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How do I stretch if stretching is painful?

Posted by Ellen on 3/19/02 at 20:26 (076913)

Hi,
Recently I discovered that my althetic shoes have been causing flareups and in my search for different shoes I reinjured myself because my feet disliked the new models even more than the old model. I don't really know how the shoes caused it, but I went from being mostly pain-free to hardly able to walk. When I walk I can feel that the calf muscle is tight and pulling on the achilles and all the way under my foot. However, if I try to gently stretch the calf muscle out so it will stop that pulling, it hurts my foot when I try and stretch. Does anyone know how I can get the calf muscle to stop being tight and stop pulling on my Fascia without causing more harm? The tightness seems to be causing even more reinjury.
The shoes also caused new pain and swelling on the medial side of the arches, more or less below the ankle bones. I wasn't doing anything in the shoes but walking around the fitness center for an hour each day. I'm now working at home and trying not to walk. Any help on the tight calf muscle would be greatly appreciated.
Thanks,
Ellen J.

Re: How do I stretch if stretching is painful?

Carole C in NOLA on 3/19/02 at 21:30 (076921)

You are right that your tight Achilles tendon is re-injuring your plantar fascia. Keep searching for shoes that don't do this. You will probably need to cut back on your walking, too, and rest more instead to allow your feet to heal.

Meanwhile, to loosen things up you have to start stretching gently at a level that doesn't hurt at all, and warm up for a few minutes doing that type of stretching. Then you may be able to stretch a little bit more, but don't push yourself. If it hurts, it will re-injure you.

Try this one; it's pretty gentle. Sit on your bed with your leg up on the bed too, stretched out in front of you. Point your toes towards your nose (upwards and inwards, in other words). Hold for ten seconds. Do the same with the other foot. If it hurts, don't point them so hard. Rest your feet and make lazy, gentle circles with them to loosen them up. Then try the stretch again. After a few times, if it hurts less, try it for a little longer up to 30 seconds. This is a good start and should help your tendons to loosen up a little. Easy does it. Hope this helps.

Carole C

Re: How do I stretch if stretching is painful?

Julie on 3/20/02 at 01:48 (076946)

How to stretch the gastroc/soleus/achilles complex without re-injuring the fascia: that's the $64,000 question. It's necessary to lengthen it, but it's not easy to do so without aggravating the injured/inflamed fascia, into which the complex feeds. Weight-bearing stretches, including (especially) the conventional stretches generally advised for PF, e.g. the wall stretch and the stair stretch are not helpful for most people (there have been exceptions: I'm generalising).

Ellen, one thing that occurs to me is that you might well benefit from using a night splint. Adjusted properly, it holds the GSA complex in a state of gentle tension for a long period of time, and over time, it helps to do the job. The N'Ice n' Stretch, which Scott sells here, is considered the most user-friendly.

I do also think you might find the two devices I mentioned last week useful: the Personal Foot Trainer and the Acu-Flex (although Alan K didn't respond last time, so it looks as though he has disappeared again).

I second Carole's thoughts about shoes, and the stretch she describes is good. I know you're athletic, and a 'do-er', so this stretch and the yoga exercises I mentioned earlier probably seem like little nothings to you, but it really is possible to be TOO active and to do TOO much. What you're after is gentle, mindful work.

Maybe you're walking too much? 'An hour around the fitness centre every day' sounds like an awful lot of weight-bearing for your fascia.

I hope this is helpful.

Re: How do I stretch if stretching is painful?

Ellen on 3/20/02 at 09:47 (076966)

Hi Carol and Julie,
Thank you both for your comments. I plan to resume my search for shoes as soon as my feet will let me walk around stores without hobbling. I did look at the personal foot trainer but was a little afraid to try it since anything where I push with the balls of my feet causes problems. I may try it when my feet get much stronger. I have been doing non-weight bearing stretches previous to the reinjury and I think I can continue them soon, as my feet are much better today than they were yesterday. I stayed off them as much as possible, iced twice and used a heating pad and applied Arnica Gel, allowing the heating pad to make the medication penetrate better. (I put a piece of plastic wrap over the gel on my foot to hold the gel on). I decided that it's not good to ice and then walk anywhere--better to let the feet return to normal temperature after icing, then stand up.
I will order a night splint.
Do you have any guidelines as to how many days after an injury we should continue to ice?
Thanks again,
Ellen

Re: How do I stretch if stretching is painful?

Julie on 3/20/02 at 15:55 (077008)

Ellen, icing reduces inflammation, so as I understand it it can be helpful to ice whenever you're in pain, not just after a specific identifiable injury. I certainly found it a relief to ice a couple of times a day when my PF was at its worst. I used a gel pack - have you got one? It's a good deal more convenient than frozen water. I agree it's better not to walk immediately afterwards.

Did you find the Arnica gel helpful?

Re: How do I stretch if stretching is painful?

Rich on 3/20/02 at 16:50 (077025)

I could not handle weightbearing stretches either. A slant board helps me, I use it up to six times a day and store it under my desk at home and work. I rest my feet on it while I'm at the computer so they benefit from the slight stretch over a longer period. I use the night splint every night! It's not very comfortable but is does work. It takes awhile to get used to....

I also ice several times a day, not just after an activity. I use both gel packs or ice cups, which work the best at getting into the insertion point.

Good Luck and be Gentle!
Rich

Re: How do I stretch if stretching is painful?

Ellen on 3/20/02 at 18:33 (077031)

Hi Julie,
I was in a bit of pain tonight after running errands so I iced when I got home and the pain was gone. I can't believe it took me 2.5 years to finally start icing. I do have a gel pack and love it, as it doesn't leak like the ziploc baggies.
The Arnica Gel does seem to work for me. At night I put it on my feet and cover the area with those extra large bandages (big square bandaids). During the day I use the heating pad technique once or twice. Some people could potentially experience skin irritaion with it, so a sensitive skinned type would want to apply sparingly and not make a poultice at first. I use a type called 'Arniflora', found at natural food stores. Arnica does not provide immdiate pain relief, however, like icing does. It is miraculous when it comes to bruises, however.
Thank you for your advice on when to ice. I am a true convert now.
Ellen J.

Re: How do I stretch if stretching is painful?

Ellen on 3/20/02 at 18:39 (077032)

Very good idea to use a slant board while working! I think I will have my Significant Other make me one, since he would enjoy such a project. Do you know what degree of slant your board has? I'm thinking of a 5 or 10 degree slant. Any opinions out there on what is the right amount?
Thanks, Rich. Everyone on this site is such a huge help!
Ellen

Re: How do I stretch if stretching is painful?

Kathy G on 3/20/02 at 18:50 (077033)

Ellen,

For what it's worth, when I wore Asics Gel Running shoes with the Duo-Max heel, my achilles tendonitis got much, much worse. My doctor said that was because my heel wasn't moving enough due to the construction of the shoe and that I should buy only Asics without the Duo-Max heel. I did what he said and it seemed to help. Perhaps a good sporting shoe store could tell you what qualities you need in a shoe to help prevent the problem with the tendon.

Stretching the calf muscle is just so difficult because the old 'stair hanging' which the Physical Therapist told me to use, along with the 'wall stretches' probably makes the heels worse. Actually, I didn't do the wall stretches because they just hurt, but I must confess that the stair hanging seemed to help, or so I thought. I have since used the slant board mentioned above but usually rely on the other methods of just pointing my toes back and inward. As to the icing, I'm very bad but Julie is right, one should ice whether they hurt badly or not. I tend to do it only when I'm in pain, but that's just because I'm not too bright!!

I'll be interested in how the Arnica works for you. I tried the tablets for tendonitis in my hand a few years ago and they worked like a charm, for a while. Then they just stopped working altogether. My assumption was that at a certain point the body just becomes accustomed to the Arnica and it becomes almost 'immune' to its anti-inflammatory properties, but who knows? If it works, keep using it and good luck!

Re: How do I stretch if stretching is painful?

Ellen on 3/20/02 at 19:07 (077034)

Hi Kathy,
Interesting that you should mention the Asics Gels. That is what I recently bought that didn't agree with my feet, though they sure seemed comfortable while I was in the store trying them on. Some people think they are great and it just goes to show how different our feet are. Once I stopped wearing those shoes and rested my feet (and walked really carefully), the tightness in my calves began to disappear. I will go back to stretching gently very soon now and I look forward to it because it had been very helpful to me previously.
I think you are right about developing a tolerance to Arnica. From what I remember reading in a homeopathy book, there seems to be a certain time in which a remedy is used and then it is stopped. I've also heard that Arnica is best used when an injury is new, as that's when it's most helpful. I'm not a doctor or homeopathist, however, so the knowlegeable people out there may contradict and correct what I'm saying. Any input from people who know about such things would be interesting to hear.
Ellen J.

Re: Just realized that I already said exactly the same thing.....

Kathy G on 3/20/02 at 19:16 (077036)

in a prior posting to you. You'd think I could keep it straight - you're the only Ellen! Sorry about that.

As to the Raynauds Syndrome, you could possibly have it. My hands and feet have been affected since I was about 14. Before that, I could go outside and sled and ice skate for hours! When I was 14, I thought I had gotten frostbitten while skating. It wasn't until years later, when a doctor mentioned my 'purple' hands and feet that I realized what I had. It's not that big a deal, for me, thankfully. I just know not to allow myself to get too cold and to really bundle up. It did limit the amount of time I could spend sliding in the winter with my kids, though, and that really bothered me because I'm still a child at heart, even if my body doesn't know it!

Well, sorry about the double posting, and good luck with your calf pain!

Re: How do I stretch if stretching is painful?

Rich on 3/20/02 at 21:30 (077050)

My PT gave us a diagram...which I cannot find, of course. Mine are about six inches high and wide enough for both feet. I leave my heels on the floor and straighten the legs till I feel the stretch. I hold for about 30 seconds, release and rest for about a minute then repeat. I do three-four sets up to six times a day. Just sitting with your feet propped, with heels on floor gives a comfortable stretch while working. Also good in front of the sink while doing dishes. And don't forget to ice at least twice a day. My hubby used scrap wood he had on hand so it didn't cost us a thing. Very basic! and it gave him some satisfaction knowing that he was contributing to my healing practice.

Re: How do I stretch if stretching is painful?

Julie on 3/21/02 at 02:38 (077064)

Ellen - I'm pleased to hear you've made friends with ice It really does help.

I have a foot rest with an adjustable tilt, which I use when I'm at my desk (like now). It keeps the feet in a gently dorsiflexed position while sitting (the night splint principle, I guess) so that the calf-achilles complex doesn't shorten. If you spend a great deal of time sitting, you'd find it helpful, I'm sure.

It's made by Rubbermaid - not sure if it's available in the States, but you could do a Google search.

Re: How do I stretch if stretching is painful?

Ellen J. on 3/21/02 at 17:57 (077138)

Hi,
I just wanted to say that I now have a nice wooden slant board and I really like it! In fact I think it will be a permanent fixture under my studio table because it is nice to have something to put the feet on while working and of course, it keeps the calves/achilles stretched nicely. Thanks to all who suggested this.
Ellen J.

Re: Just realized that I already said exactly the same thing.....

Ellen J. on 3/21/02 at 18:01 (077140)

Hi Kathy,
I imagine you have tried the activated charcoal handwarmers, etc. I just found out that Raynaud's Syndrome is a bit different than Raynaud's Phenomenon. I learn something new every day! Well, at least summer's coming so you can escape the cold for awhile. (It's snowing here in Vermont today though, so I wonder if spring is really here or not).
Ellen

Re: How do I stretch if stretching is painful?

Julie on 3/22/02 at 02:24 (077161)

Ellen, your significant other is a very quick worker!

Keeping the foot in a dorsiflexed position for long periods of time and thus avoiding shortening, is probably the most effective way of lengthening the calf muscles and achilles tendon, so I'm sure you'll find the slant board a help.

Re: How do I stretch if stretching is painful?

R C on 4/16/02 at 12:54 (079841)

Ellen,

I humbly suggest the following:

* Don't do any weight bearing stretches until your pain is gone.

* Apply ice after vigorous activity, but do not apply ice before stretching.

* A heating pad around the calf might help first thing in the morning.

* Night splint might help.

* Try new shoes with and without a separate heel lift -- the lift might be all you need to make the shoe right.

R C

Re: How do I stretch if stretching is painful?

Carole C in NOLA on 3/19/02 at 21:30 (076921)

You are right that your tight Achilles tendon is re-injuring your plantar fascia. Keep searching for shoes that don't do this. You will probably need to cut back on your walking, too, and rest more instead to allow your feet to heal.

Meanwhile, to loosen things up you have to start stretching gently at a level that doesn't hurt at all, and warm up for a few minutes doing that type of stretching. Then you may be able to stretch a little bit more, but don't push yourself. If it hurts, it will re-injure you.

Try this one; it's pretty gentle. Sit on your bed with your leg up on the bed too, stretched out in front of you. Point your toes towards your nose (upwards and inwards, in other words). Hold for ten seconds. Do the same with the other foot. If it hurts, don't point them so hard. Rest your feet and make lazy, gentle circles with them to loosen them up. Then try the stretch again. After a few times, if it hurts less, try it for a little longer up to 30 seconds. This is a good start and should help your tendons to loosen up a little. Easy does it. Hope this helps.

Carole C

Re: How do I stretch if stretching is painful?

Julie on 3/20/02 at 01:48 (076946)

How to stretch the gastroc/soleus/achilles complex without re-injuring the fascia: that's the $64,000 question. It's necessary to lengthen it, but it's not easy to do so without aggravating the injured/inflamed fascia, into which the complex feeds. Weight-bearing stretches, including (especially) the conventional stretches generally advised for PF, e.g. the wall stretch and the stair stretch are not helpful for most people (there have been exceptions: I'm generalising).

Ellen, one thing that occurs to me is that you might well benefit from using a night splint. Adjusted properly, it holds the GSA complex in a state of gentle tension for a long period of time, and over time, it helps to do the job. The N'Ice n' Stretch, which Scott sells here, is considered the most user-friendly.

I do also think you might find the two devices I mentioned last week useful: the Personal Foot Trainer and the Acu-Flex (although Alan K didn't respond last time, so it looks as though he has disappeared again).

I second Carole's thoughts about shoes, and the stretch she describes is good. I know you're athletic, and a 'do-er', so this stretch and the yoga exercises I mentioned earlier probably seem like little nothings to you, but it really is possible to be TOO active and to do TOO much. What you're after is gentle, mindful work.

Maybe you're walking too much? 'An hour around the fitness centre every day' sounds like an awful lot of weight-bearing for your fascia.

I hope this is helpful.

Re: How do I stretch if stretching is painful?

Ellen on 3/20/02 at 09:47 (076966)

Hi Carol and Julie,
Thank you both for your comments. I plan to resume my search for shoes as soon as my feet will let me walk around stores without hobbling. I did look at the personal foot trainer but was a little afraid to try it since anything where I push with the balls of my feet causes problems. I may try it when my feet get much stronger. I have been doing non-weight bearing stretches previous to the reinjury and I think I can continue them soon, as my feet are much better today than they were yesterday. I stayed off them as much as possible, iced twice and used a heating pad and applied Arnica Gel, allowing the heating pad to make the medication penetrate better. (I put a piece of plastic wrap over the gel on my foot to hold the gel on). I decided that it's not good to ice and then walk anywhere--better to let the feet return to normal temperature after icing, then stand up.
I will order a night splint.
Do you have any guidelines as to how many days after an injury we should continue to ice?
Thanks again,
Ellen

Re: How do I stretch if stretching is painful?

Julie on 3/20/02 at 15:55 (077008)

Ellen, icing reduces inflammation, so as I understand it it can be helpful to ice whenever you're in pain, not just after a specific identifiable injury. I certainly found it a relief to ice a couple of times a day when my PF was at its worst. I used a gel pack - have you got one? It's a good deal more convenient than frozen water. I agree it's better not to walk immediately afterwards.

Did you find the Arnica gel helpful?

Re: How do I stretch if stretching is painful?

Rich on 3/20/02 at 16:50 (077025)

I could not handle weightbearing stretches either. A slant board helps me, I use it up to six times a day and store it under my desk at home and work. I rest my feet on it while I'm at the computer so they benefit from the slight stretch over a longer period. I use the night splint every night! It's not very comfortable but is does work. It takes awhile to get used to....

I also ice several times a day, not just after an activity. I use both gel packs or ice cups, which work the best at getting into the insertion point.

Good Luck and be Gentle!
Rich

Re: How do I stretch if stretching is painful?

Ellen on 3/20/02 at 18:33 (077031)

Hi Julie,
I was in a bit of pain tonight after running errands so I iced when I got home and the pain was gone. I can't believe it took me 2.5 years to finally start icing. I do have a gel pack and love it, as it doesn't leak like the ziploc baggies.
The Arnica Gel does seem to work for me. At night I put it on my feet and cover the area with those extra large bandages (big square bandaids). During the day I use the heating pad technique once or twice. Some people could potentially experience skin irritaion with it, so a sensitive skinned type would want to apply sparingly and not make a poultice at first. I use a type called 'Arniflora', found at natural food stores. Arnica does not provide immdiate pain relief, however, like icing does. It is miraculous when it comes to bruises, however.
Thank you for your advice on when to ice. I am a true convert now.
Ellen J.

Re: How do I stretch if stretching is painful?

Ellen on 3/20/02 at 18:39 (077032)

Very good idea to use a slant board while working! I think I will have my Significant Other make me one, since he would enjoy such a project. Do you know what degree of slant your board has? I'm thinking of a 5 or 10 degree slant. Any opinions out there on what is the right amount?
Thanks, Rich. Everyone on this site is such a huge help!
Ellen

Re: How do I stretch if stretching is painful?

Kathy G on 3/20/02 at 18:50 (077033)

Ellen,

For what it's worth, when I wore Asics Gel Running shoes with the Duo-Max heel, my achilles tendonitis got much, much worse. My doctor said that was because my heel wasn't moving enough due to the construction of the shoe and that I should buy only Asics without the Duo-Max heel. I did what he said and it seemed to help. Perhaps a good sporting shoe store could tell you what qualities you need in a shoe to help prevent the problem with the tendon.

Stretching the calf muscle is just so difficult because the old 'stair hanging' which the Physical Therapist told me to use, along with the 'wall stretches' probably makes the heels worse. Actually, I didn't do the wall stretches because they just hurt, but I must confess that the stair hanging seemed to help, or so I thought. I have since used the slant board mentioned above but usually rely on the other methods of just pointing my toes back and inward. As to the icing, I'm very bad but Julie is right, one should ice whether they hurt badly or not. I tend to do it only when I'm in pain, but that's just because I'm not too bright!!

I'll be interested in how the Arnica works for you. I tried the tablets for tendonitis in my hand a few years ago and they worked like a charm, for a while. Then they just stopped working altogether. My assumption was that at a certain point the body just becomes accustomed to the Arnica and it becomes almost 'immune' to its anti-inflammatory properties, but who knows? If it works, keep using it and good luck!

Re: How do I stretch if stretching is painful?

Ellen on 3/20/02 at 19:07 (077034)

Hi Kathy,
Interesting that you should mention the Asics Gels. That is what I recently bought that didn't agree with my feet, though they sure seemed comfortable while I was in the store trying them on. Some people think they are great and it just goes to show how different our feet are. Once I stopped wearing those shoes and rested my feet (and walked really carefully), the tightness in my calves began to disappear. I will go back to stretching gently very soon now and I look forward to it because it had been very helpful to me previously.
I think you are right about developing a tolerance to Arnica. From what I remember reading in a homeopathy book, there seems to be a certain time in which a remedy is used and then it is stopped. I've also heard that Arnica is best used when an injury is new, as that's when it's most helpful. I'm not a doctor or homeopathist, however, so the knowlegeable people out there may contradict and correct what I'm saying. Any input from people who know about such things would be interesting to hear.
Ellen J.

Re: Just realized that I already said exactly the same thing.....

Kathy G on 3/20/02 at 19:16 (077036)

in a prior posting to you. You'd think I could keep it straight - you're the only Ellen! Sorry about that.

As to the Raynauds Syndrome, you could possibly have it. My hands and feet have been affected since I was about 14. Before that, I could go outside and sled and ice skate for hours! When I was 14, I thought I had gotten frostbitten while skating. It wasn't until years later, when a doctor mentioned my 'purple' hands and feet that I realized what I had. It's not that big a deal, for me, thankfully. I just know not to allow myself to get too cold and to really bundle up. It did limit the amount of time I could spend sliding in the winter with my kids, though, and that really bothered me because I'm still a child at heart, even if my body doesn't know it!

Well, sorry about the double posting, and good luck with your calf pain!

Re: How do I stretch if stretching is painful?

Rich on 3/20/02 at 21:30 (077050)

My PT gave us a diagram...which I cannot find, of course. Mine are about six inches high and wide enough for both feet. I leave my heels on the floor and straighten the legs till I feel the stretch. I hold for about 30 seconds, release and rest for about a minute then repeat. I do three-four sets up to six times a day. Just sitting with your feet propped, with heels on floor gives a comfortable stretch while working. Also good in front of the sink while doing dishes. And don't forget to ice at least twice a day. My hubby used scrap wood he had on hand so it didn't cost us a thing. Very basic! and it gave him some satisfaction knowing that he was contributing to my healing practice.

Re: How do I stretch if stretching is painful?

Julie on 3/21/02 at 02:38 (077064)

Ellen - I'm pleased to hear you've made friends with ice It really does help.

I have a foot rest with an adjustable tilt, which I use when I'm at my desk (like now). It keeps the feet in a gently dorsiflexed position while sitting (the night splint principle, I guess) so that the calf-achilles complex doesn't shorten. If you spend a great deal of time sitting, you'd find it helpful, I'm sure.

It's made by Rubbermaid - not sure if it's available in the States, but you could do a Google search.

Re: How do I stretch if stretching is painful?

Ellen J. on 3/21/02 at 17:57 (077138)

Hi,
I just wanted to say that I now have a nice wooden slant board and I really like it! In fact I think it will be a permanent fixture under my studio table because it is nice to have something to put the feet on while working and of course, it keeps the calves/achilles stretched nicely. Thanks to all who suggested this.
Ellen J.

Re: Just realized that I already said exactly the same thing.....

Ellen J. on 3/21/02 at 18:01 (077140)

Hi Kathy,
I imagine you have tried the activated charcoal handwarmers, etc. I just found out that Raynaud's Syndrome is a bit different than Raynaud's Phenomenon. I learn something new every day! Well, at least summer's coming so you can escape the cold for awhile. (It's snowing here in Vermont today though, so I wonder if spring is really here or not).
Ellen

Re: How do I stretch if stretching is painful?

Julie on 3/22/02 at 02:24 (077161)

Ellen, your significant other is a very quick worker!

Keeping the foot in a dorsiflexed position for long periods of time and thus avoiding shortening, is probably the most effective way of lengthening the calf muscles and achilles tendon, so I'm sure you'll find the slant board a help.

Re: How do I stretch if stretching is painful?

R C on 4/16/02 at 12:54 (079841)

Ellen,

I humbly suggest the following:

* Don't do any weight bearing stretches until your pain is gone.

* Apply ice after vigorous activity, but do not apply ice before stretching.

* A heating pad around the calf might help first thing in the morning.

* Night splint might help.

* Try new shoes with and without a separate heel lift -- the lift might be all you need to make the shoe right.

R C