a time at first.
I also got night splints around a week ago, and noticed a drastic difference in morning pain, and stiffness today, and it dissapeared within a few minutes, after I got up. I can't wait to see what happens a few months from now. (The Royce medical night splint is very comfortable, even though it doesn't look it.) The PT also did deep tissue massage on the calves, and on my peroneal tendons, which were very sore. I hadn't even noticed, that before, until she touched that area. She also messaged the tissue around the shins. The last few days I've been able to stand for a good few hours with very little discomfort. If you are getting PT asked them to check for tightness in either the achilles area, or peroneals. I have peroneal tendonitis, because I have a high arch and supinate. Most people with PF will more than likely have tight achilles tendons, so ask them to check that area, and massage there too. I'm also getting ultra sound on the peroneals, and the fascia again, and that also has helped.

Re: Vary above exercise, for a great calf stretch

Julie F on 10/24/00 at 05:11 (031125)

Lynn, that's better, because the other foot is on the floor, but the weight of the extended straight leg extended can still pull on the back. Your PT gave that particular exercise to you because she assessed you as being able to take it. Not everyone would be. The bottom line is that an exercise has to be right, by which I mean safe as well as effective, for the person performing it. Of course that goes for the floor exercise I described - lots of people cannot work both legs at the same time.

My prime concern in all practice and teaching is safety, particularly in this community where everyone is equally and understandably eager to share what has helped them, and to try anything that might conceivably help.

All the best, Julie