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Runner's World

Posted by john h on 3/01/04 at 12:51 (145725)

the current issue of Runner's World compares all the new walking/running shoes. Also a brief comment by the President of the American Orthopedic Foot and Ankle Surgeons Association on treating heel pain. He suggest standing on a stair or curb and doing heel lifts 8 times a day to strengthen the achilles tendon and calves. We often discuss this and many including me have dismissed it as something that can injure you. I may have to rethink this. Perhaps one can do this but be careful not to go to far in the stretch? These Doctors see thousands of patients and we are but a few on this board. I have a small incline board and may take this up again as you can contol the stretch more precisely.

Re: Runner's World

elliott on 3/01/04 at 13:04 (145727)

John h, was the comment made exclusively to runners? Before or after they have heel pain? Just want to know the context. Thanks.

Re: Runner's World

JudyS on 3/01/04 at 14:05 (145731)

John - it sounds as though the article may be differentiating between heel lifts and calf stretches. Would it be describing heel lifts for the purposes of strenghtening the lower leg muscles? Does it say to extend the heel below the curb level? Well, perhaps I've answered my own question - why else use a curb or step?

Re: Runner's World

Dr. Z on 3/01/04 at 15:21 (145734)

Maybe he is talking about runner who don't have plantar fasciitis yet and this is used as a preventive stretching. I just see too many patients who have aggravated pf while doing this.

Re: Runner's World

Dorothy on 3/02/04 at 16:42 (145826)

I have a brother-in-law with PF and he swears that the only thing that keeps him able to move/walk/run whatever is that stair-drop stretch. He says that as long as he does that, he is ok; if he doesn't, he has pain. I don't know what to think. I have avoided it for a long time now, since reading the cautions against it here. I am, at long last, having a very good foot day today in every way. I am reluctant (superstitious) to talk about it for fear it will stop - but for today, no significant foot pain, no Achilles pain. I am sure this means that something terrible is about to happen! But for this day, I am grateful and feeling so sweet.

Keep us updated, will you John H. on the advice you wrote about? Hope you are doing ok; we don't hear from you as much here but are glad when we do.

Re: Runner's World

Dr. Z on 3/02/04 at 17:04 (145828)

Dorothy,

I think that the stair stretch has the potential of causing problems if not done correctly or done too much. I guess that could happen with any type of stretching. I try to pick a stretch with the lease amount of potential cause additional trauma and or damage. NON weight bearing stretcing such as the personal foot trainer meet this criteria.

Re: Runner's World

john h on 3/02/04 at 20:23 (145851)

I am currently in one of my good periods so I am not doing anything to aggrevate my feet. I plan on dragging out my incline board this weekend and start a daily regimen and see how it goes.

Re: Runner's World

john h on 3/02/04 at 20:36 (145855)

Judy: They were talking specifically about heel pain and treating it with stair stretches. I have read this in to many medical journals to ignore it.

Re: Runner's World

Dorothy on 3/02/04 at 23:14 (145876)

If you don't mind saying - what do you have in mind for your daily regimen?
Very glad to hear you are in one of your good periods - and I hope it is a very long one - like one of those 25 year good periods!

Re: Runner's World

Julie on 3/03/04 at 01:17 (145890)

Judy and Dorothy

I haven't seen the article, so I don't know how the stretch was described, but if it is 'heel lifts' (i.e. without dropping the heels below the level of the curb) there is a point. Sue Luby, in 'Bodysense', a very good book which I mentioned here a while ago in another context, includes a stair stretch (suggested for strengthening the ankles and stretching the calves and achilles) that specifically cautions: 'Do NOT drop the heels'. The point is developing and maintaining alignment and control.

This stretch is quite different from, and safer as long as control is maintained, than the stretch in which the heels are dropped. This is because once you do drop the heels below stair (or curb) level it is extremely difficult (for most people) to maintain control, or even to know how far to drop them; so the calves, achilles tendon and the vulnerable, p[ossibly already torn, plantar fascia may be being stressfully loaded with the entire body weight. It is very difficult to do it correctly and not to go too far, and therein lies its potential for causing problems, even in healthy, unchallenged feet, and definitely in inflamed, injured feet.

But there are exceptions to every statement, and your brother-in-law, Dorothy, seems to be the exception to the above. Individuals vary widely in their capacity to maintain postural alignment during exercise, and to control their weight when balancing. The fact that your brother and other individuals may be able to perform this particular exercise safely says something about them, and about their abilities, not about the safety of the exercise. You might be an exception too, as you practise yoga and are clearly body-aware. But 'if I were you', which I am obviously not, I would not risk it.
.

Re: Runner's World

Kathy G on 3/03/04 at 08:58 (145908)

When I went for PT for my feet, it was when my neuroma was under control from my custom orthotics, but the pain in my arches was worse. I also was having a terrible time with a muscle spasm in one calf. The therapist insisted that stair hanging was excellent. She noticed that I always brought a book with me so I could read in the waiting room and she suggested that I stretch for up to a half an hour twice a day at home, reading while I did it. What was amazing to me is that it felt so good. It really seemed to help my calf a lot. But I still had my other problems. Then, for the first time, I awakened one morning with heel pain. I still wonder if I would ever had developed heel pain if I'd stayed away from PT. I stopped going to PT that very day and started to follow the suggestions on this board.

Now I use my handy-dandy tilt board when that same muscle acts up, but I find that Julie's Yoga Stretches work just as well, if not better.

Why doctors insist that the stair hanging is good is beyond me. When I went to an orthoepedic specialist for my sprained ankle, he mentioned it to me when he was asking me about my PF.

I believe I over-stretched and caused more damage to my fascia and I would never take a chance and try it again.

Re: Runner's World

Julie on 3/03/04 at 09:19 (145913)

Kathy

That's very interesting! Yes, the stair stretch does feel good if one's calves are tight. I've been known to enjoy it myself. The problem is, as I explained, that it's so difficult for most folks to control, and if it isn't controlled the damage is done before you know it. It's quite possible that you had a weakness at the fascia's insertion point that you weren't aware of, and your stair-hanging tipped it over the edge. The idea of reading a book while doing it gives me the willies! If you're doing it at all, it needs your full attention. I'm glad you left that physio!

One of my yoga mentors, a long time ago, used to say 'There are no dangerous postures, only dangerous people'. Stair-hanging is a perfectly acceptable way to stretch the calf muscles - IF one is able to judge one's weight accurately, maintain alignment and balance correctly, and above all maintain control. In other words, its fine for athletes, people in training, and people who know their bodies well. And above all, people whose feet, whether muscles, fascia or tendons, are not ailing.

The mistake doctors make, in counselling stair-hanging for PF sufferers may arise out of their conception of the exercise as a good stretch for the calf muscles (which it undoubtedly is). To this they unaccountably marry their knowledge that tight calf muscles are a cause of PF. Therefore: stair-hanging = a beneficial exercise for PF. And it may even be, for the odd case. But I feel that most cases are likely to be made worse by it.

The tilt board is much better. It will have a similar effect, but is much safer because it is controllable.
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Re: Where have all the posters gone? To http://fuutchat.jrmhost.com/ but you will have to replace the letter "u" with the letter "o" to get the correct link

Phil C. on 3/03/04 at 23:54 (145965)

See everyone over there.
Phil C.