Albuquerque physical therapist made the third orthotic out of softer material since I'm still having some foot/ankle pain. He wants me to try out all three to determine which one works the best. I'm supposed to give him feedback on how they work out for me.
He suggested that it may be better for me to wear neutral shoes. In general, he doesn't think that stability and motion control shoes are a good thing. I guess with the orthotics giving my feet some stability and support, I will try to find a pair of neutral athletic shoes to see how they work for my feet.
He gave me a homemade slant board to stretch my calves on. He said I should try to have the loosest calves in Los Alamos because tight calves put more pressure on the posterior tibial tendon, achilles tendon and plantar fascia. I'm supposed to stand on the board for ten minutes a day with my knees straight. I did it a little today in his office. At first I felt no stretch at all but gradually a calf stretch developed. He says that when I do my usual calf stretch which feels like a deep stretch of my calves, what I'm really stretching is nerves. He'll publish a research paper in January on this static endurance type of calf stretching. He doesn't yet know what journal it will be in. I'd like to get a copy.
I'm going to call tomorrow to cancel the Jemez Physical Therapy appointments this week. Physical therapist feels that if my arches are supported with the orthotics, my feet will naturally strengthen in the course of walking. He also said that since my right foot ligaments are on the lax side, I don't really need to stretch my feet.
He showed me how to strengthen my peroneus longus muscle which runs from the outer lower leg across the bottom of the foot and attaches to the big toe. One way to strengthen that is to raise your toes while pressing your first metatarsal head (ball of big toe) against the floor.
He suggested piriformis stretching for my hips. I know how to do one such stretch. I'll Google for other piriformis stretches.
I should continue to do the "clamshell" (side lying hip abduction with lateral rotation) that Jemez Physical Therapy gave me but he didn't think much of the toe flexor exercises and neither did I. In general, I need to strengthen my gluteals and stretch my piriformis.
He showed me how to do a lateral step up and says it's the only leg exercise he does. You begin by placing one foot on a step, with your knee bent forward over the second toe and the other foot is off the side of the step with the heel touching the floor. Straighten the knee of the foot on the step which causes the heel on the floor to raise, then repeat from the beginning. Start with 5 sets of 5 and work up to 5 sets of 10, done continuously on one leg and then switch to the other leg. Variations are do a toe raise up and down with the foot that's on the step and then another is to hike up the hip of the foot that's on the floor. You can alternate these variation within a set. If any of this ever gets easy, use a higher step to make it harder.
He said using a wobble board would be good and he'd send me a program he has for that. He also promised to send the information on the lateral step up because I have to admit that only doing it briefly in his office didn't lead to complete understanding of the exercise.
When I came to his office at 12:30pm on today, Sunday, he was finishing up with a client. When I left at 2pm, another client was already there for his next appointment. All in all, it was a very worthwhile adventure to drive to Albuquerque 2 days in a row to get these orthotics. I plan to tell the hikers about him. I walked four miles tonight in the orange 3/4 length pair. They seemed to help. I'll carefully evaluate all three over the coming weeks.
Spouse calls the surgeon in Santa Fe first thing tomorrow. He's anxious to find out when something can be done about his ailing appendix. Even though he's feeling reasonably comfortable and has no fever or extreme pain, it was hard on him to have to wait out this four day Thanksgiving weekend until the doctor's office opens again on Monday. There's a lot of anxiety in knowing that your appendix is not well.
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