medical query, of a physical therapy sort

The arches of my feet are popping again.

Used to be they did this every morning, when I got out of bed. Not always both; sometimes not even one; but popping arches were a fact of life. I’d usually push my foot over the tops of my toes to get it out of the way — a habit left over from ballet. I’d noticed they weren’t doing it as much anymore, but hadn’t really paused to consider the cause.

Turns out my arches1 have started collapsing.

Oddly, this is good news, in a way. Good because the major palpable symptom of this (since I can’t look at my own feet from behind) has been pain in my right ankle, which could also theoretically have been related to the osteochondritis dissecans I had when I was nine. The x-ray showed something indistinct, and if my pain doesn’t clear up we’ll go for an MRI to see what’s happening there, but for the time being the answer is “orthotics” rather than “surgery and six weeks on crutches.” Which I’m grateful for. Been there, done that, don’t want to go back.

So here’s the query part of the whole thing. When my doctor (a general practitioner) explained that my tibialis posterior2 (the muscle-and-tendon set running down the inside of your ankle to the arch of your foot) is weakening/strained, I immediately asked if there were exercises I could do to strengthen it. He said no. Which I frankly don’t buy. We’re talking muscles and tendons, here; even if I somehow can’t work directly on the correct bit, surely I can derive some benefit from strengthening things around them. I have resistance bands; would it help to work with one of those, maybe by pointing my foot inward? How about the thing where you scrunch up a towel with your toes? I’ve got custom insoles now to prop my feet back up to their accustomed shape, but I don’t want to rely on those; I want my arches to be strong enough on their own.

Advice appreciated. I may end up seeing a physical therapist for this, but for the time being I figured I’d ask the Great LJ Overmind.

Edited for clarity: I’m interpreting the popping thing as a sign that the insoles are doing their work; I’ve been wearing shoes around the house, instead of my usual barefoot habits, to hasten what improvement I might get. The lack of popping seems to have been a sign of collapse. Looking back at my post, this was not entirely clear in my original phrasing.

1 When the guy who custom-molds insoles to people’s feet for a living says “wow, you have really high arches . . . yeah.
2 I’m pretty sure that’s the one he named. Wikipedia seems to confirm my guess, but do correct me if I’m wrong.

0 Responses to “medical query, of a physical therapy sort”

  1. wldhrsjen3

    I recently went in for ankle pain radiating down through my arches (I have crazy narrow feet and really high arches, too) and found out I strained that same tendon. The physical therapist and my ballet teacher both told me I could strengthen the tendon and surrounding muscles to stabilize my ankle again, so this is what I do:

    1. massage the bottom of my foot from the ball to the back of my heel
    2. use a theraband to point and flex my foot, also do the foot scrunchies thing
    3. wrap the theraband around my foot and use the opposite foot as an anchor as I sickle the foot to the outside; rewrap the band with the opposite foot on the outside as an anchor as I wing the foot to the inside
    4. ice
    5. lots of relevés, a few at a time, throughout the day to increase strength without straining the tendon

    Good luck. :/ Hope it doesn’t cause too much trouble.

    • Marie Brennan

      I am highly amused that you would have outed yourself as a ballet dancer without saying so, and without the icon, just by your use of “sickle” and “wing.” 🙂

      Those, barring the massage, are pretty much what my instincts told me to do, so I find it greatly reassuring to see your list. The only downside is that I can’t do the relevés just yet, owing to a strained big toe in the same foot that’s having ankle problems — but hey, both arches are collapsing, so maybe we’ll just work on the left foot for a while.

  2. Anonymous

    I don’t know if this will assist your particular problem, but when I had a bad bad ankle sprain my orthopedist had me tracing the alphabet with my ankle. I think it was supposed to increase mobility and lightly strengthen muscles around the ankle.

  3. d_c_m

    Find a good physical therapist. I would suggest you find someone who practices Feldenkrais.

  4. defectivewookie

    Consult a podiatrist.

    I ran a shoe store for eight years, and we had podiatrists in a couple times a year to consult with people for free. What I gleaned from watching this was that very, very few general physicians know much about the foot and ankle. The docs I had in would contradict the advice of the generalists a good bit of the time, especially where alternative treatment was concerned.

    Not knowing the area you are located, one of the best bits of advice I have would be to find the best running store in your area. A lot of these have sprots medecin docs (or, sometimes, students) in at regular intervals. If they don’t, they might at least be able to point you in the right direction.

  5. london_setterby

    I second the comment to see a podiatrist. I went to a GP to ask for a referral to a podiatrist for chronic (1 1/2 yrs, daily) foot pain. And he said no. In fact he said the pain was in my head or at most I just needed a new pair of shoes. With the help of a new GP, I got my referral, & the podiatrist immediately diagnosed arthritis, sesmoiditis, & some other problems. Incidentally, the podiatrist suggested PT for my case, too (in addition to custom orthotics). I can’t think of any reason why PT wouldn’t help you–and even if it wouldn’t, a PT would be more qualified to break that news to you than a GP.

    I don’t think doctors like being second-guessed, especially when it comes to those who enjoy less prestige than them, like podiatrists & PTs.

  6. tiamat360

    Well, I can’t provide too much in the way of therapy options, but your GP probably did mean tibialis posterior. I’m not sure that there’s no stretching or other sorts of PT you could do that would help, but as the muscle is responsible for inverting your foot, it would be difficult to really stretch it well – foot eversion is not something humans are particularly good at.

    • Marie Brennan

      It doesn’t seem to me that stretching is the real goal here, though. The problem is that I’m over-pronating (which is where the ankle pain is coming from, possibly), so while it’s definitely good to make sure I don’t somehow jack the muscle up in the other direction, it seems like strengthening is the more pressing concern.

      I could be wrong, though.

  7. brigidsblest

    …I’ve been having my arches popping, too (especially the right one), and I had no idea what the heck it was.

    Something to mention to my doctor the next time I have an appointment, I guess.

  8. kendokamel

    My podiatrist gave me a set of exercises to do to help with my plantar fascitis and tendonitis in the connective tissues of the proneator muscles.

    I’ll try to remember to bring ’em to work tomorrow and then can scan them into a PDF to email to you.

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