Sunday 7 April 2013

Exercises

I thought it might be helpful to have a post with all the exercises I have to do.

Currently, I do a mixture of things my physio has given me, and some that I have found/invented myself.

1 - the elastic band
Take an elastic band, a reaonably thick one, and hook it round the big toe from below. allow the band to pull the toe up, then use muscles to pull toe back down next to the others. Repeat 20 times.
Move band so it is hooked from above. Use other foot to hold it on ground then lift foot so big toe is pointing down and other toes are not. Use muscles to pull the toe up, next to the others. Repeat 20 times.

Do 2-3 sets of these twice a day.

2 - the resistance band
Hook resistance band around something heavy, like a table leg. Place foot inside band loop, with band on big toe side of foot. Move foot till it is swung out to the side by the resistance. Then scoop the foot against the resistance even more, as though you wanted to look at the sole of your foot. Repeat 10-20 times.

Do 2 sets 2 times a day, building up to 3-4 sets once a day.

I found some pictures of this. The first one shows how I've been doing it, using the kitchen table leg to hold the band out to the side. I used to sit on a chair but it makes my knee hurt so now I sit on the floor like this guy is:



Picture courtesy of www.physioadvisor.com.au.

And then I found this picture:



Picture courtesy of https://healthy.kaiserpermanente.org

Which shows using the other foot to hold the band so you can hold it with your hand, meaning you can do it anywhere. Revelation! I'll be doing it like that from now on.

3 - toe curls
Various things to help the toes curl up and back, like tiptoeing but not while standing.

a) Lie in bed on your front. Curl toes under and use mattress resistance to help you bend them until it begins to feel uncomfortable. Stop and breathe through discomfort, then increase the stretch.

b) Face a wall, a little way away, and place palms on wall, leaning forward, as though to do a calf stretch, but then go on toes to curl them back. Do both at once if possible, one at a time if not. Increase stretch by moving further away from the wall.

Personally, I find this one scary and painful, and so I do it one at a time, but Ed says I should do it both together ideally.

c) Stand facing a stair (or wall). Position yourself so your toes are up the stair and your sole on the floor. The closer you are to the stair, the bigger the stretch.

4 - tiptoe exercise
Go up on tiptoe, either using your hand to support yourself on a table or sofa, or freestanding, and allow your weight to go through the toes. Go as high as you can.

5 - toe bends
These are to help your toes bend down, and to counteract all that tiptoeing.

a) Sit down and use your hand to bend all the toes over and down, stretchng as much as possible. Then do each toe one at a time.

b) Stand up, and tuck the toes of one foot under so the nails are on the floor. Put some body weight through until the stretch is uncomfortable, then hold.

6 - toe V-bends
Using your hands, pull the big toe out, away from the other toes, to create a V shape. Hold at your maximum stretch for a while, then release.

Currently, these are all the things I am doing, as well as massaging my feet generally, and my plantar fascia muscle (the arch of the foot) specifically, as that gets quite achy.

It's a lot, and that's why they don't all get done every day, but they do all get done over a week, usually. It is hard work, but that's the only way that the mobility can be regained - it won't come back on its own, you do need to work at it.


18 weeks - progress and an update

We are so overdue a post, and I have not told you about quite a few appointments, that I almost don't know where to start with this. Which is partly why I've not posted, because I'm one of those people who becomes overcome with procrastination when I am behind with things. Even though that just makes it worse! I know, I'm weird.

Anyway, it's been six weeks since I last updated. Then, I was finding driving challenging, limping on the foot the orthotist had yanked the toe of, getting more mobile, and due to go back to the hospital.

Now, I have been discharged from the hospital, I've been back to the orthotist (who was nice this time!) and had my feet cast for custom orthotics, and had two physio sessions.

At my discharge appointment I was very disappointed that, once again, I did not get to see my surgeon! So I haven't seen Mr Nugent since he changed my casts at 2 weeks, and won't get to see him ever again!

Is it just me, or is that weird? I really wanted to hear how HE felt it had all gone, but that's not going to happen. I did consider phoning his office and arranging to see him, but I never got around to it (see, it's that procrastination again) and now I guess I can't see the point. But it would have been nice.

Going back to the orthotist was interesting. Mainly because I spent hours beforehand trying to buy some shoes that would fit my standard orthotics, only to be told by her that I should wait till I got my custom ones. Just as well I didn't buy anything!

She had a really good look at my feet, and commented that I have good control over my tendency to overpronate (roll my feet in). I do work hard to remember to hold them straight, and it's starting to become a subconscious thing now, so that's good, as I believe that will also help my knee problems a bit.

I'm waiting for my custom orthotics to be made. They cast your feet using oasis - the stuff florists use - in a shoe box. They just just push each foot into it and then make a cast from that, then use that cast to make the orthotics.

It hurt a bit doing the oasis, because she pushed my foot down first and my toes bent up a bit, so on the next foot I asked her to push the toes down at the same time, which was much better.

I go back to get them on April 22 and then I will have to try and find some vaguely attractive shoes that will accommodate them! I've been researching already, and will do another post on that.

As for physio, Ed is very patient with the fact that I don't do my exercises as much or as often as I should! He actually is a really great physio and listens to my silly worries and then works with me to see what we can do about them, which is fantastic.

I really need to video and photograph all of them, but I already told you about the one with the elastic band in this post, and now I also have a resistance band that I have to use to work the muscles that lie along the sole of my foot and around my ankle.

I hook it around a leg of the kitchen table, then put my foot in it with the band around the big toe side, and kind of scoop my foot. The instructions say "as if to look at the sole of your foot". I'm supposed to do this 10-20 times, two times, and twice a day, building up to three to four sets of 20, once a day.

It is extremely hard work. More so than you'd imagine. And so I'm a bit lax about it which is bad, but I do try and keep up with all my exercises as much as possible. There just seem so many now!

I do have a video of me doing it, which I made a few weeks ago, and I'll upload it to YouTube and get it posted soon.

Last time I went to see Ed, we talked about how scary it is for me to do things like sit back on my heels with my toes tucked under. Like this:




So we talked about some things I can do to improve my ability to do that without the frankly frightening levels of pain it currently causes.

He also measured my progress in terms of being able to go on tiptoe. Previously, I was achieving 35 degrees, but now I have improved to 45 degrees. I'm really pleased with that, and hope to improve it further.

Last time I posted about physio, I said that 35 degrees was two third of what Ed can do, which means he can manage about 53 degrees, by my rudimentary maths. So that's something to aim for, and maybe I could even improve on it?! (competitive, me?)

Finally, in this quick round-up of the past six weeks, I'll end with the letter I received from Mr Sikranth Kodali, the doctor I saw at my discharge appointment at the Royal Berks.

He was writing to my GP, and summed up my progress as: "She is having mild discomfort in her big toes otherwise she is doing fine. I can see her excellent range of motion in the first MTP joint and the osteotomy site is solid. All the X-rays done before are satisfactory. She is not 100 per cent happy as the correction of the big toe is not 100 per cent straight. I explained to her that there is always five to seven degrees of distal interphalangeeal joint angle, but otherwise the overall alignment is absolutely fine.

"She can slowly build up her activities over the next six weeks and I am pleased to discharge her."

That last bit was something of a surprise. I didn't remember him saying that to me, and so I'd pretty much gone back to normal, but from the aching and pain that followed it's obvious I should have eased myself back in a bit more. Although how I'd have done that I don't know - after a while people expect you to be back to normal and the help and support dries up, understandably.

Anyway, as of tomorrow I'm past that magical six weeks and so I'm hoping to see improvements in my stamina. Currently, my feet and knees ache almost constantly again, but more of that in my next post, which will be about all the things I am able to do now. It's a long list, hurrah!

Tuesday 2 April 2013

An apology and a promise

Hello lovely readers

This is just a quick apology that I haven't updated in a while. I keep meaning to write a post about how I've been discharged from hospital, and how my physio is going, and I even made a video for you the other week, but finding enough time to sit down and write it is proving hard right now.

Thank you for still reading - nearly ten thousand views now! - and I promise I will write a post soon with details of my physio exercises, and how it's going.

There isn't so much to say now as there was at the beginning, because progress gets slower as the feet get better, but I do intend to continue posting at least for the first year of recovery, so please bear with me!