Hi fabulous PTs on the board!

[Sheesh]

I have a question, and was hoping one of our fabulous physical therapists on the board might have some ideas/suggestions...

I've been in PT for almost 8 weeks for treatment for plantar fascitis, achilles tendonitis, and overall tight calf muscles in general. The plantar fascitis seems to be gone, but now I am experiencing pain in the flexor hallus longus (???) - the tendon that flexes my big toe. My PT says she doesn't have many more ideas for how to address this issue and will soon be sending me back to the podiatrist. I figured it was worth a shot asking here whether anyone has ideas... We've done lots of massage and stretching, but that doesn't seem to solve the problem. The tendon is really tight and "stringy" according to my PT. Any ideas on how to make this pain go away?

Thanks for your help!
Sheesh

[Wahine]

I'll put in my two cents but Knott is really the footsie person and I'm sure she'll have suggestions.

You mentioned calf tightness and I think that this is likely the key for you.

Check out www.thestick.com, they have a great myofascial release tool that allows you to do deep tissue massage to your own calves or have a partner do it. You could also go for a deep tissue massage. It hurts like h e double l but it works for me. It's important to drink a lot of fluids after the massage and make sure you stretch a lot in the days following.

Also check out this thread:

http://forums.teamestrogen.com/showt...ntar+fasciitis

It's specific to PF but a lot of the treatments for PF are the same for flexor hallucis longus tendonitis. You might get some new ideas.

Hope that helps.

[han-grrl]

Some options to think/look at

1) sometimes a new specialist is helpful, they see with a different set of eyes that maybe the PT had missed
2) shoes, custom orthotics might solve some things, you can stretch and stretch but if you are in poor footwear and/or on bad floors (like working on a concrete floor with little shock absorption) you canl remain with chronic pain issues...
3) technique you use for your sport, like running, if you have issues with gait then that can lead to chronic issues as well...

good luck!
han

[Sheesh]

Thanks, ladies! I appreciate the quick responses.

I have been keeping up on the plantar fascitis threads, and many of the exercises mentioned are what I've been doing for 8 weeks. I've gained some flexion in my foot (they initially didn't even make a 90 degree angle, even when pushed!), but still not enough...

We thought it might be my flip flops (I know, flip flops are bad, but they are Chacos!), so I switched to other shoes (even tennis shoes) and the pain seems to actually get worse. I couldn't get an appointment for this week, but I go in twice more next week so maybe I'll get a referral back to the podiatrist and hopefully she'll have more suggestions.

If you have more ideas, please keep 'em coming! THANKS!

[Wahine]

Sheesh, does your big toe move the same amount as the other side. When you bend it backward it should bend to almost 90 degrees. If it's stiff this may be a problem.

Knott really likes these chakos:

http://www.chacousa.com/products/Pro...3&pID=25&gID=2

I just bought a pair this weekend to help with a toe issue. I got the slip on kind tho. They're hard to get used to but really cool and I think they'll do the trick.

[KnottedYet]

Chacos are good! (I have 3 pair)

I have no issues with flip-flops if they have decent footbeds (like Chacos). In fact, they can strengthen your feet since you have to have active and lively feet to keep them on.

Are you wearing any nice NEUTRAL over-the-counter footbeds in all your regular shoes, like Superfeet or Spectrum Stabilizers or Shock Doctors?

Grumpy PF/FHL are like canaries in a coalmine. If something is out of whack, they start chirping. It might not even be something out of whack in the foot; it could be ankle or knee or hip or even weak core muscles!

Sounds like something is putting huge stress on the critters that hold your arch up. So why stretch those critters? Well, your body tightens them up trying to hold them together against the stress, but tight structures cause their own problems. How about reducing the stress first? Then your streches will not be in vain (your bod won't tighten up again as quickly).

If you have a spare $35 or $40 lying around, and if you don't have orthotics or good footbeds already, how about going to a *good* shoestore and just trying a pair of Superfeet "Green" or "Berry" footbeds. If those feel icky, try the Blue or any other color the store has. (I'm voting for green, but don't listen to ME, listen to your FEET!) You have 60 days to try out the Superfeet, and you can still return them to either the store or Superfeet Co. even if you trim them or post them. (If you have trouble returning within 60 days, contact me. I have a Superfeet rep who will handle the issue.)

Ask your PT if she can post your Superfeet if you need posting. Has she given you any intrinsic foot muscle exercises? Extrinsic foot muscle exercises? Balance/proprioceptive exercises? Posture exercises? (both foot and body) Hip external rotator exercises?

There are a bazillion cool things that can be done with footsies. PM me if you need some more info!

Knot-has-a-thing-for-feet-but-thats-ok

Edit: don't let anyone talk you into the custom heat-molded Superfeet or Your Soles. You don't want to play that game. Neutral over-the-counter footbeds is the way to go first. If anything is being custom molded to your feet, please let it be done by a Licensed Orthotist. (which I am NOT, but I have one I send my patients to)

[goodjude]

I have suffered with this same problem and it really just takes lots of good shoes that are more or less orthotic, stretching the calf muscles with a yoga strap pulling the toes towards you as best you can. I also would wear a special boot at night that helped to keep the toes straight and the foot flexed. Good luck. I can't wear flip-flops at all and I live in Florida. If I wear them for only one day the next day the PF starts right back up. Be patient, it does take some time to recover from. Also do not walk on the floors in your house barefoot, make sure you have good support, no bare feet! Sorry ( most comfortable):