Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

what's helping me in the later stages of recovery

Posted by Ellen J. on 5/15/03 at 14:22 (118870)

Hi all,
I'm at the point where I can walk all around--pain free--but can't run or bicycle without hurting my feet. I have been at this stage a long time but couldn't figure out how to go beyond it until recently. I saw yet another doctor who said he thinks that at this point I have muscle imbalances and that the transient pains are more from muscle fatigue due to imbalances and weak foot muscles. I went home and thought about this and decided to start using the Foot Trainer and in addition I am walking one mile a day. I figured that since walking around on errands wasn't hurting, then I might safely use walking as a way to strengthen my foot muscles slowly, so I can bicycle and hike in the future. It turns out that the combination is working very well so far and my feet are getting stronger. I am adding about 100 feet a day to the walking distance and if my feet get a little sore I back off and let them get over it for a day or two and then continue. It feels like 'baby steps' compared to the 8 mile runs that I enjoyed 4 years ago but I'm excited to be doing any exercise at all that doesn't aggravate my feet.
I thought I would mention this in case there is anyone who is at the same stage and is trying to get over that final hump. I'm not suggesting it for anyone in the early stages of P.F. If I had done this way back when my feet were so sore, it would have probably just delayed my recovery since rest is so important in that stage.
Ellen J.

Re: PS.to my last note

Ellen J. on 5/15/03 at 14:36 (118874)

Hi,
Just wanted to clarify that the walking is great for later stages of recovery, but the Foot Trainers can be used at almost any point since the Foot Trainer exercises are so gentle. When I mentioned that I suggested that what I was doing be used for later stages of recovery, I was referring to the walking part of it. I love the Foot Trainer routine, by the way. I sit on my bed each night and watch TV while doing the little exercises and it's relaxing. I like the fact that gives me the opportunity to take an active role in the recovery process rather than just waiting and hoping to feel better.
Ellen J.

Re: PS.to my last note

Pauline on 5/15/03 at 16:00 (118889)

I still use my foot trainers too. I thought they were a good investment, probably the only good thing I bought besides night splints, but I hated wearing those night splints.

Re: Question for you Ellen

SteveG on 5/15/03 at 16:16 (118894)

Great news, Ellen. I am almost at that point and I will keep your post in mind. As I recall, you were also having some problems with your knees at one point. I have been having some problems lately, and my family doc says it is from the PF - my muscles have atropied a bit (quads) and I used to stand on the outside of my feet since it was more comfortable - what did you do to deal with this problem

Re: what's helping me in the later stages of recovery

Dorothy C. on 5/15/03 at 16:51 (118901)

Ellen ~ What you are doing is similar to what I am trying with some additional efforts and I agree that it seems to be a very useful 'program'. I have been a 'cheerleader' for the FootTrainers before and will do so again; I think this is a very, very useful item for the foot and related problems that we experience. I have been using them for approx. 2 months, I guess, and just today tried something new (for me). I had read a comment from Mr. Wilmot (FootTrainer designer) on this message board about concentrating on the muscles that are contracting. So today I made special, 'mindful' concentration on the contracting muscles while also concentrating on relaxing the non-contracting muscles. It seemed to make the exercises particularly effective. When I stood up and have continued through the day, my feet have felt more 'normal' than they have in a very long time. Best wishes to you and continued strength and improvement!

Re: what's helping me in the later stages of recovery

Ellen J. on 5/15/03 at 17:01 (118904)

Hi Dorothy,
I'm so glad to hear your feet are feeling more normal these days. Mine are too, and I'm sure it's a result of the Foot Trainer and from walking. I will make more of an effort to concentrate on the exercises, as you described. Probably the fact that I'm watching TV while doing them is not so good since I sometimes forget I'm exercising and will hold a position for twice as long as I should.
Thanks for that tip!
Ellen J.

Re: PS.to my last note

Ellen J. on 5/15/03 at 17:05 (118905)

Yes, I do think the Foot Trainers are a good investment and the exercises are enjoyable to do. It took me a bit of time to get coordinated with my toes and I still can't move my little toe up or outwards but I figure that it isn't that much of a big deal as long as I can do all the other exercises.
I tried wearing night splints too, but they bothered me. Mine were homemade and pretty comfy but I still stopped wearing them. I know they help many people and have cured many, so I think they are a good thing for those who are more tolerant of how they feel.
Keep up the good work with your foot trainers!
Ellen J.

Re: PS.to my last note

Dorothy C. on 5/15/03 at 17:12 (118907)

Ellen ~ The FootTrainer exercises that I find a little tricky are the two where the trainers are crossed and the big toe is moved toward or away from the other toes. I think I have finally gotten it right but that one (or set of two actually) has been a little more 'interesting'. Still very helpful, even if I don't have it 100% right. I just do the best I can with those.
Good luck!

Re: answer for Steve

Ellen J. on 5/15/03 at 17:29 (118908)

Hi Steve,
That's great that you are feeling better!
The knee problem I had was Patello-femoral syndrome (sp?) or chondromalacia. The pain was located below and toward the medial side of my knee. The docs told me it was because I had not been exercising and the muscles had weakened, as you described with your case. The exercises they told me to do were so boring, but I did them for a short while. Then I went to the gym and began working very carefully on the leg extension machine (the one where you sit down and a pad goes across the lower part of your shins). This machine will make the Vastus Medialis muscle stronger so that the pain will go away. However, this machine can also make the knee problem worse if you set it on too much weight. Ideally, you would want the lightest amount of weight (I did 10 pounds at first) with a high number of repetititons. It's really important that the feet DON'T go through the entire range of motion, in that they should not go all the way down nor all the way up. The two extremes will irritate the sore area of the knee. It's especially important that the feet don't come all the way up (in which case the lower legs are parallel to the floor), as it puts too much leverage on the knee. I had a sore knee for a year but once I began working on the leg extension machine, the knee problem began clearing up in two weeks and after 4 weeks the pain was gone. I now maintain the knees by using the machine regularly. I do about 80 repetitions for each set. Sounds like alot but it's easy to do that many reps when both feet are pushing 10 pounds (which is 5 lbs. per foot). I do both feet together rather than one foot at a time in order to distribute the weight load between both feet to keep from putting all 10 lbs on any one foot.
Sorry this is such a long description. I thought I had better write down the details. Good luck, and keep persisting. Don't do any exercise that causes your knee to hurt.
Ellen J.

Re: PS.to my last note

Ellen J. on 5/15/03 at 17:34 (118909)

Hi Dorothy,
I am embarrassed to admit that I have to skip the ones you described because I can't do them at all. I guess I should try harder, but I can't seem to coordinate the pads and the toes. So what I do is sit there and sort of splay out all my toes and hold that position, then I squeeze all my toes together and hold that position. I'm sure it's not as good as using the pads the way I'm supposed to though. Maybe someone on the message board can give us some tips on getting that one right.
I thought I was the only one with uncoordinated toes! :D
Ellen J.

Re: PS.to my last note

john h on 5/16/03 at 08:23 (118948)

Pauline do you not think the Oracle of John to be a good investment?

Re: what's helping me in the later stages of recovery

nancy sc on 5/16/03 at 08:46 (118950)

Ellen,

I also have been at the last stage of recovery for quite a long time. Based on Dorothy's comments a few weeks ago I bought the foot trainer
and have been using it since then, with great results. I agree with
Dorothy that it's best to concentrate on the muscle movements and not
be distracted. I think you can go through the whole routine and not
really exercise the correct muscles, if you're not paying attention

I find that if I have any pain or tightness at all, the foot trainer
session fixes my feet up right away.

I've been doing this at the same time as I've been rebuilding my exercise
regime. I've been alternately running and bicycling. After some experimentation I've found that I can bike painlessly if I wear my orthotics (with running shoes) and put the bike in as small a gear as is necessary to avoid straining the feet. You are forcing yourself to do the work with the legs, not the feet. After biking this way, my feet feel very good. If the gear is too small, though I can feel it in my knees, so it can be a bit tricky.

Regarding running, I found after trial and error that running (slowly) made my feet feel better than walking. So I started with 15 minutes every other day and have worked up to about 45 minutes every other day. Still cannot imagine running two days in a row (I used to run 6 days a week before PF) because I sometimes have tightness in my heel/arch after running. I ice after every run, then shower. Any tightness I feel later in the day I treat with ice if at work, foot trainer at home. Aboiut two weeks into the foot trainer program, I have found that I am suddenly running stronger and faster, and am able to feel strengh and power in my feet, instead of just gingerly dragging them along.

One thing to keep in mind about the foot trainer is that as you move into level two, it becomes quite time consuming, about 40 minutes per session. However, at level three you are back to about 12-15 minutes. Since I am at the end of level 2, I am currently devoting a lot of time to it, but feel it's necessary to do the regime as described. I also have difficulty with the exercises with the foot trainers crossed, and have given up on the baby toe exercise altogether; I just can't do it. I also like the foot massage described in the booklet. I do that frequently just for fun.

Nancy

Re: what's helping me in the later stages of recovery

Dorothy C. on 5/16/03 at 09:56 (118964)

Nancy ~ I enjoyed reading your note about what you are doing and how you are strengthening. Kudos for your determination! Now, I have a couple of questions about the Foot Trainers which I also use, as you mentioned.
You said, '..the foot massage described in the booklet.' I don't think I have that in my booklet; can you describe in any more detail?
Also,when you mention 'Level two...level three...' are you referring to the expansion of repetitions, length of time?? Or is there something else that I might be missing, since I don't recall a specific reference to different 'levels'. Maybe it's time for me to review my booklet!
I have wondered about bicycling and so was interested in your comments. I am really missing a regular 'physical movement' routine, but have been going slowly and cautiously out of some fear. Putting on more weight is not a good idea in my case!
Thanks for your input.
Dorothy

Re: Late Stages of Recovery Foot Trainer Exercises

Mike W on 5/16/03 at 10:28 (118966)

Hello Ellen,

It is nice to hear of your progress.

Because you are pain free and more active I think you are ready to start exercising your flexor muscles.

To do this you do the opposite of the 9 exercises you are now doing. Therfore you place the rubber pad on the BOTTOM of your toe/foot then move your toe/foot AWAY from your body and then resist with the Foot Trainer.

Follow the 3 level progression and again be very gentle.Remember to keep exercising your extensors too.

I hope this helps.

Regards,

Mike W

Re: Big toe and little toe exercise tips

Mike W on 5/16/03 at 10:43 (118968)

Ladies,

The big toe abductor/adductor and baby toe abductor muscles are the weakest toe muscles in everyone. Most of my customers have trouble with these. Here are a few tips that I hope help.

Big toe abductor exercise:
Try using one Foot Trainer at a time.
To start try to gently push your big toe down/away a bit before you begin.You should feel the contraction a bit better.

Big toe adductor:
To start try to gently pull your big toe up/towards a bit before you begin.

Baby toe adductor:
To start try to bend your toe down a bit and then resist with the Foot Trainer.

These movements are very short so it is important to try to feel for the contraction and as you progress feel for a stronger contraction.

I hope this helps.

If you have any other questions feel free to contact me personally.

Regards,

Mike W

Re: Nancy's note

Ellen J. on 5/16/03 at 10:58 (118972)

Hi Nancy,
Thank you for all your comments and helpful info. It was very interesting to hear about how you started running again. I had given up on the idea of ever being able to run again until I went to the most recent sports medicine doc and he said I probably could run again. That made me feel very hopeful! I was doing the exercise bike just the way you described, in the easiest gear so that it wouldn't put pressure on my feet. I wasn't sure that it was helping my feet as much as the walking, but then again I haven't given it as much of a long term chance.
I had moved up to level 2 on the foot trainer quite quickly, since my feet had recovered alot by the time I started the exercises. It does take a bit of time but I enjoy it since I know it's helping my feet. I had not tried using the foot trainer to help with post-exercise tightness. I will have to try that--thanks for the idea.
I appreicate all your tips,
Ellen J.

Re: Thanks, Mike /foot trainer tips

Ellen J. on 5/16/03 at 11:07 (118974)

Hi Mike,
Thanks for your note about the flexor muscles. I will start working on the flexors and see how my feet react to it. I look forward to working on them, as they are very weak. I discovered this when I purchased a pair of 'flip-flop' thongs and when I wore them my arches hurt! I thought about it and decided that it probably wasn't fascia irritation as much as unused muscles that were fatigued from the fact that a person grips with their toes when they walk in thong sandals (in order to keep the sandals form slipping off).
Are the flexor exercises listed in the Foot Trainer instruction manual? I may have read the manual wrong and missed that, or else there is a separate (more advanced) manual that I don't have. I bet I read the manual wrong--I'm an artist, so I can be an airhead! (ha) #-o
Ellen J.

Re: what's helping me in the later stages of recovery

nancy sc on 5/16/03 at 11:11 (118975)

Dorothy:

The massage is on the last page of the booklet where the PF protocol is described. I've been following that protocol, including icing, etc.

The three levels are described somewhere in the booklet, and there was an additional sheet I received where that is clarified. In level 1 you do the exercises as described until you work up to 10 reps, 10 seconds per rep. In Level 2 you go back to 5 reps, 10 seconds per rep, but you do the same exercises in 3 positions, so it takes 3 times as long. However, this level is where you really see improvement in strength and flexibility, or at least I did. In Level 3, you are back to 10 reps per exercise (from 30 in Level 2), so it's 2/3 shorter than Level 3. I haven't yet started Level 3, but will soon. Reading Mike's comments below I have to review and make sure I'm doing those big toe contractions right.

Nancy

Re: Nancy's note

nancy sc on 5/16/03 at 11:12 (118976)

Ellen:

Just wanted to mention that I ride a bicycle outside, not a stationary
bike, so am not sure how that would translate. During the worst of my
PF I tried to ride a stationary bike, and found that if there was any tension at all, I hurt my feet. But with little tension, there was no exercise. Seemed I couldn't duplicate riding up a hill in low gear!

Nancy

Re: Question for Mike

nancy sc on 5/16/03 at 11:17 (118977)

Mike:

I also think my flexors are weak for the same reason as Ellen -- when I wear clogs I feel the weakness in my arches. Is it good or bad to wear clogs/flip-flops, or any type of shoe where you are flexing to keep the
shoes on? Does it strengthen these muscles or does is aggravate PF. I am pretty well recovered from the PF.

Nancy

Re: Late Stages of Recovery Foot Trainer Exercises

Dorothy C. on 5/16/03 at 16:49 (119033)

Mr. Wilmot:
Ok, I have to say that I don't get this. For flexors: You say to put the rubber pad of the Foot Trainers on the bottom of the foot/toe.....do you mean that the foot is to be entirely outside of the two pads? Do you mean that the foot is to resist against the smaller/narrower of the pads, the one that is farthest away from the shaft?? Huh?? What??
I need a visual - or words that make it more visual.
Thanks to you and Nancy and Ellen -
Dorothy

Re: Big toe and little toe exercise tips

Ellen J. on 5/16/03 at 17:01 (119034)

Thanks, Mike.
That is a hellp and I'll start using one foot trainer at a time. It will probably help to only focus on one foot at a time for those particular exercises. Thanks for your suggestions.
Ellen

Re: Re:bikes, indoors and out

Ellen J. on 5/16/03 at 17:08 (119035)

Hi Nancy,
Good question that you asked Mike about flip-flops and clogs. I'm very curious about that too and I hope he has time to answer the question.
Also, I have a regular bike on an indoor bike trainer (a cyclops trainer) and a road bike for outdoors. I use both, but I find that trying to get up a long steep hill sometimes bothers my feet when I use the road bike. The good thing about the indoor bike is that the tension can be set very light and it stays that way. Very boring to ride indoors, however!
Ellen

Re: foot trainers/flexor exercises

Ellen J. on 5/16/03 at 17:13 (119036)

Hi Dorothy,
I could have interpreted Mike's instructions incorrectly, but from what I can gather, you have your feet inside the pads but instead of the tops of your toes pressing against the top pad, the bottoms of your toes press against the bottom pad instead, so that you are pushing with your toes rather than pulling upward with your toes. The flexor exercises sound similar to the towel-gathering exercise that you see mentioned in alot of the P.F. articles. Now, I might have all this wrong, so maybe Mike can clarify. I checked my Foot Trainer manual again and didn't see anything about massage or about flexor exercises--there are only extensor exercises in mine.
Ellen J.

Re: To John PS.to my last note

Pauline on 5/16/03 at 19:30 (119043)

Are you talking about John the Baptist:*)

Re: foot trainers/flexor exercises

Dorothy C. on 5/16/03 at 22:33 (119066)

Same with mine, Ellen.
Your clarification of the flexor exercises is helpful; I think I understand it and will give it a try. I do wonder about that part of the pad - the bottom part - since it doesn't seem to have the same strength as the top part, but I haven't tried it yet so maybe it will prove to be as strong. Thank you, Ellen; your notes are much appreciated.

Re: Nancy's note

Mike W on 5/17/03 at 09:47 (119086)

Hello Ellen,

I do not include the Flexor muscle exercises in the manual because in the past my customers would perform them too early and forget about the extensor muscles.

Please read my post above for info or contact me directly and I will try to help.

Regards,

Mike

Re: Question for Mike

Mike W on 5/17/03 at 09:52 (119087)

Hello Nancy,

I am not sure if this is good or bad. I think it depends on your level of healing. I think it probably helps strengthen the flexors but you depending on how long you wear them you could be overdoing it.

Regards,

Mike W

Re: Late Stages of Recovery Foot Trainer Exercises

Mike W on 5/17/03 at 10:01 (119089)

Hello Dorthy,

Place the Foot Trainer so that your feet are between the two rubber pads.
Instead of moving the foot trainer forward until you feel the rubber pad touch your toes/feet you move the foot trainer back until you feel the rubber pad touch the bottom of your toes/feet.

If you are not sure please contact me.

Regards,

Mike

Re: To John PS.to my last note

john h on 5/17/03 at 12:56 (119104)

Not really as John The Baptist had his head handed to Salome on a platter because she danced so well for Herod.

Re: Re:flip flops

Ellen J. on 5/17/03 at 19:36 (119143)

Hi Nancy,
What I'm doing is this: I keep the flip flops in my studio and put them on once a day and walk around doing a few things until I feel a slight bit of fatigue (just the tiniest bit) and then I remove them. I'm kind of using them as a form of exercise, but only very briefly. This is an experiment, so I can't suggest it to others since I don't know if it's a good idea or a bad one. I could not have done this earlier when my P.F. was bad. I am healed up enough now that my feet can withstand brief little things like this, so I'm adding it to my routine. I'm also using a wobble board (also called a balance board) when I'm on the phone so that I can make worthy use of phone time.
Ellen

Re: Re:Next level of Foot Trainer exercises

Ellen J. on 5/17/03 at 19:40 (119144)

Hi Mike,
Thanks, and I'll try and contact you directly through the foot trainer website when I get a moment. I look forward to going up another level! It is so exciting to feel my feet getting stronger. For a long time they felt as fragile as glass and now they are starting to feel like normal feet again, thanks to you and the Foot Trainer.
Ellen J.