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should i keep stretching

Posted by lisa71 on 8/19/04 at 08:54 (158393)

I have been doing the stretches for my plantar fascia ( stretching the foot up and toes back) and calves for about a week but after I do it my foot seems to hurt more. Should I be icing after? This may be an obvious yes but i was just wondering. Is it normal for you feet to hurt a little more after stretching? Thanks again. I love these boards. Thanks again.

Re: should i keep stretching

R C on 8/19/04 at 09:35 (158399)

Seems to me that if it hurts, it's probably not helping. (One exception I am aware of is vigorous massage to break up scar tissue, but that is done by a professional.)

Re: should i keep stretching

Susan S on 8/19/04 at 17:41 (158433)

I have to do that stretch very very gently, or my pain will increase. If I overstretch, I wait until the pain dies down, usually several days, and then start stretching again, but more gently than before. I don't think stretching should increase pain. (I'm not a medical professional.)

I have a hard time stretching my calf muscles. When I do, it usually overstretches the PF. That's just me of course.

Re: should i keep stretching

Pauline on 8/19/04 at 19:48 (158436)

I hope Julie will respond to your post. I like to think of her as our exercise specialist because her advice seems to help everyone and it
sounds like you're using some of her suggestions already.

When ever I did any type of stretching I always followed by icing. I'm no expert, but it seemed to help calm down even the slightest sensitivity.
Another thing I did was to do massage and those gentle toe stretches in warm water, then followed the stretch by putting my feet in cold water.
Never stretch in cold water, but I used it similar to icing, but as I said I think Julie really knows the most about exercise.

Re: Stretching

Julie on 8/20/04 at 02:57 (158448)

Susan has hit the nail on the head: efforts to stretch the calf muscles will almost always irritate the plantar fascia, because the fascia is the end point of a continuum: the calf muscles (gastrocnemius and soleus) lead into the achilles tendon, which leads into the plantar fascia, which inserts in the heel bone. The fascia's insertion point is where PF generally begins: it's the weak link in the chain, if you like. PF is a repetitive motion injury - every one of the billions of steps we take in a lifetime stresses that insertion point. Bad shoes, uncorrected overpronation, weak foot muscles, asking the feet to carry too much body weight are among the factors that add to the stress. A tight gastroc/soleus/achilles complex is another - but it is only one, and it doesn't apply to everybody.

I have very mixed feelings about stretching. Tight, shortened calf muscles can be a contributory cause of PF. This is one of the reasons why runners and aerobics enthusiasts get PF: all impact activity shortens muscles, which is why it is so important to stretch faithfully before and after it. If shortened muscles are contributing to PF, then it's important to lengthen them, but how?

The first thing to say is that before you do any stretching, you need to determine whether a tight gastroc/soleus/achilles complex is in fact contributing to your PF. If it isn't, there is not much point in stretching it, and risking further irritation of the PF at its insertion point. Strengthening the intrinsic foot muscles is more important, in my view. See Mike Wilmot's website http://www.foottrainer.com for an explanation of why this is so, and why most of the stretches commonly recommended for PF are incorrect.

If a tight GSA complex IS a factor in your PF, then stretching can be useful, but stretching muscles is a long job, and for PF people, very problematic. Nobody's muscles appreciate being forced to stretch: they will always react by tightening further, so even people with no PF problems need to work very patiently on themselves. People with PF of course need to be even more patient, and very careful. Weight-bearing stretches really are more than likely to make matters worse (though we've had people here who feel they have been helped by the wall stretch, and even the hanging-off-the-stair stretch).

The 'PF stretch', described by Dr Z and in the article we read the other day, is really a stretch for the GSA complex, and is an improvement on the above exercises. That's because it is not asking the poor, injured PF to bear your full body weight, and because you can control it. But pulling on the toes to activate the so-called windlass mechanism can still be too strong for some people - and it obviously is for Lisa and Susan. One answer is to do it much more gently, another is not to do it at all. A good rule with most exercise is, if it hurts, stop: your body is telling you that what you're doing isn't good for it.

So where does that leave us? First determine whether a tight GSA complex is a factor in your PF. If it isn't, don't worry about stretching it. If it is, think about using a night splint, which places a gentle tensioning on the GSA complex for several hours at a time. This is how muscles like to be lengthened, and they will respond to it.

Finally, have a look at the yoga foot exercises (click on the word yoga). They strengthen as well as stretch. One or two people with very severe pain have reported that they've found doing them painful, but most people who have used them have found them helpful. There is no weight-bearing, and no pulling, so they are unlikely to cause damage. But the bottom line is that anyone doing any exercise needs to judge the suitability of that exercise for themselves.

Re: Stretching

john h on 8/20/04 at 10:12 (158458)

I have a friend (older than dirt) who is a lifetime runner. He is in the Arkansas running Hall of Fame. He still runs all the major marathons with outstanding times. He is tight as a drum. He could not begin to place his leg on a waist high rail and straighten it out. He is beyond stiff. He takes these short choppy steps and seems he can run forever at a face pace.I bet his muscles are almost incapable of stretching and we all make fun of him on this count. Every morning I see him running by my house on a 10-15 mile jog. A lack of loose muscles or stretching never effected this guy. of course he is an exception not a rule.

Re: Stretching

Julie on 8/20/04 at 13:04 (158469)

John, your friend's tight muscles may be no obstacle to his prowess on the track, but you can be sure that his lack of stretching has affected his ability to function in his daily life.

We all need a balance between strength and flexibility, between aerobic fitness and overall well-being.

Re: Stretching

Susan S on 8/20/04 at 13:05 (158470)

Thanks Julie, great as usual. This answers a lot of questions. Another post to print out and put on my refrigerator.

Re: Stretching

john h on 8/20/04 at 14:22 (158472)

Julie he is older than me and is always running with the young women so he seems to be functioning in at some areas of his life. He happes to be an x-pilot. I have run in many races with him and he is like a machine. I guess running is his life. His daughter is in her 40's and she is also a big runner. I just do not picture runners to be as stiff as him. He is very much all muscle even at his age. Probably weighs about 145 lbs and about 5'7'. He did tell me over the years he has had PF a few times but it never lasted long. He has made the run many times up the Rocky Mountains which a marathon uphill all the way. I always tried to keep limber and stretch and was envious that he could run past me like a bullet and was older and stiff as a board. Life is not fair.

Re: Stretching

Julie on 8/20/04 at 14:49 (158476)

No more it is, John. Anyway, take heart. I'm sure there are things you can do, because you have kept stretching, that he can't.

Re: Stretching

lisa71 on 8/22/04 at 07:10 (158525)

Thanks that explained alot. My doc told me my primary reason for pf is stretching so I think I need to keep doing it. I am just going to adjust some of the exercises so the put less pressure on my plantar fascia.