The Agony of the Feet, Part Three

(Read Part One and Part Two first, if you missed them.)

It’s been exactly five years since I first wrote about the agony of my feet. In the intervening years, I have certainly been probed, tested and even sliced open by plenty of doctors. I even underwent three surgeries last year hoping they would alleviate the chronic inflammation in my feet. My foot problem is not gone, but at least the agony has morphed into the occasional annoyance. For me, this is great progress.

I have learned a lot along the way, and not all of it is flattering to our medical establishment. My primary care physician was of little help. He never studied foot problems in any detail but was glad to refer me to specialists. The podiatrist said the pain and numbness, mostly in my right foot, could be a number of things. Initially he started with steroid shots injected into certain spots in my foot. They seemed to help a bit, but the symptoms recurred later with worse pain. I pointed him to my varicose veins, predominant in my right leg, and wondered if that could be the problem. The conservative approach seemed to be to remove some veins on the theory that blood was pooling in my feet and this was adding to the pressure there, thus causing the pain. One vein was cauterized last May. I spent weeks wearing compression stockings, which due to all the leg compression made the pain worse. Later last summer I had the more egregious surface veins on my right leg removed and spent more weeks in compression stockings. The surgeries did little to reduce the pain, but I must say my legs look great.

The podiatrist also sent me to a neurologist, who confirmed tarsal tunnel syndrome in my right foot and well as various neuropathies elsewhere. This eventually resulted in the tarsal tunnel surgery I had in January. If you have tarsal tunnel, this should mean that a nerve is compressed in your ankle, right? It seemed a reasonable assumption. However, after surgery and three weeks staying at home, at best I had only a little relief. I knew the surgery did not have a great success record, and sometimes it took months for symptoms to moderate, but I could think of nothing else to do. There was no one specialist to go to who could put it altogether. Each specialist saw my problem in relation to their specialized training only.

I did notice that the back of my thighs also felt irritated. Could the problem not be in my feet, but further up in my sciatic nerve? Could I be compressing nerves elsewhere and feeling the result acutely in my feet? After a follow up with the surgeon, I asked and received a referral for physical therapy to chase possible sciatica. Perhaps through the right kind of exercise elsewhere better results would trickle down to my feet. It seemed a wild idea, but it was worth a try. I had few other options.

It took only a few sessions with Donna and Rebecca (the physical therapists who worked on me) to realize this is where I should have started, not where I ended. Most likely, all the other surgery could have been avoided, along with thousands of dollars in medical costs. Granted, physical therapy is not a lot of fun and takes a lot of time. However, the proof is in the pudding. My symptoms are 50-70% improved compared to when I started physical therapy a month or so ago.

I had no idea that our nerves are sheathed inside tubes, and with the right stretching your nerves will slide inside these tubes. These exercises forced my nerves to move from their favorite spots, where they may have been stuck and thus more likely to feel compressed and inflamed. Good physical therapists (and both Donna and Rebecca are excellent) will note connections. It seems I have bad posture. It was nothing I gave much though to before. Of course, everything in your body is connected, so stressing and stretching nerves the wrong way (such as via slouching, leaning back in chairs, hunching over my desk or not sitting in an ergonomic position) were all contributing toward the major problem manifested in my feet.

Now I spend about an hour a day stretching my muscles. I do pinformis stretches. I do hamstring stretches. I do supine nerve glides and horizontal braces. I do leg marches. I use a tennis ball to massage my plantar fascia (the bottoms of my feet). I do calf stretches and pointing ankle-strengthening exercises. I do other exercises too numerous to mention here, all of which take a lot of time and are boring as hell but which seem to alleviate symptoms quite well. I am in good hands with Donna and Rebecca, literally, because they are often massaging my feet, legs and surgical scares with cream and very firm strokes. They are also big believers in ultrasound, which they use liberally on my surgical scar. Through repeated therapy, I went from having the tightest legs and ankles they had seen in six month to relaxed calves and feet like normal people.

I also pull on long, stretchy rubber bands, mainly to improve my posture by strengthening my back muscles. I also sit on big bouncy balls and place a ball between my legs while I lift my calves. I also learned how to properly get in and out of bed. Apparently, the way I had been doing it for the first 53 years was wrong. You have to roll in a certain way and drop your feet toward the floor while pushing yourself up with your hands. There are many secrets these masters know about how not to stretch my sciatic nerve.

A good ergonomic chair is also helpful for us desk dwellers, but sitting properly in any chair is also important. Sitting up straight still does not come naturally to me. However, I discovered that making sure my feet, knees and waist form right angles when I sit could relieve many symptoms. One thing I was doing wrong was sitting too high in my chair. This obtuse angle simply put extra pressure on the bottom of my thighs, aggravating the sciatica.

It all seems to come natural to physical therapists that as a class seem to be skinny, beautiful, have great skin and, naturally, great posture. They eat right too. No processed foods (it seems) for these specimens of great human health. They’ve got it all figured out, and they practice what they preach.

Are my foot problems solved? Not yet, but thanks to my excellent physical therapists, I am seeing great changes in a chronic problem that has dogged me for more than five years. Perhaps next time you have any muscular or nerve related problems, you should seek out a good physical therapist first. It may be all you need.

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