Re: What type of stretches can I do for my PF? This Is Long

Posted by Sarah on 9/05/99
It seems that this question reoccurs periodically so I saved several of my posts in a file and repost it every now and again for new sufferers. It has helped me to become alomost pain free as well as most recently hiring a personal sports trainer who has a 4 year college degree and who is faliliar w/ pf

Posted by Sarah on 6/24/99
Again, check out Denise's "New Sufferer". As for stretching, I am not much of an athlete so I will attempt to describe:

1. If your heel is sore and swollen, as mine was for a very long time, my physical therapist told me to massage it prior to getting out of bed
first thing in the morning to disperse any fluid that may have collected there thus resulting in immediate pain. I take my thumb and
press/rub in a sideways motion from the inside of foot to the ankle. For some reason my PT stressed that direction rather that up down
from toe to heel. I do it now only on days when I have been out walking a lot.

2. I do a Runner's Stretch in the shower or against a wall somewhere in the house. Place hands against wall, place right leg behind you with
heel firmly planted on the ground. Bend other knee and stretch counting to 30. You will feel calf stretch. Change feet and repeat. I do this
in the morning, at least, and Whenever I thing of it throughout the day.

3. Heel lifts (which to me are really toe lifts, but I am quite literal sometimes). Again, with your hands against the wall, or holding onto a
counter, bend on leg up at the knee (like a flamingo) and raise yourself up on one foot with your toe ( like the front half of you foot- ball to
toe- like your reaching for something high up in a cabinet). The key is to do balance on one foot at a time and slowly bring your heel back
to the ground. Repeat 15 times for each foot (assuming both feet have problems). Again, I do this whenever, like if I am a at the grocery
checkout counter waiting to be totaled.

4. Towel Scrunches (read the Denise "New Sufferer 6/19). This was a biggie and I did it five times in a row for each foot.

5. The tilt board: I replicated this at home by beginning with my toe pointed straight and rotating in a clockwise fashion about ten rotations
and counter clockwise another ten times. I'll do this under my desk at school or while laying in bed at night. It is hard to describe because I
learned the motion on a tilt board at physical therapy. I guess, imagine putting you foot on a giant beach ball and moving the ball in a
circular fashion with your foot, and imagine never raising you foot from the ball to accomplish this.

6. I will stand with my heels hanging over the edge of a step and raise up on my toes and then I will slowly come down over the edge as far
as I can drop. This stretches the calf out in a major way, and at my worst level of pain this exercise was somewhat painful. However, I was
told, and I know nothing about human anatomy, that the tendon causing plantar fasciitis connects all the way up your back heel and up into
your calf.

7. At my worst level of pain, I refrained from any distance walking and tennis. I iced my heel for 3 ten minute intervals (at least) throughout
the day. Now I ice only after physical activity and will leave the ice pack on for 20 to 30 minutes. My feet have become very accustomed to
this. This spring I was up to playing tennis two times per week (very intensive tennis drills through a workout program) and iced my foot
probably 4 out of 7 days a week to prevent any inflammation from coming back. Ice is a cheap and easy precautionary measure to take.

At the start of physical therapy, I wasn't walking heel to toe. rather, I was walking toe to heel on the outer edge of my foot. My physical
therapist assessed my gait and remarked that I was flat footed on one foot and partially flat footed on the other. Interestingly enough, my
mom had me in orthopedic shoes as a baby to correct this problem. I guess it is too late to get her money back for that! Anyway, while at
physical therapy i would begin my time there with my right foot( most painfully affect, with the smaller heel spur (left is bigger but was
corrected with 1 cortisone shot) in a 60 degree whirlpool bath for 10 minutes. I also had ultra sound on my heel and I paid out of pocket
for something they called "ionto". Ionto (sp?) was a Cortisone cream the would place on my heel and use electrical currents to send into
my most painful area. Insurance wouldn't pay for it (about $75 -$100 a pop) and they said it has mixed results. I didn't feel much long
term improvement with this which helped my pain for about 1 1/2 days after and should have helped for 4-5 days after. At any rate, i finally
got a second shot and stayed off of my heel for another 1 1/2 months to let the cortisone set in there and work (both doctor's and physical
therapists advice). I then added tennis back once a week and eventually twice a week. I have been well since, but I am taking the summer off
from tennis and attempted to walk a few miles distance two days in a row. I felt some gnawing pain so i have resolved that I am going to
buy a new bike and take swimming back up because I have gained more weight due to lack of exercise. It is a vicious cycle, but I am
hoping that if I get my weight down and space my vigorous, impact exercise apart with a lot of icing in between, I will be fine. It is all trial
and error and reading your body's signs of rejection. I hope this verbose passage will prove beneficial to you and others. I am glad that you
have found my comments helpful. I really believe that part of the package is finding a good doctor. I started off with a good one, but I did
my homework first. My family had learned first hand that doctor's can be lousy bums. My sister had a lump in her neck in high school
which her doctor said was just a"swollen gland". Luckily, my mom didn't buy that explanation and took her to another Doctor who
biopsied it and found out that she had 4a staged Hodgkin's Disease (cancer of lymph nodes). Very scarey but she is alive today because
my mother didn't put all her faith in one opinion. Good luck and let me know how you are doing.

I am by no means a doctor but here is what put me on the road to recovery:

- Ice (10 mins. minimum) directly on sore spot as ofen as possible, especially after exercise.

- Wear orthotics (mine were custom made) at all times. NEVER GO BAREFOOT. This has made a big difference. Pull ou all inserts in shoes
and put a Dr Scholl's (SP) insert in (air pillow is what they are called I think). This inserts are pretty thin you do not want anything real fluffy
because what you need is strong support. Place orthodic on top. If you don't remove inserts from shoes you may over correct the problem and
cause other problems.

- Stretching exercises. This was fundamental for me and painful at first, but you need to limber up a tight, too short tendon, which is the root
of your problem.
During physical therapy I was told to do a runnner's stretch, heel lifts, circulate foot 20 times each rotation (to replicate motion of foot tilt
board), and towel scrunches where you sit on a bench and start with your toes just over the edge of the flat towel and use your toes in a
scruching fashion to pull the towel and scrunch it under your foot. This towel scrunch was a biggie and I was to do it five times in a row for
each foot.

- If you get a cortisone shot, refrain from strenuous exercise so that the med can sit in there and do its job. I was told to refrain from exercise
until we got it under control, and then we gradually added it back.

- If you are taking Ibuprofen (sp) do not be on it for unlimited time due to the fact that it causes stomach ulcers.

Good luck. I would get several opinions and research this websight before doing anything too drastic. I still cannot understand why your Dr.
told you no stretching. That was an integral part to getting myself back on the road to recovery and I still am religious about my stretching so
that my foot remains limber and won't be stressed when I do exercise.

Hope my info helps.

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