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tight tendons and what to do about them

Posted by Carole C on 12/14/01 at 15:57 (066973)

I'm pretty new to having heelspurs and PF. When I went to get my orthotics, the pedorthist mentioned several time about how *tight* I am, referring to how tight the various tendons or other soft tissues are, that run from my foot up through my ankle and lower leg. They are pretty tight all the way around my ankle and lower leg, and I think they might be a source of my pain. They do keep me up at night sometimes.

She recommended some stretching and showed me how to do it. I'm to put my leg on a sofa or bed, so that my knee is supported and doesn't hyperextend too much. Then I am to push down gently on my knee and point my toes up towards my face and inwards, and hold for a few seconds. At first she wanted me to tug on my toes with my hand, but when I looked pretty aghast she said I could just point my toes instead.

The shoes and orthotics she made me give my heel a bit of a lift, compared to the Birkenstocks I was wearing and still wear in the evenings, so that helps. But does the heel lift allow my tissues to tighten further?

When I am sitting at a desk, I can either put my foot straight down (in which case the weight of my leg falls squarely on my heel, and that hurts), or else I can extend my legs by straightening them so that the back edge of the heel of my shoe meets the floor, in which case my heel doesn't bear any weight, but my tendons/tissues feel overly stretched. That wasn't true a few weeks ago (but I have been breaking in my first Birks, and then my orthotics, during the past three weeks).

Could this tightness lead to TTS? I tried the 'tapping test', and it looks like I don't presently have it. I don't want it, either! Any comments are welcome.

Carole C

Re: tight tendons and what to do about them

Dr. Marlene Reid on 12/16/01 at 00:16 (067098)

A tight achilles tendon is diagnosed by testing the amount of motion that is available at the ankle joint. Normal is at least 15 degrees of dorsal or anterior flexion. Anything less then that is usually due to a tight tendon. A tight achilles tendon can cause several problems, including heel pain, plantar fasciitis, chronic tearing of the tendon with possible eventual rupture, posterior heel spurs, and pronation which can cause deformities such as bunions and hammertoes as well as problems like TTS. As an adult it is difficult to gain much motion once the tendon is tight, but stretching can help some of the symptoms. If the tightness is severe and some of these other problems are beginning and stretching does not prove to increase the motion, I usually perform surgery to lengthen the tendon.

Re: tight tendons and what to do about them

Dr. Marlene Reid on 12/16/01 at 00:16 (067098)

A tight achilles tendon is diagnosed by testing the amount of motion that is available at the ankle joint. Normal is at least 15 degrees of dorsal or anterior flexion. Anything less then that is usually due to a tight tendon. A tight achilles tendon can cause several problems, including heel pain, plantar fasciitis, chronic tearing of the tendon with possible eventual rupture, posterior heel spurs, and pronation which can cause deformities such as bunions and hammertoes as well as problems like TTS. As an adult it is difficult to gain much motion once the tendon is tight, but stretching can help some of the symptoms. If the tightness is severe and some of these other problems are beginning and stretching does not prove to increase the motion, I usually perform surgery to lengthen the tendon.

Re: tight tendons and what to do about them

Adam C on 2/03/05 at 12:51 (168402)

I have been a chronic PF and TTS sufferer ever since I was highly active in high school sports activities. I am now a chronic sufferer for over 15 years. I went through all of the non-surgical treatments but nothing provided relief. I had two PF releases in my right foot and one on the left but only gained minimal relief. After seeing many podiatrists in two states, I finally found a doctor that diagnosed the tight tendon. I had tendonitis in my heels but associated that with PF and not Achilles Tendonitis. 9 months ago I had a 3rd surgery where the Pod. did a PF release using a different method of cutting the fascia and stitching the stretched tendon to allow it to heal properly stretched and minimize scar tissue from recovery and healing. I also had a Tarsal Tunnel release even though all nerve conductivity tests were normal (not uncommon). While performing the TTS release, the MD discovered that the two major veins running through the tunnel were vericous. This helped explain why the pF release alone did not resolve my pain. Lastly, the MD also did an achilles tendon release. This was the first MD that diagnosed the tight achilles. Well, its has been 9 months later and aside from an ovulsion fracture on the same foot (which kept me off my foot and out of PT for 3 months) I can say that without a doubt the surgery has improved my foot pain by atleast 60%. I highly recommend other PF sufferers to consider the achilles in their diagnosis.

Just wanted to pass along my experience.