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possible tendonitis in foot
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riftweaver
Posted 2006-11-08 4:11 PM (#69002)
Subject: possible tendonitis in foot


A week ago Monday, I started exhibiting a pain in the side of my foot. (Not yoga related.)

The pain is on the outside of my right foot, below the ankle and above the fleshy part; forward along what feels like the bony area approaching the toes. My chiropractor thinks it's likely tendonitis, since I exhibit none of the symptoms of a break/fracture (no swelling; and he can flex my foot in any direction without causing pain). It mostly only seems to be painful when I'm walking, i.e. bearing weight. It is likely an outgrowth of ongoing knee trouble, heh.

Strangely, the pain seems to vary by degree. A couple of nights ago I performed a very short, gentle yoga practice, and it seemed to diminish any discomfort. Last night after work, I was suprised to notice all pain vanish. Yet this morning it hurt worse than before. A followup with the chiro still suggests tendonitis as the culprit. While walking does hurt, yoga didn't seem to aggravate it.

I have an appt with a foot specialist next week to further look into this; but meanwhile, on the assumption that it IS tendonitis in that area of the foot/ankle, are there any suggestions for a yoga practice to support/improve my injury?

Outside of yogasana, I'm trying to follow RICE as much as possible (although compression seems to cause discomfort); and I have an anti-inflammatory that I am taking.

Thanks for sharing any suggestions and wisdom.

--Jason
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pamela
Posted 2006-11-08 10:00 PM (#69016 - in reply to #69002)
Subject: RE: possible tendonitis in foo


Hi Jason,

If it is tendonitis, give your foot as much rest as possible. So, avoid the poses that irritate it (I imagine that may include many standing poses) and poses that put lots of work on your foot (like leg balances).

You may be able to modify some poses so that they won't bother you, too.

If I knew more about how you normally practice I could offer some more concrete suggestions.

Hope your foot is better soon

Pamela
Yoga in Grand Junction Colorado
Viniyoga Video
Free Yoga Audio
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joscmt
Posted 2006-11-08 11:40 PM (#69024 - in reply to #69002)
Subject: RE: possible tendonitis in foo


riftweaver- sounds like tendonitis to me too.. although I'm no doc, I had tendonitis in both my feet for a long time- it takes a long time to heal. At least, it did for me, because I work on my feet all the time. My suggestion would be to avoid standing poses altogether and focus on floor poses. It's just one of those things you have to baby to heal it. Excess exercise will make it worse. I feel for ya. It sucks! Good luck with it.
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Nick
Posted 2006-11-09 3:13 AM (#69026 - in reply to #69002)
Subject: RE: possible tendonitis in foot



20005001002525
Location: London, England
Hi Jason,
Just to let you in on a little secret-"tendonitis" usually means the therapist doesn't know exactly what is causing the problem it's a great word, not too hard for the patient to remember, and sounds good. So I always smile when I hear someone has tendonitis-I mean, if a muscle is tight, then it tends to pull on its tendon, then the tendon sends out signals that it is in trouble-so the cause is muscle tension, and as most chiropractic adjustments work on adjusting muscle-well, you see my point. Not to say that the chiro treatments aren't going to work!
The question is, if there's no swelling, why are you trying to compress the injured area-this is what compression is for, to reduce inflammation-same with ice, etc. I think the whole idea of RICE is over-used and highly debateable:

"The Detrimental Effects of Ice on Sports Injuries
The cells that make up ligaments, tendons, and organs are extremely temperature-sensitive. The metabolic rate at which these cells function is directly proportional to the temperature in their environment. For each 10 degree Celsius change in the temperature, there is a more than two-fold increase in the cell metabolism. (Guyton, A. et al. Textbook of Medical Physiology. Philadelphia, PA: W. B. Saunders, 1996, p. 620.) In other words, in order to increase cell metabolic rate by more than 100 percent, the temperature of the tissue must increase by 10 degrees. Conversely, cooling tissue will decrease that cell's metabolism."

And also, NSAIDS are perhaps over-used-again, especially as you said there is no inflammation, and also inflammation can in fact speed the recovery of damaged tissues-still, I cannot see your foot, hope it all works out.

Nick
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Orbilia
Posted 2006-11-09 5:34 AM (#69032 - in reply to #69026)
Subject: RE: possible tendonitis in foot


Periodically, I get pain in one foot in the same area you mention. To me it always feels more like a deep bruise than a strain though, even though there's no skin marking. I've never been able to pin-point what I was doing at the time the pain started however so avoiding repitition's been a bit difficult! I don't think it's yoga though as I used to get it a bit before I started my practise.

Fee

Edited by Orbilia 2006-11-09 5:34 AM
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tourist
Posted 2006-11-09 10:25 AM (#69051 - in reply to #69032)
Subject: RE: possible tendonitis in foot



Expert Yogi

Posts: 8442
50002000100010010010010025
Take a close look at your shoes. I have a bit of a similar pain right now and I am pretty sure it is because I am wearing shoes that need to be replaced. Slopping around in slippers also causes some of this type of pain for me. Wear supportive shoes with good, level soles (we talked about this somewhere else recently) - look at the soles of your shoes to see if they are worn. The foot specialist will likely suggest orthotics, because that is what they do Minehave been a huge and amzing help, although since yoga I don't need them much anymore, but many people I know have spent the big bucks on orthotics and hated them or worse, had them create more problems than they had in the first place.
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riftweaver
Posted 2006-11-09 11:51 AM (#69056 - in reply to #69002)
Subject: RE: possible tendonitis in foo


I forgot to mention, I occasionally get mild tingling in the bottom outside of my foot, like an extra-gently "pins and needles." Wouldn't that suggest that I have a tight muscle somewhere above?

Thanks for the responses. I still suspect that this problem stems from the tight calf above it, and my temperamental knee. (Tight with scar tissue, as opposed to just a short muscle.) A pulling on the kinetic chain, so to speak. There is still no visible swelling.

I did some calf/hamstring stretches (lying on back, and using a strap) this morning; and it seemed to curb the pain a bit. Possibly because it loosened up all of the leg muscles? I still only have trouble while walking.

The problem started while I was wearing barely-worn Adidas sneakers. I have had similar discomfort from these shoes in the past; but not to any lasting extent. I wear those with double socks to prevent blistering around the heel/ankle (I have skinny feet and big ankles!). Perhaps wearing them for a full day/evening was too much for my poor feet to bear, and this is how they are thanking me. *sigh*

An x-ray will be reassuring that I don't have a hairline fracture or something; but that is about it. The fact that this pain has vanished a couple of times tells me it's not likely broken...

Thanks again for the kind words. The consensus appears to be: rest and be patient. A test of yogic principles indeed!

--Jason

Edited by riftweaver 2006-11-09 11:54 AM
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Nick
Posted 2006-11-09 12:21 PM (#69060 - in reply to #69056)
Subject: RE: possible tendonitis in foo



20005001002525
Location: London, England
Hi Jason,
Did you know that there are different ways of tying laces to suit different foot types?-I will see if I can find a site which goes through this.
Nick
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Nick
Posted 2006-11-10 3:35 AM (#69090 - in reply to #69056)
Subject: RE: possible tendonitis in foo



20005001002525
Location: London, England
Hi Jason,
yes that suggests some irritation of the sciatic nerve somewhere along its course-this could be anywhere from the nerve root to the ankle-as you mentioned knee problems this might be the cause, but often people with knee probs change their walking style and the altered movement can cause nerve root impingement from at the lumbosacral junction, from where the nerve emanates, or either side of the junction.
Just in case, here's some info on lacing patterns-you never know , you may get instant relief, doubt it, but fingers crossed!
http://www.wcsportsmed.com/education_htm.asp?EducationID=2

Nick
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riftweaver
Posted 2006-11-10 11:52 AM (#69108 - in reply to #69002)
Subject: RE: possible tendonitis in foo


I don't know much about the sciatic nerve; but is this something that could have been affected by an increased focus on asanas that stretch hamstrings? (Mostly a variety of forward folds.) Could that cause the pain I described in my foot?

Today, it's pain on the side; and light tingling above the ankle, and of the achilles tendon. (I've had that in the past though.)

When looking at my knee problems, my PT felt that there was likely a pinched nerve in the area of my right hip/lower back.

Thanks for the site link, I'll keep my fingers crossed too! Geez, I feel like a mess right now.

--Jason

Edited by riftweaver 2006-11-10 11:59 AM
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Nick
Posted 2006-11-10 12:11 PM (#69111 - in reply to #69108)
Subject: RE: possible tendonitis in foo



20005001002525
Location: London, England
Hi Jason,
Absolutely brilliant question-questions like that provide the answers that for me, make this forum worthwhile.
To answer your question-possibly! In order to determine whether a patient has sciatic pain, a straight leg raise is performed-you lay them on the table and lift one leg up to the ceiling-this stretches the nerve, and if the nerve is impinged upon, the action will reproduce their symptoms.
So stretching the hamstrings in yoga positions may well irritate the nerve. In this case, I change the way students do their forward bends-the modification depends on the severity of pain, and also will try to improve their posture so that the nerve is not irritated by bad technique.

Having said that, it is important to find out what is responsible-a tight muscle, injuries-is it a person's structure, or is it dysfunction which is reproducing the pain. Your chiropractor will be attempting to isolate what is responsible, but they are not watching you in a yoga class, and it may be that their treatment is undone by the way you practice yoga. As it is much easier to attain bad posture than it is to attain good posture, you can see that many students will be creating dysfunction rather than optimal function.
You may want to work on technique in your yoga for a while-try to notice which practice sessions result in pain the next day, and try to be religious about the rehabilitation exercises your chiro gives you. Then try to practice your yoga in a way which complements the rehab-if you notice that some postures seem to go against the rules of rehabilitation, then change the way you practice them-otherwise you will go two steps back for every step forward that the rehabilitation is attempting.

Nick
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Posted 2006-11-20 2:44 AM (#69732 - in reply to #69002)
Subject: RE: possible tendonitis in foo


Hi jason,

Since Nick is thoroughly "in" on this one I don't need to weigh in much.

He so aptly covers the anatomical all that remains to be mentioned are the leftovers.

Just as there are layers of fascia, tissue, muscle, there are layers of truth.
Our feet represent our foundations in the world, how we "stand" and this will need to be looked at (Svadhyaya) by the practitioner very carefully. Otherwise the anatomical remedies may come but the dis-ease will return as its deeper cause has not been addressed.

Forward bends are often poorly taught without compassion. Students are not properly advised about their safety in these sorts of poses and teachers indiscriminently "take" students into and out of them as though they were shopping malls. In addition most teachers rarely, if ever, assess the flow of the sacrum before leading students "forward". Some students NEED lots of padding before forward bending and instructions often neglect the necesssary lengthening of the front of the spine, instead emphasizing degree of fold.

One way to think of this is to envision the legs on a card table. To retract them and fold them up they must first be pulled up and away from their root and then they can be folded. And much like the table leg, the front and back sides both remain long.

When the sacrum of the student in a dandasana-like position is not at least 90ยบ to the floor AND the sacrum doesn't flow WITH the spine, it is inappropriate for the student to do the forward bend without a prop under the sitting bones to achieve these two states.

I dont' know if you've got tendonitis or false sciatica, or if you're lordotic or kyphotic. Can't see you brother. So I try like the d|ckens to avoid prognosticating.

Consider lifestyle changes (diet and emotional work) and rest in your asana practice finding ways to "be" your practice without the poses that aggravate your condition. Get yourself to a qualified instructor (check them out) and see how that goes. Avoid forward bending as described and for those done standing, if you do them please do bend the knees. In the seated FB only lengthen up toward the ceiling and no folding.

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Nick
Posted 2006-11-21 3:01 AM (#69797 - in reply to #69108)
Subject: RE: possible tendonitis in foo



20005001002525
Location: London, England
Hi Jason,
"I don't know much about the sciatic nerve; but is this something that could have been affected by an increased focus on asanas that stretch hamstrings? (Mostly a variety of forward folds.) Could that cause the pain I described in my foot?"

I'm afraid not just forward bends aggravate the sciatic nerve-backbends can also affect the nerve by basically making the hole (foramen) smaller through which the nerve root passes as it leaves the spine-then the nerve gets squashed at its root, leading to all kinds of changes which can be felt any where from the spine to the toes.
So whilst forward bends can stretch the nerve and cause irritation, backbends can squash the nerve root and cause irritation. one good way to avoid either of these scenarios is to prevent the spine from going to the limit of flexion or the limit of extension in your yoga postures-take the stretch in other parts of the bnody, not the low back!

Nick
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riftweaver
Posted 2006-11-21 3:51 PM (#69843 - in reply to #69002)
Subject: RE: possible tendonitis in foo


Strangely, this problem cleared up on its own a couple Saturdays ago. The pain wasn't present during the day. I went to a winery; then late that night, went out dancing, and it was all good!

Talk about the body doing strange things.... I mean, I'm talking "dancing madly" here, and the foot has been fine!

--Jason
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Posted 2006-11-30 4:58 PM (#70594 - in reply to #69843)
Subject: RE: possible tendonitis in foo


Let's hope so.
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tourist
Posted 2006-11-30 7:52 PM (#70611 - in reply to #70594)
Subject: RE: possible tendonitis in foo



Expert Yogi

Posts: 8442
50002000100010010010010025
Dancing madly is good therapy Dancing badly is just bad Dancing the quickstep is madly theraputic
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