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Heel Cords

Posted by J. King on 5/12/02 at 06:28 (083589)

I have high arches and my heel cords are very tight and painful.
If feels like I am walking on a tight bow string. Is there a procedure where the heel cords are cut to relieve the pressure. What would the consequence be of cutting heel cords? Would my arch collapse? I don't have traditional heel pain since the pain is in the arch.

Re: Heel Cords

Carole C in NOLA on 5/12/02 at 08:12 (083593)

J, I'm not a doctor but I have fairly high arches and my heel cords were very tight and painful also. I too have had pain in my arches, as well as heel pain and pain on the side of my foot. Your symptoms sound very similar to mine, and I have heel spurs, plantar fasciitis ('PF'), tendonitis, and bursitis (all of which often occur together as a syndrome). Did you have a similar diagnosis? I would think that probably you did.

I noticed in your other post that you are not stretching because it worsens the pain. This is an indication that you are not stretching GENTLY enough. You have to start really, really slow and gently (at least I did). Some foot professionals routinely recommend stretches that are much too severe for those of us with very tight heel cords so I would urge you to try the following before considering surgery.

My C.Ped started me out in stretching by having me sit on my bed with my legs out in front of me. Then, gently point my toes inwards and upwards (basically towards my nose. Hold for 30 seconds (I could only do this for 5-10 seconds at first, and then worked up to 30 seconds). Then do it with the other foot. Do this before getting out of bed, and several times during the day.

Don't do anything that hurts! If this hurts, point your toes more gently (less vigorously). Even very gentle stretching can help get you started in stretching, and in the days to follow you will be able to do more.

Eventually, after several MONTHS of toe pointing, I was able to grab my toes and pull gently. I still have never done any standing (weight bearing) stretches. My heel cords have loosened up a tremendous amount and my PF is nearly healed. Although in December and January I was truly in agonizing pain, now I am pretty much recovered and able to go about my normal life with little to no pain. I hope this gentle stretching (along with other conservative treatments) works for you too, which is why I'm writing this post.

I don't know how many of the other conservative treatments you have tried, so I will describe some that you should try before considering surgery. Conservative treatments (non-surgical treatments) have a greater success rate than surgery.

Other things that you need to do are to never, ever go barefoot, not even in the shower, until you have recovered. Wear shower shoes, and/or use a shower stool. While your pain is acute you should ice your feet daily to reduce the swelling. I rest my feet on a bag of frozen peas and that works quite well. I am a bit 'chicken' about cold, so I ice them 4-5 minutes or until it starts feeling uncomfortable, and then take them off for a minute, and then repeat a number of times for about a half hour. Other people ice for longer periods of time before removing their feet from the cold. Your doctor can prescribe anti-inflammatories as well. Rest your feet as much as possible, so they can heal. Avoid stairs and lifting heavy things.

Read the heel pain book on this website for more suggestions. I found that custom orthotics and Birkenstocks were all I could wear on my feet until I felt better. Some people get good results from taping, which is described and illustrated in the heel pain book (I never tried it). You will probably need a night splint if you can't get the stretching to work.

Good luck, and I sincerely wish you feet that are free of pain!

Carole C

Re: Heel Cords

paula on 5/12/02 at 09:07 (083600)

carol, when you say you pointed your toes inward and upward, do you mean you pigeon toed before you pulled your ankle up towards your head?

Re: Heel Cords

Carole C in NOLA on 5/12/02 at 09:28 (083608)

Paula, I was instructed to rotate my foot clockwise (for the left foot) or counter clockwise (for the right foot), and then point my toes upwards (which essentially dorsiflexes the foot). This results in pointing my toes towards my nose. If you do this, you can feel a gentle tug on some tendons that are tight, that wouldn't get gently stretched if you didn't rotate your foot first.

I was not instructed to pull my ankle at all! Just point the toes, gently, without using your hands except to hold your knee down so that your leg remains flat on the bed. This is a very gentle stretch, if done right, and so it works for those of us with very tight tendons.

At first my C.Ped wanted me to tug on my toes with my hands, and when I looked at her with an expression of utter horror and spluttered 'I can't, that would kill me!', she quickly backpedaled and said I could do this instead at first. It has helped me a lot.

Hope this helps clarify my description.

Carole C

Re: Heel Cords

paula on 5/12/02 at 09:43 (083612)

that's interesting carol. my p.t. wants me to do a sole-to-sole. fifty a day! it sounds kinda similar. sitting down with knees bent and hanging over edge, supported because you are sitting high enough up, turn ankles inward. this seems to give a stretch to the outside ankle and maybe the outside heel cord. it seem when i try your idea i get the same stretch. not exaclty my calf muscle and not the inside heel cord but the outside of the ankle and lower leg gets stretched. is this waht you get?

Re: Heel Cords

J. King on 5/12/02 at 11:08 (083618)

Thanks for the advice. My feet have hurt so long that I get frustrated with
waiting and trying new things. I will try the gentle stretches.

Re: Heel Cords

Carole C in NOLA on 5/12/02 at 16:30 (083643)

Not the same at all for me..... for me the toe pointing does so much more, because it gets a lot of those tight tendons and muscles in the lower leg that just aren't involved with the sole-to-sole. The sole to sole mainly seems like it's limited to the sides of the ankles, but then that would make sense, from the symptoms you've described which are not typical of ordinary PF because of your complications. Try holding your knee down when you do the toe pointing. That might help you to feel what I'm talking about. Or maybe I'm doing the sole-to-sole wrong. LOL

Carole C

Re: Heel Cords

paula on 5/12/02 at 17:13 (083647)

thanks carole i'll try straightening kneew

Re: Heel Cords

J. King on 5/13/02 at 09:25 (083690)

I tried pointing my toes and today my feet hurt like hell. Of course, I walked around the flea market for about 30 minutes yesterday. My arch feels so tight and painful in my left foot that I can hardly put weight on it. I know that when I have stretched in the past I have had trouble like this in my arch. I assume what is happening is that the heel cords are suffering micro injuries from being so tight.

Re: Heel Cords

Carole C in NOLA on 5/13/02 at 19:10 (083742)

Walking around for 30 minutes in a flea market may have done that. I omitted mentioning that I combined stretching with other conservative measures, including *substantial* rest (no grocery store and almost no housework), ice, orthotics, and many other things. However, all these other treatments didn't loosen my tendons the way that gentle stretching in combination with them did. Finding the right combination of conservative treatments isn't easy, I know.

With tight heel cords like that, you probably can't just walk a half hour at a flea market without damaging your feet and causing the micro-tears. I know that I sure could not have done that. I could hardly hobble six feet to the bathroom.

In order to be able to walk longer without re-injuring yourself, you have to build up slowly with the gentle stretching over several months until your heel cords are not so tight, and the pain is much less. When your tissues are tight, they are stretched and it is easier to strain them.

Carole C

Re: Heel Cords

paula on 5/13/02 at 21:57 (083768)

the foot rest from alimed seems to be continuing to help my tight heel cords. maybe scott might want to carry it here. other people seem to find some help with night splints. both are passive stretches i guess. the night splint is still too much for me. the foot rest was also too much stretch but i built up a feww moments at a time.

Re: Heel Cords

Carole C in NOLA on 5/14/02 at 00:01 (083777)

Paula, I do believe that night splints and the foot rest from alimed can be helpful for some people.

Unfortunately after reading her description I'm afraid the problem may be overdoing. Overdoing can cause straining and/or tearing of tissues and I don't know of any stretch or device that would fix the effects of that.

I doubt the tiny effects of gentle toe-pointing (as described, for ten seconds with no pain felt while doing it) could be distinguished from the probably much larger effects of overdoing while walking around at the flea market, if that is what happened.

There's always the possibility that the stretches are not being done the same way as I did them, but they sure helped me. I do think that my tendons must have been a good deal tighter than hers when I first started my stretching, because even if I had wanted to do so I simply was not capable of walking that long.

Carole C

Re: Heel Cords

paula on 5/14/02 at 09:00 (083813)

good point carole. it probably cannot be emphasized enough not to overstretch or overdo. i think most of us agree on that one. what i like about passive stretching is that it relaxes the calves as dr ed described once here.but most important , what works for one does not work for all. i am using your stretch to good adbantage, so thanks again for explanation.

Re: Heel Cords

JeanB on 5/16/02 at 00:38 (084107)

Just recently went to a new podiatrist who taught me a great stretch for gastroc/soleus that doesn't irritate Achilles or arch. Stand about two feet from a wall. Place right toes against wall, bend right knee until it touches the wall. Keep left foot two feet from wall and make sure left foot is pointed straight toward wall. Now lean upper torso into wall until shoulders touch wall and hold for 30 seconds. This gives me a great stretch in the calves without hurting my heels.

Re: Heel Cords

Carole C in NOLA on 5/12/02 at 08:12 (083593)

J, I'm not a doctor but I have fairly high arches and my heel cords were very tight and painful also. I too have had pain in my arches, as well as heel pain and pain on the side of my foot. Your symptoms sound very similar to mine, and I have heel spurs, plantar fasciitis ('PF'), tendonitis, and bursitis (all of which often occur together as a syndrome). Did you have a similar diagnosis? I would think that probably you did.

I noticed in your other post that you are not stretching because it worsens the pain. This is an indication that you are not stretching GENTLY enough. You have to start really, really slow and gently (at least I did). Some foot professionals routinely recommend stretches that are much too severe for those of us with very tight heel cords so I would urge you to try the following before considering surgery.

My C.Ped started me out in stretching by having me sit on my bed with my legs out in front of me. Then, gently point my toes inwards and upwards (basically towards my nose. Hold for 30 seconds (I could only do this for 5-10 seconds at first, and then worked up to 30 seconds). Then do it with the other foot. Do this before getting out of bed, and several times during the day.

Don't do anything that hurts! If this hurts, point your toes more gently (less vigorously). Even very gentle stretching can help get you started in stretching, and in the days to follow you will be able to do more.

Eventually, after several MONTHS of toe pointing, I was able to grab my toes and pull gently. I still have never done any standing (weight bearing) stretches. My heel cords have loosened up a tremendous amount and my PF is nearly healed. Although in December and January I was truly in agonizing pain, now I am pretty much recovered and able to go about my normal life with little to no pain. I hope this gentle stretching (along with other conservative treatments) works for you too, which is why I'm writing this post.

I don't know how many of the other conservative treatments you have tried, so I will describe some that you should try before considering surgery. Conservative treatments (non-surgical treatments) have a greater success rate than surgery.

Other things that you need to do are to never, ever go barefoot, not even in the shower, until you have recovered. Wear shower shoes, and/or use a shower stool. While your pain is acute you should ice your feet daily to reduce the swelling. I rest my feet on a bag of frozen peas and that works quite well. I am a bit 'chicken' about cold, so I ice them 4-5 minutes or until it starts feeling uncomfortable, and then take them off for a minute, and then repeat a number of times for about a half hour. Other people ice for longer periods of time before removing their feet from the cold. Your doctor can prescribe anti-inflammatories as well. Rest your feet as much as possible, so they can heal. Avoid stairs and lifting heavy things.

Read the heel pain book on this website for more suggestions. I found that custom orthotics and Birkenstocks were all I could wear on my feet until I felt better. Some people get good results from taping, which is described and illustrated in the heel pain book (I never tried it). You will probably need a night splint if you can't get the stretching to work.

Good luck, and I sincerely wish you feet that are free of pain!

Carole C

Re: Heel Cords

paula on 5/12/02 at 09:07 (083600)

carol, when you say you pointed your toes inward and upward, do you mean you pigeon toed before you pulled your ankle up towards your head?

Re: Heel Cords

Carole C in NOLA on 5/12/02 at 09:28 (083608)

Paula, I was instructed to rotate my foot clockwise (for the left foot) or counter clockwise (for the right foot), and then point my toes upwards (which essentially dorsiflexes the foot). This results in pointing my toes towards my nose. If you do this, you can feel a gentle tug on some tendons that are tight, that wouldn't get gently stretched if you didn't rotate your foot first.

I was not instructed to pull my ankle at all! Just point the toes, gently, without using your hands except to hold your knee down so that your leg remains flat on the bed. This is a very gentle stretch, if done right, and so it works for those of us with very tight tendons.

At first my C.Ped wanted me to tug on my toes with my hands, and when I looked at her with an expression of utter horror and spluttered 'I can't, that would kill me!', she quickly backpedaled and said I could do this instead at first. It has helped me a lot.

Hope this helps clarify my description.

Carole C

Re: Heel Cords

paula on 5/12/02 at 09:43 (083612)

that's interesting carol. my p.t. wants me to do a sole-to-sole. fifty a day! it sounds kinda similar. sitting down with knees bent and hanging over edge, supported because you are sitting high enough up, turn ankles inward. this seems to give a stretch to the outside ankle and maybe the outside heel cord. it seem when i try your idea i get the same stretch. not exaclty my calf muscle and not the inside heel cord but the outside of the ankle and lower leg gets stretched. is this waht you get?

Re: Heel Cords

J. King on 5/12/02 at 11:08 (083618)

Thanks for the advice. My feet have hurt so long that I get frustrated with
waiting and trying new things. I will try the gentle stretches.

Re: Heel Cords

Carole C in NOLA on 5/12/02 at 16:30 (083643)

Not the same at all for me..... for me the toe pointing does so much more, because it gets a lot of those tight tendons and muscles in the lower leg that just aren't involved with the sole-to-sole. The sole to sole mainly seems like it's limited to the sides of the ankles, but then that would make sense, from the symptoms you've described which are not typical of ordinary PF because of your complications. Try holding your knee down when you do the toe pointing. That might help you to feel what I'm talking about. Or maybe I'm doing the sole-to-sole wrong. LOL

Carole C

Re: Heel Cords

paula on 5/12/02 at 17:13 (083647)

thanks carole i'll try straightening kneew

Re: Heel Cords

J. King on 5/13/02 at 09:25 (083690)

I tried pointing my toes and today my feet hurt like hell. Of course, I walked around the flea market for about 30 minutes yesterday. My arch feels so tight and painful in my left foot that I can hardly put weight on it. I know that when I have stretched in the past I have had trouble like this in my arch. I assume what is happening is that the heel cords are suffering micro injuries from being so tight.

Re: Heel Cords

Carole C in NOLA on 5/13/02 at 19:10 (083742)

Walking around for 30 minutes in a flea market may have done that. I omitted mentioning that I combined stretching with other conservative measures, including *substantial* rest (no grocery store and almost no housework), ice, orthotics, and many other things. However, all these other treatments didn't loosen my tendons the way that gentle stretching in combination with them did. Finding the right combination of conservative treatments isn't easy, I know.

With tight heel cords like that, you probably can't just walk a half hour at a flea market without damaging your feet and causing the micro-tears. I know that I sure could not have done that. I could hardly hobble six feet to the bathroom.

In order to be able to walk longer without re-injuring yourself, you have to build up slowly with the gentle stretching over several months until your heel cords are not so tight, and the pain is much less. When your tissues are tight, they are stretched and it is easier to strain them.

Carole C

Re: Heel Cords

paula on 5/13/02 at 21:57 (083768)

the foot rest from alimed seems to be continuing to help my tight heel cords. maybe scott might want to carry it here. other people seem to find some help with night splints. both are passive stretches i guess. the night splint is still too much for me. the foot rest was also too much stretch but i built up a feww moments at a time.

Re: Heel Cords

Carole C in NOLA on 5/14/02 at 00:01 (083777)

Paula, I do believe that night splints and the foot rest from alimed can be helpful for some people.

Unfortunately after reading her description I'm afraid the problem may be overdoing. Overdoing can cause straining and/or tearing of tissues and I don't know of any stretch or device that would fix the effects of that.

I doubt the tiny effects of gentle toe-pointing (as described, for ten seconds with no pain felt while doing it) could be distinguished from the probably much larger effects of overdoing while walking around at the flea market, if that is what happened.

There's always the possibility that the stretches are not being done the same way as I did them, but they sure helped me. I do think that my tendons must have been a good deal tighter than hers when I first started my stretching, because even if I had wanted to do so I simply was not capable of walking that long.

Carole C

Re: Heel Cords

paula on 5/14/02 at 09:00 (083813)

good point carole. it probably cannot be emphasized enough not to overstretch or overdo. i think most of us agree on that one. what i like about passive stretching is that it relaxes the calves as dr ed described once here.but most important , what works for one does not work for all. i am using your stretch to good adbantage, so thanks again for explanation.

Re: Heel Cords

JeanB on 5/16/02 at 00:38 (084107)

Just recently went to a new podiatrist who taught me a great stretch for gastroc/soleus that doesn't irritate Achilles or arch. Stand about two feet from a wall. Place right toes against wall, bend right knee until it touches the wall. Keep left foot two feet from wall and make sure left foot is pointed straight toward wall. Now lean upper torso into wall until shoulders touch wall and hold for 30 seconds. This gives me a great stretch in the calves without hurting my heels.