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.
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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?
Tim
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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... -
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 -
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....
Cheers,
The Girl With a Forget-Me-not TatLast edited: Aug 1, 2011 -
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!
tim -
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: -
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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 ? -
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?
Tim -
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. -
I was trying to cover myself , thanks ,very useful , very interesting by the way that belinda looks very young to be a podiatrist?
Tim -
http://www.thedailymash.co.uk/category/agony-aunt/ -
serendipity 5.3.66 so do you swim both way? or drink like a fish?
tim -
Really? Almost twins! Not sure how to take the first question, but I have been known to like the odd pint of soapy stuff.
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I mean pesky pisces which is two fish swimming different directions
tim -
Oh I see! Thought you were being personal :eek:
No, I only swim in one direction..... -
No just bad puns, word plays and general messing about :drinks
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I have seen at least 15 different foot variation exercises on youtube using therabands.
http://www.youtube.com/
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.
http://www.youtube.com/watch?v=ER7De2UqGes -
Stronger muscles may lead to increased problems. -
Mike
your info on spatial location axis has really make me think about what I am trying to achieve with muscle stregthening
Thanks
Tim -
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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 -
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With a Quote from Robert - -
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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:
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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?. -
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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
Tim -
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?. -
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
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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. -
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
Tim -
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. -
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... -
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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