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stretching

Posted by paula on 9/04/01 at 15:56 (059018)

any one have good stretches to do from a bed or a chair. i always want other ideas. especially legs, hips , calves, heel cord. my new therapist wants me to do all my stretches for a full minute. she doesn't care how gentle or little i stretch as long as i hold it a minute. if i can't do that then i can relax for a few seconds and then start strethcing and counting from where i left off. what are others doing, and for how long? always helps to have this discussion, eh?

Re: stretching

Carmen H on 9/05/01 at 07:58 (059076)

Paula~
I'm a little confused....did your PT not give you any stretches especially for your condition?

Re: stretching

ellen w on 9/05/01 at 12:18 (059107)

Hi Paula,

I re-started PT about 2 weeks ago for what my doc calls 'phase II' of his PF treatment -- a supervised stretching regime. After the first 4 sessions, I had increased pain on the day of therapy, but felt better the day after; now at session 7 I am beginning to feel pretty good.

This is the at home stretching regime I've been given (just note that my pain was at the low end of the scale, and I have been able to stand for significant periods of time without major consequeces.) I do these in bed in the morning before getting up.

1.
Sit with towel or strap around foot, holding the towel with both hands. Pull the top of the foot toward your body so that you feel a stretch. Hold 20-30 seconds, 2-3 times a day.

2. Lie on back with leg up in air; keep the opposite leg straight, but bent at the knee. Loop towel around the bottom of your foot and pull your foot down, towards your body. Hold 20 seconds, 2-3 repetitions, 2-3 times per day.

3. Bend ankle up, down, and side by side, holding each position for a few seconds and pushing foot as far as it will go in each direction. Repeat this several times during the day.

4. Move ankle around slowly in a large circle. Repeat in the opposite direction. 20 repetitions, several times per day.

5. Move ankle slowly around as if tracing the letter of the alphabet, A-Z. Repeat several times per day.

6. Sitting down, roll a tennis ball under your foot, up/down, side to side, for several minutes. (this is my favorite)

I usually begin this series with Julie's toe stretches (do a search for her post to 'Rudy').

During appointments, I receive ultrasound, massage, and electrical stimulation, as well as some standing stretches. I also take a drug called Mobic, which is helping with joint stiffness.

She also has me doing what she calls an ice massage -- freeze water in a dixie cup, and once frozen, tear down the paper so that the top of the ice is exposed but you have the paper cup to hold on to. Run it up and down the length of your foot, 5 minutes or until your foot begins to feel numb.

Like Glenn, once the heel pain is gone, I think the next step for me will be to try and regain a strong walking gait. (Thanks Glenn, Carmen, and Julie if you're reading this, I think this has been a really important discussion.)

Tammie also makes a good point, backing up what Dr. Davis has said -- you have to be at a point where you are ready to do the right exercises at the right time.

ellen

Re: Ellen Glenn and Carmen

Carmen H on 9/05/01 at 13:18 (059113)

We are all on the same track it seems! Let's keep in touch and see how we all do with this type of treatment. Makes perfect sense to me.
After only ONE day of stretching my feet are LESS sensitive to pain. They still hurt but less sensitive and that's a good step for me!

Re: Ellen Glenn and Carmen

paula on 9/05/01 at 15:27 (059122)

thanks for the details. i've been to 4 pt s each one has different stretches, some the same others not. i find a gem of a sttretch each time i ask this question. or a technique that i find applies. my current pt has no problem with me experimenting and then checking with her if i should continue . more stretching details would be great. by the way i often stick my feet in warm water up the the knees before i stretch. thought i'd pass that on. do most people here ice after stretching or exercise? i find it sorta frustrating when folks say something works and then don't give any details. if it hadn't been for this board i would still probably be stretching too hard. any one else with any stretching ideas that work for them?

Re: Ice AFTER

Carmen H on 9/05/01 at 16:20 (059129)

My PT said Ice after. Never before. You want the muscle loose and as flexible as it can be. I don't use warm water to loosen but I am sure it can't hurt. At this point I just need to get the muscle loose enough so the stretches do me some good. I use a rolling pin five minutes back and forth under each arch where it's tight.
Keep your hamstrings loose and your calves as well...
I am doing much the same stretches as Ellen. A little less though b/c I believe my hamstrings and Piriformus need more attention at this point. But the towel one has to be my favorite so far. Boy do I feel it. The Therabdn has too much flex in it so I am done with that method. I can definitely feel the difference.
If I learn anything else from PT I will post it.
Do you just have the PF? Or something else in conjunction?

Re: stretching

Glenn X on 9/05/01 at 20:37 (059171)

Ellen: Sounds thorough and fitting. You seem well able to manage your tolerance level too.

Am I understanding the difference between the 1st and 2nd exercises correctly? Both are dorsiflexing your ankle, but one is with your leg straight and one is with your knee bent? I've wondered if I should go at my calves with bent knee too.

Right on with the right exercises at the right time comment. I may have finally learned to listen to my body about that. Formerly I, and others, kept shoulding all over me. And I too often went with the shoulds instead of with my gut feelings.

Dialoguing on heelspurs about all this, besides giving me extremely valuable treatment suggestions, has helped me seize and maintain sensible control over my own treatment. I still listen to others, but I ponder and ask others here on HS, and test the waters more, before lurching off in suggested directions. For that particular insight I thank a GREAT MANY people here on heelspurs. This site is empowering!

Re: Ellen Glenn and Carmen

Glenn X on 9/05/01 at 21:03 (059173)

Paula: Calves in warm water are a great idea. When I have time I rest mine on a heating pad before stretching.

Back in June, I think, I shared some highlights from, I believe a Texas A&M study, that verified warming muscles before stretching helps them better elongate. They tested that hypothesis by a variety of methods: warming up from exercise (toe lifts), heating pads, and ultrasound. (And maybe another I can't recall). I believe 10 minutes of pre-stretch warming was the suggestion.

Anyway, warming beforehand made a significant difference in attaining a better angle of dorsiflexion.

Re: stretching

Julie on 9/06/01 at 05:28 (059190)

Glenn, I think I can answer your question about Ellen's stretches 1 and 2. The first one, with the towel looped around the top (ball) of the foot, is essentially using the windlass mechanism: bending the toes back from the metatarsal to create a stretch along the fascia. The second, with the towel around the bottom of the foot, would provide a stretch all along the hamstring/calf/achilles complex. In this one the windlass mechanism isn't being involved (the stretch would be too strong for the fascia if it were). But maybe Ellen has something to say on this?

Re: Warm muscles

Julie on 9/06/01 at 05:33 (059192)

Warming muscles before stretching is always a good idea, whatever method is used. Cold muscles are more easily injured, so it's particularly important to be warm when stretching to deal with injured tissues as in PF. This is why stretching before getting out of the bed in the morning is particularly beneficial: the whole body is warm from a (presumably) cozy night's sleep.

Equally important is that the room you're stretching in be warm. 70 degrees is optimum. Whatever advantage given byeating pads and hot water bottles will soon be lost if the stretching is done in a cold environment.

Re: Warm muscles

Julie on 9/06/01 at 05:34 (059193)

Not 'eating' pads. 'Heating' pads.

Re: Warm muscles

ellen w on 9/06/01 at 10:27 (059226)

Glenn,
Julie is correct, and though my reference to a bent knee actually was about the opposite leg, I did leave out of my post that my therapist actually wants me to do stretch # 1 in both ways -- with the leg being stretched straight, and with the knee slightly bent, because it stretches different muscles. She also has me doing several standing stretches as well (one using a Pro Stretch, and a second an inclined board), and in the last session had me doing them straight legged and with knee bent, again to reach different muscles in the legs. If you email me your fax number, I can send you the exercise sheet she gave me (ewatson @ netmail. hscbklyn. edu) {{delete the spaces -- I put those in per a tip on this board about being careful of how you list your email.)

Re: stretching

JudyS on 9/06/01 at 14:49 (059250)

Ditto on that 'bent knee' calf stretch, Glenn. It's as important as the 'regular' calf stretch because it stretches the more-specific soleus. A word to the wise, however. It can be a very demanding stretch so, as with all else, conservative caution while doing it!

Re: stretching

Julie on 9/06/01 at 16:11 (059269)

Judy, that's exactly right, I think. When the leg is straight you're stretching mainly the gastrocnemius; when it's bent the stretch is working into the soleus. That's the point at which it may, if not very carefully done, start to irritate the achilles and possibly the fascia.

Re: stretching

john h on 9/06/01 at 19:15 (059291)

julie: i get so confused when you call these muscles by their proper medical terms.

Re: stretching

Julie on 9/07/01 at 03:13 (059335)

Sorry about that, dear John. But it's useful to differentiate them, and not just say 'calf muscles', because they need to be targetted individually targetted. The gastroc is a big fat muscle, easily stretched when the leg is straight without getting into difficulties. When you get into stretching soleus, with the knee bent, that's when you need to be mindful, to avoid pulling clumsily on the achilles and the fascia. So we do need to be precise.

I don't believe you, actually, and suspect you're pulling my leg. Go right ahead (just don't pull too hard on my achilles).

Re: stretching

john h on 9/07/01 at 11:02 (059370)

my flying is precise. my knowledge of anatomy is much less precise.

Re: stretching

Julie on 9/07/01 at 11:26 (059377)

I do like to be as precise as I can be, given my limited knowledge, because I necessarily have a professional as well as a personal interest in the workings of the human body. And I've had to teach (very) basic anatomy to my trainee teachers. It's useful, when we talk about 'stretching', to know what we're talking about. I know Glenn will agree with me here.

But I cannot fly a plane.

Re: stretching

Glenn X on 9/07/01 at 20:53 (059432)

Thanks: I'll ease it in.

Re: stretching

Carmen H on 9/05/01 at 07:58 (059076)

Paula~
I'm a little confused....did your PT not give you any stretches especially for your condition?

Re: stretching

ellen w on 9/05/01 at 12:18 (059107)

Hi Paula,

I re-started PT about 2 weeks ago for what my doc calls 'phase II' of his PF treatment -- a supervised stretching regime. After the first 4 sessions, I had increased pain on the day of therapy, but felt better the day after; now at session 7 I am beginning to feel pretty good.

This is the at home stretching regime I've been given (just note that my pain was at the low end of the scale, and I have been able to stand for significant periods of time without major consequeces.) I do these in bed in the morning before getting up.

1.
Sit with towel or strap around foot, holding the towel with both hands. Pull the top of the foot toward your body so that you feel a stretch. Hold 20-30 seconds, 2-3 times a day.

2. Lie on back with leg up in air; keep the opposite leg straight, but bent at the knee. Loop towel around the bottom of your foot and pull your foot down, towards your body. Hold 20 seconds, 2-3 repetitions, 2-3 times per day.

3. Bend ankle up, down, and side by side, holding each position for a few seconds and pushing foot as far as it will go in each direction. Repeat this several times during the day.

4. Move ankle around slowly in a large circle. Repeat in the opposite direction. 20 repetitions, several times per day.

5. Move ankle slowly around as if tracing the letter of the alphabet, A-Z. Repeat several times per day.

6. Sitting down, roll a tennis ball under your foot, up/down, side to side, for several minutes. (this is my favorite)

I usually begin this series with Julie's toe stretches (do a search for her post to 'Rudy').

During appointments, I receive ultrasound, massage, and electrical stimulation, as well as some standing stretches. I also take a drug called Mobic, which is helping with joint stiffness.

She also has me doing what she calls an ice massage -- freeze water in a dixie cup, and once frozen, tear down the paper so that the top of the ice is exposed but you have the paper cup to hold on to. Run it up and down the length of your foot, 5 minutes or until your foot begins to feel numb.

Like Glenn, once the heel pain is gone, I think the next step for me will be to try and regain a strong walking gait. (Thanks Glenn, Carmen, and Julie if you're reading this, I think this has been a really important discussion.)

Tammie also makes a good point, backing up what Dr. Davis has said -- you have to be at a point where you are ready to do the right exercises at the right time.

ellen

Re: Ellen Glenn and Carmen

Carmen H on 9/05/01 at 13:18 (059113)

We are all on the same track it seems! Let's keep in touch and see how we all do with this type of treatment. Makes perfect sense to me.
After only ONE day of stretching my feet are LESS sensitive to pain. They still hurt but less sensitive and that's a good step for me!

Re: Ellen Glenn and Carmen

paula on 9/05/01 at 15:27 (059122)

thanks for the details. i've been to 4 pt s each one has different stretches, some the same others not. i find a gem of a sttretch each time i ask this question. or a technique that i find applies. my current pt has no problem with me experimenting and then checking with her if i should continue . more stretching details would be great. by the way i often stick my feet in warm water up the the knees before i stretch. thought i'd pass that on. do most people here ice after stretching or exercise? i find it sorta frustrating when folks say something works and then don't give any details. if it hadn't been for this board i would still probably be stretching too hard. any one else with any stretching ideas that work for them?

Re: Ice AFTER

Carmen H on 9/05/01 at 16:20 (059129)

My PT said Ice after. Never before. You want the muscle loose and as flexible as it can be. I don't use warm water to loosen but I am sure it can't hurt. At this point I just need to get the muscle loose enough so the stretches do me some good. I use a rolling pin five minutes back and forth under each arch where it's tight.
Keep your hamstrings loose and your calves as well...
I am doing much the same stretches as Ellen. A little less though b/c I believe my hamstrings and Piriformus need more attention at this point. But the towel one has to be my favorite so far. Boy do I feel it. The Therabdn has too much flex in it so I am done with that method. I can definitely feel the difference.
If I learn anything else from PT I will post it.
Do you just have the PF? Or something else in conjunction?

Re: stretching

Glenn X on 9/05/01 at 20:37 (059171)

Ellen: Sounds thorough and fitting. You seem well able to manage your tolerance level too.

Am I understanding the difference between the 1st and 2nd exercises correctly? Both are dorsiflexing your ankle, but one is with your leg straight and one is with your knee bent? I've wondered if I should go at my calves with bent knee too.

Right on with the right exercises at the right time comment. I may have finally learned to listen to my body about that. Formerly I, and others, kept shoulding all over me. And I too often went with the shoulds instead of with my gut feelings.

Dialoguing on heelspurs about all this, besides giving me extremely valuable treatment suggestions, has helped me seize and maintain sensible control over my own treatment. I still listen to others, but I ponder and ask others here on HS, and test the waters more, before lurching off in suggested directions. For that particular insight I thank a GREAT MANY people here on heelspurs. This site is empowering!

Re: Ellen Glenn and Carmen

Glenn X on 9/05/01 at 21:03 (059173)

Paula: Calves in warm water are a great idea. When I have time I rest mine on a heating pad before stretching.

Back in June, I think, I shared some highlights from, I believe a Texas A&M study, that verified warming muscles before stretching helps them better elongate. They tested that hypothesis by a variety of methods: warming up from exercise (toe lifts), heating pads, and ultrasound. (And maybe another I can't recall). I believe 10 minutes of pre-stretch warming was the suggestion.

Anyway, warming beforehand made a significant difference in attaining a better angle of dorsiflexion.

Re: stretching

Julie on 9/06/01 at 05:28 (059190)

Glenn, I think I can answer your question about Ellen's stretches 1 and 2. The first one, with the towel looped around the top (ball) of the foot, is essentially using the windlass mechanism: bending the toes back from the metatarsal to create a stretch along the fascia. The second, with the towel around the bottom of the foot, would provide a stretch all along the hamstring/calf/achilles complex. In this one the windlass mechanism isn't being involved (the stretch would be too strong for the fascia if it were). But maybe Ellen has something to say on this?

Re: Warm muscles

Julie on 9/06/01 at 05:33 (059192)

Warming muscles before stretching is always a good idea, whatever method is used. Cold muscles are more easily injured, so it's particularly important to be warm when stretching to deal with injured tissues as in PF. This is why stretching before getting out of the bed in the morning is particularly beneficial: the whole body is warm from a (presumably) cozy night's sleep.

Equally important is that the room you're stretching in be warm. 70 degrees is optimum. Whatever advantage given byeating pads and hot water bottles will soon be lost if the stretching is done in a cold environment.

Re: Warm muscles

Julie on 9/06/01 at 05:34 (059193)

Not 'eating' pads. 'Heating' pads.

Re: Warm muscles

ellen w on 9/06/01 at 10:27 (059226)

Glenn,
Julie is correct, and though my reference to a bent knee actually was about the opposite leg, I did leave out of my post that my therapist actually wants me to do stretch # 1 in both ways -- with the leg being stretched straight, and with the knee slightly bent, because it stretches different muscles. She also has me doing several standing stretches as well (one using a Pro Stretch, and a second an inclined board), and in the last session had me doing them straight legged and with knee bent, again to reach different muscles in the legs. If you email me your fax number, I can send you the exercise sheet she gave me (ewatson @ netmail. hscbklyn. edu) {{delete the spaces -- I put those in per a tip on this board about being careful of how you list your email.)

Re: stretching

JudyS on 9/06/01 at 14:49 (059250)

Ditto on that 'bent knee' calf stretch, Glenn. It's as important as the 'regular' calf stretch because it stretches the more-specific soleus. A word to the wise, however. It can be a very demanding stretch so, as with all else, conservative caution while doing it!

Re: stretching

Julie on 9/06/01 at 16:11 (059269)

Judy, that's exactly right, I think. When the leg is straight you're stretching mainly the gastrocnemius; when it's bent the stretch is working into the soleus. That's the point at which it may, if not very carefully done, start to irritate the achilles and possibly the fascia.

Re: stretching

john h on 9/06/01 at 19:15 (059291)

julie: i get so confused when you call these muscles by their proper medical terms.

Re: stretching

Julie on 9/07/01 at 03:13 (059335)

Sorry about that, dear John. But it's useful to differentiate them, and not just say 'calf muscles', because they need to be targetted individually targetted. The gastroc is a big fat muscle, easily stretched when the leg is straight without getting into difficulties. When you get into stretching soleus, with the knee bent, that's when you need to be mindful, to avoid pulling clumsily on the achilles and the fascia. So we do need to be precise.

I don't believe you, actually, and suspect you're pulling my leg. Go right ahead (just don't pull too hard on my achilles).

Re: stretching

john h on 9/07/01 at 11:02 (059370)

my flying is precise. my knowledge of anatomy is much less precise.

Re: stretching

Julie on 9/07/01 at 11:26 (059377)

I do like to be as precise as I can be, given my limited knowledge, because I necessarily have a professional as well as a personal interest in the workings of the human body. And I've had to teach (very) basic anatomy to my trainee teachers. It's useful, when we talk about 'stretching', to know what we're talking about. I know Glenn will agree with me here.

But I cannot fly a plane.

Re: stretching

Glenn X on 9/07/01 at 20:53 (059432)

Thanks: I'll ease it in.