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Dr. ED....need your input

Posted by Carmen on 9/12/01 at 16:10 (060001)

Okay....need to know what you know about FHL (Flexor Hallicus Longus) Tendinitis?

Re: Dr. ED....need your input

Dr. Zuckerman on 9/12/01 at 16:33 (060008)

Not Dr. Ed but will try to answer anyway. I think his e-mail is down. FHL
is the tendnon that runs in the same canal known as the Tarsal tunnel.
The tendon get inflamed or hurt at the level of the tunnel, back of the talus bone. and up to the big toe joint. Can be part of TTS. An MRI can be used to evaluate this tendon and if it is torn.

Re: Thanks Dr. Z

Carmen H on 9/12/01 at 18:51 (060029)

Welcome back....we missed you. I have this exact problem in both feet. Is that possible? The bilateral symptoms? The stretching and PT have been helpful so far.

Re: One more thing...

Carmen H on 9/12/01 at 19:11 (060035)

What is common treatment for this? I am in my 14th week of 'PF'...which is obvious to me this is NOT pf....

Re: One more thing...

Ed Davis, DPM on 9/12/01 at 22:23 (060063)

Hello. Just got up and running with ATG, Advanced Telecom Group--they are awesome! Got me DSL service in less than one week. Up and running without a hitch. They are a small telecom company providing service in the Tacoma, WA and Santa Rosa, CA areas--actually in the black financially.

FHL runs down the back of the leg, wraps around the back of the talus, dives under the sole of the foot and attaches to the base of the big toe. A tendinitis of FHL can occur in different places. Where does it hurt?
Ed

Re: Glad you are up and running!

Carmen H on 9/13/01 at 07:45 (060098)

Good deal! We need you! The FHL runs down the back of the leg?????????
That's where my pain starts!!! It feels like shooting fire from the bottom of my read (sitting bones) to my big toe.....Pain isn't consistent though. The bum is the only place it REALLY hurts constantly/
My foot pain is minimal....until the end of the day. Then burning and tingling sets in. When I pull back my big toe there is a tendon that is HARD as a rock (looks like a bowstring) stretching from the big toe to the heel. There is mild tender pain at the calcaneous (sp?). I am in therapy for EXTREMELY tight hamstrings and calves.....(I had a surgery in Dec 2000 that has caused these muscles to tighten like mad) and am wondering if this has made the FHL occur? Is there a possiblity that with the PT to get some flexibility in the hamstrings and calves and gluets that the FHL will loosen up and give me some relief? THANKS dr. Ed....

Re: Glad you are up and running!

Ed Davis, DPM on 9/13/01 at 13:08 (060144)

Carmen:
FHL is generally difficult to feel once it 'dives' into the sole of the foot. You could be feeling the FHL especially if it pops out when you bend your big toe back--something that would be helpful to see. What type of surgery did you have?
Ed

PS An anatomy atlas can be a useful and interesting reference book to own so you can trace and understand the route of muscles, tendons, etc.

Re: surgery

Carmen H on 9/13/01 at 15:28 (060160)

I hadthe Piriformus muscle released from the sciatic nerve as it was entangled in the muscle. ugly little situation. Helped with the searing sciatic pain but I am still in pain from the glues to the feet. I am not giving up though...I know all of this has to have a simple solution. It's just finding a doctor that WANTS to help.
As my husband says I'll fly your butt out to Calif for treatment if I have to to get you better!!!!

Re: surgery

Ed Davis, DPM on 9/13/01 at 19:45 (060216)

Irritation or compression of the sciatic nerve can cause symptoms on the bottom of the feet. The bottoms of the feet have innervation which derives from the S1, S2 nerve roots (first and second sciatic). I cannot envison a direct connection to FHL tendinitis though. You have described a scenario of foot pain that is not common so I think a good exam is in order. Where do you live--will let you know if I know anyone in your area.
Ed

Re: Atlanta

Carmen H on 9/14/01 at 08:11 (060288)

I am going to the GP today and possibly getting a Neurologist to see if it's a nerve issue....it's nerve 'pain' if that makes sense. My muscles don't hurt...but the shooting pains and tingling snesations make me think it's nerve related. What do you think?
If you know of anyone that deals with FOOT/back/gluteal pain that would be GREAT. So far NO ONE has been able to help..

Re: Atlanta

Ed Davis, DPM on 9/14/01 at 11:24 (060311)

I assume you are the same Carmen as in the next post on the page who has seen Dr. Ruch??
Ed

Re: Atlanta

CArmen H on 9/14/01 at 14:55 (060342)

I am the very one...with alllll the problems.

Re: Dr. ED....need your input

Dr. Zuckerman on 9/12/01 at 16:33 (060008)

Not Dr. Ed but will try to answer anyway. I think his e-mail is down. FHL
is the tendnon that runs in the same canal known as the Tarsal tunnel.
The tendon get inflamed or hurt at the level of the tunnel, back of the talus bone. and up to the big toe joint. Can be part of TTS. An MRI can be used to evaluate this tendon and if it is torn.

Re: Thanks Dr. Z

Carmen H on 9/12/01 at 18:51 (060029)

Welcome back....we missed you. I have this exact problem in both feet. Is that possible? The bilateral symptoms? The stretching and PT have been helpful so far.

Re: One more thing...

Carmen H on 9/12/01 at 19:11 (060035)

What is common treatment for this? I am in my 14th week of 'PF'...which is obvious to me this is NOT pf....

Re: One more thing...

Ed Davis, DPM on 9/12/01 at 22:23 (060063)

Hello. Just got up and running with ATG, Advanced Telecom Group--they are awesome! Got me DSL service in less than one week. Up and running without a hitch. They are a small telecom company providing service in the Tacoma, WA and Santa Rosa, CA areas--actually in the black financially.

FHL runs down the back of the leg, wraps around the back of the talus, dives under the sole of the foot and attaches to the base of the big toe. A tendinitis of FHL can occur in different places. Where does it hurt?
Ed

Re: Glad you are up and running!

Carmen H on 9/13/01 at 07:45 (060098)

Good deal! We need you! The FHL runs down the back of the leg?????????
That's where my pain starts!!! It feels like shooting fire from the bottom of my read (sitting bones) to my big toe.....Pain isn't consistent though. The bum is the only place it REALLY hurts constantly/
My foot pain is minimal....until the end of the day. Then burning and tingling sets in. When I pull back my big toe there is a tendon that is HARD as a rock (looks like a bowstring) stretching from the big toe to the heel. There is mild tender pain at the calcaneous (sp?). I am in therapy for EXTREMELY tight hamstrings and calves.....(I had a surgery in Dec 2000 that has caused these muscles to tighten like mad) and am wondering if this has made the FHL occur? Is there a possiblity that with the PT to get some flexibility in the hamstrings and calves and gluets that the FHL will loosen up and give me some relief? THANKS dr. Ed....

Re: Glad you are up and running!

Ed Davis, DPM on 9/13/01 at 13:08 (060144)

Carmen:
FHL is generally difficult to feel once it 'dives' into the sole of the foot. You could be feeling the FHL especially if it pops out when you bend your big toe back--something that would be helpful to see. What type of surgery did you have?
Ed

PS An anatomy atlas can be a useful and interesting reference book to own so you can trace and understand the route of muscles, tendons, etc.

Re: surgery

Carmen H on 9/13/01 at 15:28 (060160)

I hadthe Piriformus muscle released from the sciatic nerve as it was entangled in the muscle. ugly little situation. Helped with the searing sciatic pain but I am still in pain from the glues to the feet. I am not giving up though...I know all of this has to have a simple solution. It's just finding a doctor that WANTS to help.
As my husband says I'll fly your butt out to Calif for treatment if I have to to get you better!!!!

Re: surgery

Ed Davis, DPM on 9/13/01 at 19:45 (060216)

Irritation or compression of the sciatic nerve can cause symptoms on the bottom of the feet. The bottoms of the feet have innervation which derives from the S1, S2 nerve roots (first and second sciatic). I cannot envison a direct connection to FHL tendinitis though. You have described a scenario of foot pain that is not common so I think a good exam is in order. Where do you live--will let you know if I know anyone in your area.
Ed

Re: Atlanta

Carmen H on 9/14/01 at 08:11 (060288)

I am going to the GP today and possibly getting a Neurologist to see if it's a nerve issue....it's nerve 'pain' if that makes sense. My muscles don't hurt...but the shooting pains and tingling snesations make me think it's nerve related. What do you think?
If you know of anyone that deals with FOOT/back/gluteal pain that would be GREAT. So far NO ONE has been able to help..

Re: Atlanta

Ed Davis, DPM on 9/14/01 at 11:24 (060311)

I assume you are the same Carmen as in the next post on the page who has seen Dr. Ruch??
Ed

Re: Atlanta

CArmen H on 9/14/01 at 14:55 (060342)

I am the very one...with alllll the problems.