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Foot exercise

Discussion in 'General Issues and Discussion Forum' started by timharmey, Jul 31, 2011.

  1. timharmey

    timharmey Active Member

    Members do not see these Ads. Sign Up.
    I have Started this thread on the advice of Professor kirby.I have a No of patients who have weak resisted dorsiflexion in their feet, (Not foot drop , spinal impingment) who have benefitted from undertaking exercise with a Thera band i,e pulling against it. This has come to light with patients with shin splints and unexplained ankle pain. In one case of a weak tib ant I had a girl wrapping a Thera band around her hallux and pulling it with good effect.
    I also issue an advice sheet from a product called pediroller (a grooved rubber cylinder) following advice from a colleague to patients with plantar fasciitis with good result(I have not got the I.T skills to upload it). I would be interested in any thoughts, good practice, or good foot exercises that have been shown to be successful that people would like to share?
  2. Perthpod

    Perthpod Active Member

    Hi Tim,
    Hi Tim,
    For plantar fasciitis I have been using a tennis ball (working like the pediroller) 3 x a day and a seated plantar fasc. stretch (affected foot on other knee and pull toes back towards affected side knee, hold for 10 sec when stretch felt, repeat x 10, 3 times a day), plus gastroc and soleus stretch with good results in a barefoot runner (me); and others (patients) in combination with insoles/strapping.
    I just wanted to comment on the theraband around the hallux - I feel that this exercise in the wrong hands - vasc compromised patient/patient using for longer or tighter than should be - could be detrimental (acting like a tourniquet)? Then again would have to see it in action...
  3. timharmey

    timharmey Active Member

    Thanks perthpod
    That exercise regime makes sense.I can see the concern about the hallux and the Thera band , but it is done in a safe way!I suppose what I am trying to get at is how many of my patients are physically weak.I have 23 year old women who have just so little power.It does seem that many such patients fit the Fibromyalgia pattern i.e low mood lots of general muscular pain , fatigue, some however are just unfit. I dont suppose it is the same in Oz with all that sunshine and out door space.I dont want to turn in to Mr grumpy but is the Uk developing a large inactive physically weak section of society? I know there are various public health programmes and I do see a lot of people in pain due to pathology but there does seem to be an awful lot of people who would benifit from "Boot camp " rather than Msk podiatry
    Tim ( victor meldrew)
    Last edited: Aug 1, 2011
  4. blinda

    blinda MVP

    Interesting. Not thought of wrapping a band specifically around the hallux. I usually advise pts to loop a towel around the forefoot and then slowly pulling back until they feel a stretch in the lower calf and heel and hold for 10 seconds, amongst other stretches.

    As for the lethargy brigade, I have a few self diagnosed (Googled), fibromyalgia pts who cant/wont exercise yet would clearly benefit from a good ol` fashioned endorphin release. Catch 22, I guess.

    Hope that helps!

    Slack day today. Off to read my book and have my coffee `n meatball sandwich in the garden. I blame Larsson....

    The Girl With a Forget-Me-not Tat
    Last edited: Aug 1, 2011
  5. timharmey

    timharmey Active Member

    which Larsson not the one who played for celtic?Your sarnie is not one I have heard of before is it a plain coffee and meat ball or do you chuck in a skinny latte!
  6. blinda

    blinda MVP

    Nope, this Larsson;


    Great trilogy, but half of the text just describes the coffee and sandwich habits of the Swedish.

    Not really a latte type of gal, skinny or not. Like Twirls, I like my coffee blick.:morning:
  7. Who don´t eat much in the way of smörgås by the way - Norwegians do - it just one of the strange thing you learn while living here.
  8. Tim one of the big things with exercise programs with feet it the fact that making a muscle stronger may make the problem worse.

    Spatial location of axis is very important here.

    Knowing when the muscle is firing in relation to axial position should be the first important point of reference.

    If the force vector of the muscle is the wrong side of the spatial location of the axis for the joint involved then increasing the muscle strength will in-fact have a negative result.

    Does that make sense ?
  9. timharmey

    timharmey Active Member

    I saw the films which where good she can "handle 'Er self on tha cobbles" as they say in Sarf london .Mike i was puzzled a bit but i thought about it on the way home and I think I do, If there is a force the wrong side of say a medially displaced sub talar axis strengthening that muscle will increase the problem , there you go made myself look thick in public?
  10. Why would you make yourself look thick. what you say is perfectly correct.

    Say we have a patient medially deviated Subtalar joint axis ( STJA) who problem is say Deltoid ligament and the Peroneus Longus and Tibialis Anterior muscles create a force vector which is lateral to the STJA axis when firing.

    If we increase the strength of these 2 muscles in the hope of reducing the loads on the Detoid ligaments by reducing the Supination moments - we will have in fact increased the internal supination moment and thus increased the loads on the deltoid ligaments.

    Thats the theory anyway the problem is that the muscle will not create a vertical force vector, but more a force vector which follows the line of the tendon, so much less black and white and more a little of both.
  11. timharmey

    timharmey Active Member

    I was trying to cover myself , thanks ,very useful , very interesting by the way that belinda looks very young to be a podiatrist?
  12. blinda

    blinda MVP

  13. timharmey

    timharmey Active Member

    serendipity 5.3.66 so do you swim both way? or drink like a fish?
  14. blinda

    blinda MVP

    Really? Almost twins! Not sure how to take the first question, but I have been known to like the odd pint of soapy stuff.
  15. timharmey

    timharmey Active Member

    I mean pesky pisces which is two fish swimming different directions
  16. blinda

    blinda MVP

    Oh I see! Thought you were being personal :eek:

    No, I only swim in one direction.....
  17. timharmey

    timharmey Active Member

    No just bad puns, word plays and general messing about :drinks
  18. blinda

    blinda MVP

    Me too. Better stop or we`ll have the fluff police on our backs. ;)
  19. Sicknote

    Sicknote Active Member

    I have seen at least 15 different foot variation exercises on youtube using therabands.


    Key words:

    posterior tibial muscle strengthening
    peroneus longus muscle strengthening
    peroneus brevis muscle strengthening
    flexor hallucis longus strengthening
    flexor digitorum longus strengthening
    plantaris strengthening
    abductor hallucis strengthening
    flexor digitorum brevis strengthening
    flexor hallucis brevis strengthening
    abductor digiti minimi strengthening
    quadratus plantae strengthening
    tibialis anterior strengthening
    extensor digitorum longus strengthening
    extensor hallucis longus strengthening

    posterior tibial muscle exercises
    peroneus longus muscle exercises
    peroneus brevis muscle exercises
    flexor hallucis longus exercises
    flexor digitorum longus exercises
    plantaris exercises
    abductor hallucis exercises
    flexor digitorum brevis exercises
    flexor hallucis brevis exercises
    abductor digiti minimi exercises
    quadratus plantae exercises
    tibialis anterior exercises
    extensor digitorum longus exercises
    extensor hallucis longus exercises

    A few gems in there.

    Also check out the ArchCOACH.

  20. and how many mention the spatial location axis ? None , right - Not all is want is seems.

    Stronger muscles may lead to increased problems.
  21. timharmey

    timharmey Active Member

    your info on spatial location axis has really make me think about what I am trying to achieve with muscle stregthening
  22. Sicknote

    Sicknote Active Member

    Do we have a citation?.
  23. Told you before it's all about length/ tension relationships. A muscle may test strong in one area of the joint range but weak in another. See janda. The kendalls book gives lots of examples of potential problems with short muscles which will test stronger than their elongated antagonists. Moreover, if you attempt to strengthen a lengthened muscle all you do is move the length/ tension curve upward, what you really need to do is move the length/ tension curve across. This is achieved by stretching the short strong antagonist not be strengthening the long weak agonist.

    See also the work of mark comerford
  24. Sicknote

    Sicknote Active Member

    And this applies to athletes/runners or just patients?.
  25. Cool - Tim not sure if you have seen this thread, might be of interest - How significant is the Peroneus longus as a Plantarflexor of the 1st Ray?

    With a Quote from Robert -
  26. mammals
  27. Sicknote

    Sicknote Active Member

    No good for me then.
  28. Found these slides in a lecture I used to give back in about 2000, I think they came from Janda or Comerford. The first shows how shortening and lengthening of muscles influences the length/ tension relationships; the second shows what happens to these curves when you concentrate on muscle strength as oppose to muscle length. It's about hitting the right force at the right point within the range. Strength exercises lift the curves upwards, but it doesn't shift them back horizontally to where they should be, i.e. the "control" in the first slide. Note too, that shortening and lengthening of the muscles changes their recruitment and thus their phasic activity.

    Attached Files:

  29. Sicknote

    Sicknote Active Member

    I think it's one thing knowing about length/tension relationships but how one goes about shifting the curve optimally to where it should be & how the athlete/runner should go about doing it is a whole different ball game.

    For the average gym rat who lifts a lot of weights this would seem an impossibility?.
  30. Like I said, it's about focusing on length, not strength. In my experience, many gym bunny's who "lift lots of weights", generally will have trouble spelling their own name, never mind understanding muscle physiology. I generally have patients use PNF techniques.
  31. timharmey

    timharmey Active Member

    Thanks Mike I will read it throughly tomorrow I think it is Fascinating.If i dont go and eat my dinner I will be divorced I will reply fully when I undertand implications
  32. Sicknote

    Sicknote Active Member

    I think I have found the answer Simon.

    Isometric (static contractions) with no change to muscle length/force = 0 during isometric contraction.


    At more elongated lengths passive tension accounts for most of the total force. So the more elongated the muscles are, the more force they can put out when running?.
  33. Perthpod

    Perthpod Active Member

    Just wanted to report that my pl fasc exercises above have eradicated a 2 yr severe arch pain in a new barefoot runner (me), such a relief to have this pain disappear ;D
  34. I don't know what the question is. Remember, you were a student researching an essay. I have no idea what it is that you are seeking, I think its got something to do with your ambition to run faster.
  35. Sicknote

    Sicknote Active Member

    Do isometric (static contractions), taking into account there is no change to muscle length/force = 0 during isometric contraction, shift the curve optimally to where it should be?.
  36. I doubt that very much, since isometric or any other contraction force will be dependent on the resting length of the muscle. If the muscle is is too long or too short in it's resting state then the isometric contraction will not adequately control the joint dynamics.

    See the graphs, all you'll get with the isometric is the short mucle creating force in the same place in the joint range but without the length change, so a single point within that curve. The same will be true for the lengthened muscle. Single areas of force, still not necessarily in the right areas of the joint range.
    That's all from me until you can show some honesty.
  37. timharmey

    timharmey Active Member

    Hi mike
    have read thread very intresting .I had this mad idea that a flexible plantiflexed 1st ray was due to peroneous contracture ,i am no saying it is but it might be ?Enjoyed my dinner ,still married and enlightened on peroneal longus function thanks
  38. Sicknote

    Sicknote Active Member

    It just seems to me that shifting the curve optimally to where it should be is an impossibility for a runner with all the shortening and lengthening muscles undertake during the day.

    If lengthening is more important than strengthening then you would surely recommend yoga for runners?. But then there can be a case made that having too much flexibility can be detrimental.
  39. http://www.youtube.com/watch?v=q1L5bR3o400
    Yes you know how some things seem like God's gift
    Easy come and easy go
    They disappear before you know it
    And in the light of this new day dawning
    We see things a different way
    With such a price on what we say

    But I'm so pleased for you
    I'm so pleased
    You have all the answers

    Thanks a million for your thoughts on culture
    Please feel free to speak your mind
    Though people say it turns you blind
    And did you know there's a God here with you
    He knows what is right or wrong
    'Cause he's read the book for far too long

    But I'm so pleased for you...

    What do you know about good and evil?

    So here's a thought while we burn our bridges
    If the pen's not worth the sword
    Then pass the gun and praise the Lord

    But I'm so pleased for you...
  40. Sicknote

    Sicknote Active Member

    Seems like your chasing the holy grail with regards to length/tension relationships Simon?.

    This is one pot of gold that can't be reached.

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