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

Another success like Ellen J

Posted by Robert J on 12/09/04 at 19:59 (165415)

Ellen J's report of success after 5 years seems to greatly resemble my own recovery after 2.5 yrs. Like Ellen, my problem was located in the arches not in the heel. Also, I never had first-step pain. Not sure that Ellen was devooid of first-step pain but I suspect we both fit into the 'atypical category.'

In my own case, I came across an article in the New Yorker that described a Harvard Medical School clinic for chronic lower-back sufferers. The theory of the clinic is that many low-back people have so protected their backs that they have created an endless syndrom of weakness and pain. It guides patients into progressive exercise routines that build up strength even if the exercises initially cause an increase in pain. The New Yorker reported that this approach has helped many people who have suffered sometimes for decades.

So I thought, what the hell, if it works for backs it might work for feet, and I decided to use myself as a guinea pig. I gave up resting my feet, gave up my orthotics (that function, after all, like a back brace),gave up taping, and began a self-devised program of progressive strengthening exercises. Eventually I was doing 45 minutes of exercises a day. Also, I began taking short walks that gradually got longer and longer.

And it worked. Within a month I knew that I was on the right track. Within two months I was walking for 30 minutes at a time. Now, six months later, I go on hikes of two hours or more and, for the most part, never think about my feet. Like Ellen, I walk barefoot a lot and that seems to help my feet rather than hurt.

The recovery is not absolutely complete. I find that if I DON'T exercise regularly, the pain starts to creep back. Also, I have not had the guts to try running yet. My experience tells me that I will likely be prone to this injury for a long time, maybe forever. But the transformation in my life from simply being able to walk anywhere, well, it's been amazing. I had almost given up.

I know that my experience is contrary to that of many others, and I would caution that this approach, and its success, may be limited to those with the atypical form of PF. But for those of you who have arch pain rather than heel pain and who do not have first-step pain, I would suggest thinking about this kind of approach, especially if the rest/ tape/orthotic route is not helping.

Re: Another success like Ellen J

Dorothy on 12/09/04 at 21:44 (165423)

Would you take a few minutes and describe the exercises and the exercise regimen that you have been doing when you say 'progressive strengthening exercises'? I am very interested in this approach; it suits me better than always resting, resting, resting! Thank you so much.

Re: Another success like Ellen J

Dorothy on 12/09/04 at 23:50 (165425)

Robert J: I should have addressed this to you before, so I will try again:
Posted by Dorothy on 12/09/04 at 21:44
Would you take a few minutes and describe the exercises and the exercise regimen that you have been doing when you say 'progressive strengthening exercises'? I am very interested in this approach; it suits me better than always resting, resting, resting! Thank you so much.

Re: Robert

Julie on 12/10/04 at 02:49 (165430)

Robert, it really would be useful if you would describe the strengthening exercises you settled on and that have been so helpful to you. As you know, the emphasis when considering exercise for PF is on stretching to lengthen tight calf muscles and achilles tendons. Little attention is given to strengthening the intrinsic foot muscles, which I believe is equally if not more important. So if you have developed an effective strengthening regime, it would be helpful to many here to know about it.

As one who has written about exercise, I do know the amount of work and effort involved in formulating clear instructions. But your articulate posts suggest that you are capable of doing it, if you'd like to - so please have a go if you can.

Thanks, Julie

Re: Dorothy

Julie on 12/10/04 at 02:53 (165431)


No offense meant, and I hope none taken, but - a few minutes? Give the poor guy a few hours, at least. Seriously - it's the hardest thing in the world to describe an exercise clearly, accurately, and above all safely, so that the person reading the instructions and attempting to follow them can do so correctly and safely. If Robert is willing to describe his regime, it will be a labour (not necessarily of love, but a labour of sorts).

I hope you're continuing to improve?

Re: Dorothy again

Julie on 12/10/04 at 02:55 (165432)

Incidentally, that reminds me: you were off the board when this happened, but I communicated with Dr Z and Scott about the PF Stretch, wrote it up, and there is now a link to it, as you see. You were the one who asked me to do it, so if you missed this, you'd like to know.

Re: The exercises, stretches

Robert J on 12/10/04 at 13:39 (165449)

Actually, I don't think describing my exercises will be difficult because most of them have been described here many times. Trust me, my regime was garden variety. The trick--for me--was doing them with great consistency and working up to more reps over time so that real strengthening was taking place. As Julie suggested, most of the exercises were geared to the intrinsic foot muscles along the bottom of the foot. Each morning's session also started with a stretching session. Anyway, here goes:

--Stretching: I did only non-weight bearing stretches that were taken from the Mattes method. I bought one of Mattes' books, 'Specific Stretches for Everyone,' and it served well. For those not familiar with Mattes, he advocates short stretches of 2-second duration with many reps. My stretches include those for hamstrings, quads, calf, and bottom of the foot. For the calf I used an elastic band while sitting on the floor. For the foot, I simply bent the toes back according to Mattes' book. I did 15 reps for each exercise (15 per side, or a total 30 calf stretches, etc)


+Windshield washers. Sit in chair, press feet to floor, make windshielf washer motion with feet. 2 sets of 20 reps.

+Heel lifts. Nothing extreme here. Eventually I did lifts with balls of feet resting on a dictionary. 2 sets of 20 reps.

+Toe curling. Sit in chair, put one foot on the other knee. Curl toes, then use hand to uncurl toes while the toes resist. Repeat with other foot. This is called eccentric exercise, I think, and stretches muscles and tendons while strengthening rather than shortening. 2 sets of 20 reps for each foot.

+Chair pull. Sit in office chair (with wheels) on hardwood floor. Pull yourself forward across room using your toes on the floor. 4 trips across 20' room.

+Calf flex pull. Sit on floor with back against wall. Put elastic band under ball of one foot. Pull bank tight then press ball of foot forward against band pressure. Repeat with other foot. 2 sets of 15 reps.

+Calf extensor pull. Same position as above. Point toes of one foot away from you. Place resisting device (like a Foot Trainer but other devices will also work) against tops of toes. Pull toes toward you against resistance. 2 sets of 15 reps.

As for the walking, I started with short, timed walks, beginning at 6 minutes. I increased intervals by 3-4 minutes every third walk. After a while I gave up the timing and just walked.

One other thing that was important, for me at least. I tossed out every device that was designed to take stress off my feet: orthotics, tape, etc. I tossed them because the whole idea of my experiment was to increase stress on my feet in a gradual way rather than protect them from stress. I also started walking barefoot simply because it seemed to feel good.

I want to repeat my caveat about all this. I have believed for a long time that atypical PF people have a significantly different injury from those with classic PF. Mine is atypical. I suspect that this regime would be much more likely to help other atypicals rather than classics.

Hope this helps.


Re: Dorothy

Dorothy on 12/10/04 at 15:51 (165451)

Julie -

I see that Robert has posted his regimen and I have printed it. It looks thorough and clear. It was very kind of him to do so. I do know how difficult it is to verbally describe exercise, or other physical activity, clearly and accurately. It is why I was trying to get Dr. Z to hone the description of the PF exercise; my questions where they were not clear to me were to help clear it up - and did, I think; at least they did for me.

I think I am, yes - It's a gray, cold day here and I am feeling the pressure of holiday obligations. I did get all my Hanukkah packages and cards mailed to my Jewish friends and family members. Now, it's on to Christmas! I think the world needs ONE holiday, with no gifts and no cards. Just lots of good food and camaraderie!

How are you doing today? Are you getting any more sleep? Fingers crossed for you and good thoughts your way ~

Re: The exercises, stretches

Dorothy on 12/10/04 at 15:53 (165452)

Robert ~

Thank you so much! This is an excellent resource. I have printed it out so I can refer to it. I do appreciate your time and thought in putting this together. I know that many more than I will benefit from your work. Thank you again!

Re: The exercises, stretches

Julie on 12/11/04 at 09:54 (165478)


Thank you for doing this. The exercises sound good to me, and I think it would be good if they too had a permanent place on the website. Perhaps you should email ScottR and discuss it with him.

Your theory makes sense, and I wouldn't be so sure that it doesn't apply to 'typical' PF sufferers. There is no doubt in my mind that strengthening is vital for all cases, all people, whether typical or atypical. Most people who have incorporated the foot trainer exercises into their programme, for example, have found them a help. My feeling is that there is an over-emphasis on stretching, which although often necessary because a tight calf/achilles complex is a common cause of PF, and not sufficient emphasis on strengthening. Your exercises all seem safe, all but one is non-weightbearing, and people could do a lot worse than try them.

One other point: you applied consistent intelligent effort in following your plan. The best exercise in the world is only good if one does it, regularly and consistently, for a period of time. Obvious, really.

Thanks again, and congratulations on your recovery and best wishes for its continuation. Go from strength to Strength!

Re: Dorothy

Julie on 12/11/04 at 09:59 (165479)

I think so too, as I've said to Robert. I hope his regime works for you.

Have you looked at the PF Stretch since it got its place and its link?

You do sound improved, and I'm glad for you. I think I have turned a corner too, so thanks for your crossed fingers and good thoughts. Heavy-duty codeine has helped the sleep the past few nights, and I feel better. My back feels better too. I walked up the road this afternoon: 20 minutes to the top and back. Three days ago I couldn't walk through our house without collapsing into a squat. (Elegantly, of course.)

Keep improving. let's hope we both do.

Re: Dorothy

Dorothy on 12/11/04 at 12:26 (165484)

Julie -

RE: 'Have you looked at the PF Stretch since it got its place and its link?'
Yes, and it looks excellent. I'm glad you added the comments about sitting on the edge of a bed versus using a chair. Here's an observation and an adaptation that I made while in bed with back pain. I really couldn't sit in a chair yet and certainly not on the edge of the bed, but I had started some intermittent,halting, walking in the house. Feeling some foot discomfort, I was concerned about addressing that while incapicitated. So here's an adaptive move that might be useful for anyone who finds it difficult for whatever reason - arthitis, inflexibility, weight, back problems, etc. - to sit and cross one leg over the other.
The yoga move where one lies on one's back, legs outstretched or bent at knees, feet on floor (this position is a choice based on one's abilities and is simply the starting position for what is our aimed-for position). From the starting position, move one's leg's into a kind of 'reverse-frog' position with the knees bent out to the sides, bottoms of feet together (outer ankle bone touching the floor, soles of feet touching each other, knees relaxed outward toward the floor - but not necessarily touching the floor -). When one is doing the yoga move, the legs/feet slide upward toward the buttocks, etc. However, that is not the point of my adaptation. When one has the feet and legs in this position, one can use the heel of one foot to perform the PF stretch on the other foot and then reverse the move. This way, one can get an APPROXIMATION of the PF stretch when one cannot sit in the recommended way. The heel of one foot fits nicely into the arch of the other foot. Obviously one can't use the hand to pull the toes back when in this position, but one can simply bend the toes back (this is an APPROXIMATION of the PF stretch) - or perhaps one could use a belt or other prop to help pull the toes back (I didn't do this). Until one can get back into a chair or sitting position, this stretch can help. Julie, maybe you can or want to clarify this with better descriptions; if so, please feel free. As previously discussed, verbal descriptions of physical moves is difficult.

Julie - I am so glad to hear of your improvement which sounds significant! What good news that is. There's some of that ecstacy you were wishing for! Yes, I share your hope - and do keep up the mending. Better days ahead and good lessons learned (we hope!)

Last night my husband and I went to a holiday party. This was my first real outing in quite a while but I felt good and was ready for it. I was gussied up, we went and had a nice time; I stood the entire time and socialized and all went well. We left, walked down the walk and reached a driveway which we walked down to reach the street. It was an odd curb that LOOKED like a sloped driveway but was really a pretty sharp drop; we both tripped. My trip set off some nasty alarms in the left foot, ankle, and back. I actually thought I was going to break down in tears thinking I had undone all my progress in one trip on a curb. I cursed all the ignorant sidewalk and road designers! I did hurt some last night and some this morning, but tolerable so far. I'll have to do some tending today and try not to get tensed up about this.....So, not home free I guess, but still better. Take good care, Julie - and continued better health.

Re: Another success like Ellen J

Doug on 11/03/06 at 09:30 (214859)

I agree about the excercise, the only thing I have found that stops the pain is the use of the treadmill daily, it seems to stretch what needs to be stretched in order to totally relieve the pain.