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New Orthotics...need advice

Posted by Carmen H on 7/17/01 at 18:39 (053531)

I just got my Orthotics today and will be wearing them for the first time tomorrow. They a have a Metatarsal bump in them that worries me a little though. Can anyone tell me what to expect in the first day of Custom Orthotic wearing? I know not too long (max. 4 hours first day) but as far as the pain goes?

Re: New Orthotics...need advice

wendyn on 7/17/01 at 21:56 (053543)

You should not be experiencing 'pain' - some discomfort maybe - but pain is a bad sign.

4 hours sounds like an awful lot to me to start out with - if you're having a lot of pain I'd personally go no more than an hour and than work up in increments of one hour or so at a time. Really let your feet be your guide.

I did have two pairs with the metatarsal bump -hated it, wonder if it's contributed to my problems...my most recent pair don't have it. If you really hate it you may want to have it removed....some doctors don't feel they're necessary.

Re: New Orthotics...need advice

Andrea R. on 7/18/01 at 06:42 (053559)

Carmen,

I agree with Wendy. No more than about an hour the first day and add an hour a day. Even at that rate it can still take a while to get comfortable with them.

Andrea

Re: Thanks Wendy and Andrea

Carmen H on 7/18/01 at 07:50 (053562)

I just reread my post and I didn't state my question very clearly....I hadn't worn them yet so wasn't having any pain just wanted to know if I was to EXPECT any pain and how much. I wore them this morning for about 30 minutes. Plan to again tomorrow and the next day etc. Just taking it slow. I can't afford to have a set back. My feet actually didn't hurt getting up this morning! What a relief! I did the stretches Julie suggested and I am thinking it is helping me more than the wall stretches, therband stretches etc. Any progress is GOOD progress right? Thanks for your replies.....I appreciate it!

Re: Thanks Wendy and Andrea

Julie on 7/18/01 at 08:21 (053565)

Any progress is good progress, yes! I'm glad the exercises I described are helping you. And I agree with the others: break your orthotics in slowly, and go back to your pod/pedorthist who made them if there are any problems with that metatarsal bump.

Re: New Orthotics...need advice

Richard, C.Ped on 7/18/01 at 16:33 (053606)

Hi Carmen,
If you have never worn orthotics before, I usually recommend wearing them for about 15 to 30 minutes the first day, then 30 to 45 the next, and so on. Your feet may feel tired and achy because they are not used to that extra support under the arch.

Were you having pain in the ball of your foot? Sometimes places add a metatarsal pad even if you don't need one. I don't know why. Some chiropractors will do this with their orthotics.

Keep an eye on your feet. Look for any redness in the arch area. We don't want a blister to come up. If this happens, have them adjusted.

If you have any questions, please feel free to ask.
Richard, C.Ped

Re: New Orthotics...need advice

Beverly on 7/18/01 at 17:21 (053608)

Carmen,

My first few pairs of orthodics were a disaster. I was about to give up on them altogether. Then, this last time I finally found someone who knew how to make them for my feet. But they still took some getting used to. I had to work up to being able to wear them all day very slowly. At first, I wore them for no more than an hour.

We're all different. I have the metatarsal bump and like mine. As you can see, others here found it uncomfortable.

I wondered at first what made these so much better. Here are two big differences: This pair was actually made at the same place that cast them and they were made by a professional orthodist and not a tech.

I've also discovered that different shoes make the orthodics feel different. In some, the arch is far more pronounced than in others.
Good luck,
Beverly

Re: No Ball of foot pain

Carmen on 7/19/01 at 08:49 (053697)

I haven't had any pain in the ball of the foot yet but last night it was pretty sore after only 30 minutes of wearing the orthotics early in the day.
I will keep an eye on them though. It is confusing though....obviously my feet hurt from the PF anyway...well having to keep track of all the things that may affect my feet is hard. I am journaling and keeping track in writing but with NEW stretches, NEW Orthotics, NEW ibuprofen etc...it's hard to tell if I am making the PF worse and if I am from which change??
VERY frustrating. I have read that wall stretches are good...but without bending the knee...then I hear you have to bend the knee to stretch the Achilles....I've heard that the towel rolling with toes is a GREAT exercise and then I hear NO! it's not. I am getting frustrated. I KNOW that some things work for some and others work for others but how do I know if what I am doing is helping or hurting? ARGH!!!
Thanks for leting me vent. I am just trying to get back in the gym and continue to exercise nad stay healthy but this is a very hard injury to be positive about.
Any words of wisdom are VERY appreciated. Everyone has been very helpful!

Re: No Ball of foot pain

Julie on 7/19/01 at 09:21 (053699)

Carmen, when you do the wall stretch with the back leg straight, you are stretching the gastrocnemius. When you do it with the knee bent, you're stretching the soleus. They are two different stretches. Doing the bent-knee version you are more likely to irritate the Achilles Tendon, which connects the soleus muscle to the heel. Tendons don't stretch. They can become tight, and restored to their optimum length with appropriate exercise, but with PF you really do have to be careful: you can re-injure the fascia and, as I said, irritate the Achilles.

Please be careful with any weight-bearing stretches. As you are probably aware, there are differences of opinion about them. I believe that non weight-bearing is better for most people. As a general rule, if you do anything and it hurts - then or later - it is making matters worse. So respect the signals your body gives you.

I know it's frustrating not to be able to do the things you used to do and want to do, but healing PF has to be your health priority for now. Don't worry: whatever you lose through not being able to keep to your previous routine, you'll get back again in time. And you'll learn about your body during this healing process.

Re: Carmen - ps

Julie on 7/19/01 at 09:35 (053702)

Carmen, you could try going to the gym and doing upper body work, sitting or lying . As long as it doesn't increase your foot pain, it should be all right.

Re: Tried that... :-(

Carmen H on 7/19/01 at 19:14 (053765)

I tried that....went to the gym three times and had my sister bring the weights to me while I sat and did all my exercises....that worked okay. Felt REALLY good to work my arms. BUT she lives in NC and I am in GA. Husband can't work out with me in the morning b/c he goes to work early. At night it's too painful from a long day to think about walking from the car to the gym.....sigh. I feel beaten down Julie. I'm more tired now then I have ever been. I used to concentration curl 15 & 20 pound weights and now picking up a can of soup feels like 100 pounds, I am normally so active and efficient I feel like I am losing my mind. You and everyone else have really helped though. Trust me I would have been a WORSE WRECK without you all. I have printed the ideal doctor visit from the previous posting and am highlighting the areas I want more info on and when I get to the doc I am asking questions and getting answers this time. I am also bringing the PF Book printout with highlighted areas. I haven't done ANY weight bearing exercises since I started the stretching you recommended. That has been the best so far. My POD didn't even do the PF test on me......
My routine looks like this from morning to end....tell me if you think I am on the right track for the first month and 1/2 of this if you don't mind. Keep in mind I am sitting all day so resting is almost a whole day thing.....minimal walking to keep the feet from stiffening up and keeping them flexible. I take the dog out 4 times a day walk up to the mailbox and back.
Morning: 'Julie's' Stretches :-) and massage feet before getting out of bed. Wear orthotics for 30 minutes and ice for 15.
Mid morning: Julie's stretches, ice and massage.
Noon: Ice while eating lunch (15 minutes-20 minutes)
Mid noon: Stretch, ice and massage.
EVening: (LONGEST part of the day) cook dinner and ice while eating. Stretch, massage and ice again before heading to the bedroom.
Right before bed. Julie's stretches and massage.
I alternate between birks and Saucony's b/c wearing one style too long hurts them. Better results with exchange.
What do you think? I appreciate your input very much. thanks!!!
By the way what do you do Julie? Besides help on here? :-)

Re: Some ideas for you

Julie on 7/20/01 at 01:23 (053785)

Carmen, the routine sounds all right - except you might be icing for too long. I think ten minutes is supposed to be maximum: if done longer, it starts having the opposite effect.

Also, I would suggest you experiment with taping, which replaces the support for the arch that the plantar fascia is supposed to give (but cannot give when it is injured). It aids healing as well as relieving pain, and even though you aren't walking a great deal, it would make the walking you do do easier and less likely to re-injure. See instructions in part 2 of the heel pain book.

If you can't get to the gym, why don't you try experimenting with upper body exercise at home? Be inventive with soup cans, wrist weights, even books might help.

The foot exercises I gave you are part of a series for all the joints of the body. You might like to try the ones for the other joints. They won't feel the same for you as weights, but maybe now that you've felt the benefit of the foot exercises, you're ready now to welcome a different experience.

With your arms out in front of you at shoulder level:

Stretch your fingers wide, opening big spaces between them
Then make fists with the thumbs inside, and squeeze hard on the thumbs
9x, breathing in as you stretch, out as you squeeze

Bend your hands back at the wrists, as if pushing your palms against a wall
Bend them forward, pointing the fingers down. All the movement is at the wrists, none at the knuckles
9x, breathing in as you bend the hands back, out as you bend them forward

With your hands gently fisted, circle the wrists 9x in each direction - first the right, then the left, then both
Breathe naturally

Fingertips to shoulders, elbows forward:
Straighten your arms, then bend the elbows and bring the fingertips back to the shoulders
5-9x, breathing in as you straighten, out as you bend

Arms loose by your sides:
Lift your shoulders towards your ears
Draw them back, keeping them high: feel the squeeze between the shoulder blades
Pull them down: imagine heavy weights in the hands as you do this
5-9x, breathing in as you lift the shoulders and draw them back; out as you pull them down

Fingertips on shoulders:
Draw circles with your elbows, bring them forward, then up, then back, then down, then forward etc...
5-9x, then reverse the direction, bringing elbows up in back, then forward and down
Breathing: in as you lift the elbows, out as you lower them
All the movement is in the shoulders

Returning to the lower limbs, there are also exercises for the knees and hips:

Sitting towards the front of a straight backed armless chair:
Straighten one knee, then bend it back
5-9x breathing in as you straighten, out as you bend
Then the other knee (not both: the weight of both legs will pull too strongly on your lower back)

Still sitting towards the front of the chair:
Hold and lift your right knee, and draw circles with it - 5-9x in each direction.
Breathe naturally as you perform this hip rotation.
Then work the left hip in the same way

So: you can work through all your joints systematically: fingers, wrists, elbows, shoulders, toes, ankles, knees and hips.

Practised regularly, these exercises will help to maintain full range movement in all the joints. They strengthen the muscles and ligaments, and improve circulation. They speed the removal of toxins from the body, thus releasing blockages and enhancing energy flow. If you decide you want to do them, do them with full awareness, not 'perfunctorily'. The physical benefits are there even if your mind wanders to 'what's for lunch' while you're doing them, but they work on deeper levels if you pay full attention to what you are doing.

You asked what I do. I am a yoga teacher: I teach classes, and train yoga teachers. I also teach people with cancer, do workshops on how yoga can serve as a source of inner strength and healing in times of crisis, and training days for teachers who are drawn to this area of work. Having had breast cancer myself, and having integrated what I learned from that experience into my teaching I'm privileged to be able to give some help to others who are going through it.

I hope some of this is useful!

All the best to you, Julie

Re: Theraband

Julie on 7/20/01 at 02:27 (053792)

Another thought, Carmen - ask your doctor about therabands. It's a wide elastic strip that you cut to the right length and tie the ends together: you use it to exercise your feet (it provides resistance). You might like it. My pod had it in stock, and cut a length for me. I didn't use it much, but I know others here have, with benefit - Ellen posted about it the other day.

Re: THANKS!

Carmen H on 7/20/01 at 07:55 (053798)

I am printing your exercises as we speak! Thank you so much for all the time you took to write everything down for me. As you can tell I'm a bit of a work out freak.....time to calm down about it maybe?
I have been working with a theraband (minimal resistance) for years now for shoulder work (rotator cuff problem about 3 years ago) etc. and was using it to stretch to start with but felt 'not so good' effects on my feet when I used it. I have retired it but will get it back out to use for upper body. Thanks again Julie.....You're a true help!

Re: THANKS!

Julie on 7/20/01 at 09:59 (053812)

That's a pleasure.

Don't beat yourself up, Carmen. Maybe it is time to 'calm down', but it's hard enough not being able to do what you like to do and are used to doing without feeling guilty as well. But I do think that what seems at first an unwelcome obstacle can be an opportunity to branch out, try something different, add to your pleasures. That's why I posted the yoga exercises. Maybe they'll be useful to others, too.

Let me know how you get on.

Re: Some ideas for you ATTN: JULIE!

Lisa C on 7/21/01 at 00:49 (053881)

Julie, What do you mean that icing too long can have the opposite effect? I easliy ice 30 min each night. I use zip loc bags filled with ice and a thin dish towel on top of the ice. (it is actually an ex-dish towel :o) 10 minutes seems so quick. Let me know if I am making my prob worse. Thanks!!

Re: Lisa: Ice

Julie on 7/21/01 at 03:11 (053895)

Lisa, I've copied from the heel pain book the section on icing:

Ice was ranked the third most favorite treatment. Applying ice after activity or injury is very important. It may be beneficial to apply ice 3 times a day. My favorite method is to place a few pieces of ice on a towel (to absorb the water) and to step on it while sitting down for 5 minutes (10 minutes may be too long for direct contact). For me, placing ice directly against the skin seems best. Some patients use frozen water in a plastic soda bottle. This method may need to be applied longer than 5 minutes because of the insulation the plastic provides. It's best to keep the injury cool as much as possible for up to 48 hours after the injury. I would apply ice every evening immediately after daily activities. Keeping a recent injury cool reduces internal 'micro-bleeding' which leads to micro-scars (and possibly calcium spur deposits) and keeps down inflammation. Applying ice for longer periods of time may cause v
vasodilation (blood vessels increase in diameter in order to keep the tissue warm) that may speed healing by improving blood flow, but it may be harmful by increasing inflammation if the injury occured within the last 2 days. The vasodilation theory of healing with ice has been questioned. Some sources say apply ice for 15 minutes, but that may be too long unless the ice is insulated from the skin by plastic or a towel, or unless the ice is being moved around and not concentrated on a single area. Some sources recommend moving the ice around during the application. Applying ice until the skin turns blue is a definite sign it has been applied for too long.

So - if you're trying to reduce inflammation, which is why you're icing, you don't want to increase it. Something else to bear in mind is that icing for too long, particularly as you are using real ice, can cause frostbite. I think Laurie had a bad trip recently with this (please correct me Laurie, if I've mis-remembered)

Re: Julie: Ice

Lisa C on 7/22/01 at 00:21 (053945)

Thank you Julie for the info! I guess this is a good example of why we should all read and RE-read the heel pain book! I remember the posts about burning the feet by icing too long. I couldn't figure it out, as I was icing longer then was stated. I do move my foot around heel, arch, side... I do use a towel too. I iced about 10 minutes tonight. I'll stick to that from now on.

Re: Some ideas for you ATTN: JULIE!

john h on 7/23/01 at 10:06 (054019)

the length of icing i would think would somewhat be determined by how you ice your feet. i use the store bought ice packs you place in a freezer. i then place them in a cloth stretchable material with velcro tape and wrap them snugly around my foot. these packs do not freeze into a frozen state and after about 20 minutes are barely cool. they are very different than putting a bag of ice in a ziplock bag as they are nearly as cold.

Re: New Orthotics...need advice

wendyn on 7/17/01 at 21:56 (053543)

You should not be experiencing 'pain' - some discomfort maybe - but pain is a bad sign.

4 hours sounds like an awful lot to me to start out with - if you're having a lot of pain I'd personally go no more than an hour and than work up in increments of one hour or so at a time. Really let your feet be your guide.

I did have two pairs with the metatarsal bump -hated it, wonder if it's contributed to my problems...my most recent pair don't have it. If you really hate it you may want to have it removed....some doctors don't feel they're necessary.

Re: New Orthotics...need advice

Andrea R. on 7/18/01 at 06:42 (053559)

Carmen,

I agree with Wendy. No more than about an hour the first day and add an hour a day. Even at that rate it can still take a while to get comfortable with them.

Andrea

Re: Thanks Wendy and Andrea

Carmen H on 7/18/01 at 07:50 (053562)

I just reread my post and I didn't state my question very clearly....I hadn't worn them yet so wasn't having any pain just wanted to know if I was to EXPECT any pain and how much. I wore them this morning for about 30 minutes. Plan to again tomorrow and the next day etc. Just taking it slow. I can't afford to have a set back. My feet actually didn't hurt getting up this morning! What a relief! I did the stretches Julie suggested and I am thinking it is helping me more than the wall stretches, therband stretches etc. Any progress is GOOD progress right? Thanks for your replies.....I appreciate it!

Re: Thanks Wendy and Andrea

Julie on 7/18/01 at 08:21 (053565)

Any progress is good progress, yes! I'm glad the exercises I described are helping you. And I agree with the others: break your orthotics in slowly, and go back to your pod/pedorthist who made them if there are any problems with that metatarsal bump.

Re: New Orthotics...need advice

Richard, C.Ped on 7/18/01 at 16:33 (053606)

Hi Carmen,
If you have never worn orthotics before, I usually recommend wearing them for about 15 to 30 minutes the first day, then 30 to 45 the next, and so on. Your feet may feel tired and achy because they are not used to that extra support under the arch.

Were you having pain in the ball of your foot? Sometimes places add a metatarsal pad even if you don't need one. I don't know why. Some chiropractors will do this with their orthotics.

Keep an eye on your feet. Look for any redness in the arch area. We don't want a blister to come up. If this happens, have them adjusted.

If you have any questions, please feel free to ask.
Richard, C.Ped

Re: New Orthotics...need advice

Beverly on 7/18/01 at 17:21 (053608)

Carmen,

My first few pairs of orthodics were a disaster. I was about to give up on them altogether. Then, this last time I finally found someone who knew how to make them for my feet. But they still took some getting used to. I had to work up to being able to wear them all day very slowly. At first, I wore them for no more than an hour.

We're all different. I have the metatarsal bump and like mine. As you can see, others here found it uncomfortable.

I wondered at first what made these so much better. Here are two big differences: This pair was actually made at the same place that cast them and they were made by a professional orthodist and not a tech.

I've also discovered that different shoes make the orthodics feel different. In some, the arch is far more pronounced than in others.
Good luck,
Beverly

Re: No Ball of foot pain

Carmen on 7/19/01 at 08:49 (053697)

I haven't had any pain in the ball of the foot yet but last night it was pretty sore after only 30 minutes of wearing the orthotics early in the day.
I will keep an eye on them though. It is confusing though....obviously my feet hurt from the PF anyway...well having to keep track of all the things that may affect my feet is hard. I am journaling and keeping track in writing but with NEW stretches, NEW Orthotics, NEW ibuprofen etc...it's hard to tell if I am making the PF worse and if I am from which change??
VERY frustrating. I have read that wall stretches are good...but without bending the knee...then I hear you have to bend the knee to stretch the Achilles....I've heard that the towel rolling with toes is a GREAT exercise and then I hear NO! it's not. I am getting frustrated. I KNOW that some things work for some and others work for others but how do I know if what I am doing is helping or hurting? ARGH!!!
Thanks for leting me vent. I am just trying to get back in the gym and continue to exercise nad stay healthy but this is a very hard injury to be positive about.
Any words of wisdom are VERY appreciated. Everyone has been very helpful!

Re: No Ball of foot pain

Julie on 7/19/01 at 09:21 (053699)

Carmen, when you do the wall stretch with the back leg straight, you are stretching the gastrocnemius. When you do it with the knee bent, you're stretching the soleus. They are two different stretches. Doing the bent-knee version you are more likely to irritate the Achilles Tendon, which connects the soleus muscle to the heel. Tendons don't stretch. They can become tight, and restored to their optimum length with appropriate exercise, but with PF you really do have to be careful: you can re-injure the fascia and, as I said, irritate the Achilles.

Please be careful with any weight-bearing stretches. As you are probably aware, there are differences of opinion about them. I believe that non weight-bearing is better for most people. As a general rule, if you do anything and it hurts - then or later - it is making matters worse. So respect the signals your body gives you.

I know it's frustrating not to be able to do the things you used to do and want to do, but healing PF has to be your health priority for now. Don't worry: whatever you lose through not being able to keep to your previous routine, you'll get back again in time. And you'll learn about your body during this healing process.

Re: Carmen - ps

Julie on 7/19/01 at 09:35 (053702)

Carmen, you could try going to the gym and doing upper body work, sitting or lying . As long as it doesn't increase your foot pain, it should be all right.

Re: Tried that... :-(

Carmen H on 7/19/01 at 19:14 (053765)

I tried that....went to the gym three times and had my sister bring the weights to me while I sat and did all my exercises....that worked okay. Felt REALLY good to work my arms. BUT she lives in NC and I am in GA. Husband can't work out with me in the morning b/c he goes to work early. At night it's too painful from a long day to think about walking from the car to the gym.....sigh. I feel beaten down Julie. I'm more tired now then I have ever been. I used to concentration curl 15 & 20 pound weights and now picking up a can of soup feels like 100 pounds, I am normally so active and efficient I feel like I am losing my mind. You and everyone else have really helped though. Trust me I would have been a WORSE WRECK without you all. I have printed the ideal doctor visit from the previous posting and am highlighting the areas I want more info on and when I get to the doc I am asking questions and getting answers this time. I am also bringing the PF Book printout with highlighted areas. I haven't done ANY weight bearing exercises since I started the stretching you recommended. That has been the best so far. My POD didn't even do the PF test on me......
My routine looks like this from morning to end....tell me if you think I am on the right track for the first month and 1/2 of this if you don't mind. Keep in mind I am sitting all day so resting is almost a whole day thing.....minimal walking to keep the feet from stiffening up and keeping them flexible. I take the dog out 4 times a day walk up to the mailbox and back.
Morning: 'Julie's' Stretches :-) and massage feet before getting out of bed. Wear orthotics for 30 minutes and ice for 15.
Mid morning: Julie's stretches, ice and massage.
Noon: Ice while eating lunch (15 minutes-20 minutes)
Mid noon: Stretch, ice and massage.
EVening: (LONGEST part of the day) cook dinner and ice while eating. Stretch, massage and ice again before heading to the bedroom.
Right before bed. Julie's stretches and massage.
I alternate between birks and Saucony's b/c wearing one style too long hurts them. Better results with exchange.
What do you think? I appreciate your input very much. thanks!!!
By the way what do you do Julie? Besides help on here? :-)

Re: Some ideas for you

Julie on 7/20/01 at 01:23 (053785)

Carmen, the routine sounds all right - except you might be icing for too long. I think ten minutes is supposed to be maximum: if done longer, it starts having the opposite effect.

Also, I would suggest you experiment with taping, which replaces the support for the arch that the plantar fascia is supposed to give (but cannot give when it is injured). It aids healing as well as relieving pain, and even though you aren't walking a great deal, it would make the walking you do do easier and less likely to re-injure. See instructions in part 2 of the heel pain book.

If you can't get to the gym, why don't you try experimenting with upper body exercise at home? Be inventive with soup cans, wrist weights, even books might help.

The foot exercises I gave you are part of a series for all the joints of the body. You might like to try the ones for the other joints. They won't feel the same for you as weights, but maybe now that you've felt the benefit of the foot exercises, you're ready now to welcome a different experience.

With your arms out in front of you at shoulder level:

Stretch your fingers wide, opening big spaces between them
Then make fists with the thumbs inside, and squeeze hard on the thumbs
9x, breathing in as you stretch, out as you squeeze

Bend your hands back at the wrists, as if pushing your palms against a wall
Bend them forward, pointing the fingers down. All the movement is at the wrists, none at the knuckles
9x, breathing in as you bend the hands back, out as you bend them forward

With your hands gently fisted, circle the wrists 9x in each direction - first the right, then the left, then both
Breathe naturally

Fingertips to shoulders, elbows forward:
Straighten your arms, then bend the elbows and bring the fingertips back to the shoulders
5-9x, breathing in as you straighten, out as you bend

Arms loose by your sides:
Lift your shoulders towards your ears
Draw them back, keeping them high: feel the squeeze between the shoulder blades
Pull them down: imagine heavy weights in the hands as you do this
5-9x, breathing in as you lift the shoulders and draw them back; out as you pull them down

Fingertips on shoulders:
Draw circles with your elbows, bring them forward, then up, then back, then down, then forward etc...
5-9x, then reverse the direction, bringing elbows up in back, then forward and down
Breathing: in as you lift the elbows, out as you lower them
All the movement is in the shoulders

Returning to the lower limbs, there are also exercises for the knees and hips:

Sitting towards the front of a straight backed armless chair:
Straighten one knee, then bend it back
5-9x breathing in as you straighten, out as you bend
Then the other knee (not both: the weight of both legs will pull too strongly on your lower back)

Still sitting towards the front of the chair:
Hold and lift your right knee, and draw circles with it - 5-9x in each direction.
Breathe naturally as you perform this hip rotation.
Then work the left hip in the same way

So: you can work through all your joints systematically: fingers, wrists, elbows, shoulders, toes, ankles, knees and hips.

Practised regularly, these exercises will help to maintain full range movement in all the joints. They strengthen the muscles and ligaments, and improve circulation. They speed the removal of toxins from the body, thus releasing blockages and enhancing energy flow. If you decide you want to do them, do them with full awareness, not 'perfunctorily'. The physical benefits are there even if your mind wanders to 'what's for lunch' while you're doing them, but they work on deeper levels if you pay full attention to what you are doing.

You asked what I do. I am a yoga teacher: I teach classes, and train yoga teachers. I also teach people with cancer, do workshops on how yoga can serve as a source of inner strength and healing in times of crisis, and training days for teachers who are drawn to this area of work. Having had breast cancer myself, and having integrated what I learned from that experience into my teaching I'm privileged to be able to give some help to others who are going through it.

I hope some of this is useful!

All the best to you, Julie

Re: Theraband

Julie on 7/20/01 at 02:27 (053792)

Another thought, Carmen - ask your doctor about therabands. It's a wide elastic strip that you cut to the right length and tie the ends together: you use it to exercise your feet (it provides resistance). You might like it. My pod had it in stock, and cut a length for me. I didn't use it much, but I know others here have, with benefit - Ellen posted about it the other day.

Re: THANKS!

Carmen H on 7/20/01 at 07:55 (053798)

I am printing your exercises as we speak! Thank you so much for all the time you took to write everything down for me. As you can tell I'm a bit of a work out freak.....time to calm down about it maybe?
I have been working with a theraband (minimal resistance) for years now for shoulder work (rotator cuff problem about 3 years ago) etc. and was using it to stretch to start with but felt 'not so good' effects on my feet when I used it. I have retired it but will get it back out to use for upper body. Thanks again Julie.....You're a true help!

Re: THANKS!

Julie on 7/20/01 at 09:59 (053812)

That's a pleasure.

Don't beat yourself up, Carmen. Maybe it is time to 'calm down', but it's hard enough not being able to do what you like to do and are used to doing without feeling guilty as well. But I do think that what seems at first an unwelcome obstacle can be an opportunity to branch out, try something different, add to your pleasures. That's why I posted the yoga exercises. Maybe they'll be useful to others, too.

Let me know how you get on.

Re: Some ideas for you ATTN: JULIE!

Lisa C on 7/21/01 at 00:49 (053881)

Julie, What do you mean that icing too long can have the opposite effect? I easliy ice 30 min each night. I use zip loc bags filled with ice and a thin dish towel on top of the ice. (it is actually an ex-dish towel :o) 10 minutes seems so quick. Let me know if I am making my prob worse. Thanks!!

Re: Lisa: Ice

Julie on 7/21/01 at 03:11 (053895)

Lisa, I've copied from the heel pain book the section on icing:

Ice was ranked the third most favorite treatment. Applying ice after activity or injury is very important. It may be beneficial to apply ice 3 times a day. My favorite method is to place a few pieces of ice on a towel (to absorb the water) and to step on it while sitting down for 5 minutes (10 minutes may be too long for direct contact). For me, placing ice directly against the skin seems best. Some patients use frozen water in a plastic soda bottle. This method may need to be applied longer than 5 minutes because of the insulation the plastic provides. It's best to keep the injury cool as much as possible for up to 48 hours after the injury. I would apply ice every evening immediately after daily activities. Keeping a recent injury cool reduces internal 'micro-bleeding' which leads to micro-scars (and possibly calcium spur deposits) and keeps down inflammation. Applying ice for longer periods of time may cause v
vasodilation (blood vessels increase in diameter in order to keep the tissue warm) that may speed healing by improving blood flow, but it may be harmful by increasing inflammation if the injury occured within the last 2 days. The vasodilation theory of healing with ice has been questioned. Some sources say apply ice for 15 minutes, but that may be too long unless the ice is insulated from the skin by plastic or a towel, or unless the ice is being moved around and not concentrated on a single area. Some sources recommend moving the ice around during the application. Applying ice until the skin turns blue is a definite sign it has been applied for too long.

So - if you're trying to reduce inflammation, which is why you're icing, you don't want to increase it. Something else to bear in mind is that icing for too long, particularly as you are using real ice, can cause frostbite. I think Laurie had a bad trip recently with this (please correct me Laurie, if I've mis-remembered)

Re: Julie: Ice

Lisa C on 7/22/01 at 00:21 (053945)

Thank you Julie for the info! I guess this is a good example of why we should all read and RE-read the heel pain book! I remember the posts about burning the feet by icing too long. I couldn't figure it out, as I was icing longer then was stated. I do move my foot around heel, arch, side... I do use a towel too. I iced about 10 minutes tonight. I'll stick to that from now on.

Re: Some ideas for you ATTN: JULIE!

john h on 7/23/01 at 10:06 (054019)

the length of icing i would think would somewhat be determined by how you ice your feet. i use the store bought ice packs you place in a freezer. i then place them in a cloth stretchable material with velcro tape and wrap them snugly around my foot. these packs do not freeze into a frozen state and after about 20 minutes are barely cool. they are very different than putting a bag of ice in a ziplock bag as they are nearly as cold.