Wednesday, 11 September 2013

Getting Back on My Feet

When I had the cheilectomy operation on my foot at the end of July, I was warned that the success of it would be largely down to me.  After the first two weeks, where I was advised to keep the weight off it but do plenty of point and flex exercises (as described in a previous blog post here), I was told I should get onto it, mobilise it, use it even though it hurts, and it should start to respond. I don't normally hold with the 'no pain, no gain' method of doing things, but accept that movement will hurt at the moment and it's okay.

It healed very well in the initial two weeks, and I had high hopes that I wouldn't need to go back. Since then, despite doing my daily physio exercises, it's not really making a difference except in terms of producing pain (lots, as well as throbbing, stabbing, stinging, prickling and other strange sensations which I dismiss as part of the healing), stiffness (quite a bit) and swelling (a little). I wonder if I'm being too aggressive, or not working it hard enough. Or perhaps I'm just being impatient; after all, the other tissues will be tight as well after years with a limited range of movement in the big toe.

I am hoping that I shall be able to start dancing and teaching again from the beginning of November, which means I have a lot of belly dance rehab to get on with now that I am back on my feet. It still depends partly on how well my knee supports my weight, but that's a different story.  So, as part of the occasional 'use it or lose it' series, here are my foot and ankle exercises.  I do each exercise at least once a day and I don't do all in one session as it takes too long and after a certain point, I can't cope with the pain.

I find as I get older, my feet need warm-up exercises before I go into any sort of pulse-raiser warm-up with involves stepping, otherwise my feet quickly start to hurt. A selection of these exercises work well as a warm-up and are also very useful if you suffer from plantar fasciitis, which used to be one of the banes of my life until I started dancing regularly again.

Some of these exercises are best sitting or standing, and some can be done any old how - I like to lie on my back with my feet in the air for the point and flex and foot circles. Do feel free to join me and comment on them. These may not be good for you if you have pinned, fused toe joints. Remember the rules (if in doubt, leave it out and ask a medical professional first, stop if it hurts, go for quality, not quantity - and so on).

This exercises the tissues of the arch.
Sit comfortably with the feet flat on the floor.
Tense the underside of the foot, as if you are trying to make the balls of your big and little toes meet your heel. You should see your arch lift a little.
Relax. Repeat, alternating feet to work both feet equally.

Pencil Pick-Up
This isn't the exercise for you if you have long or slender toes and find it easy to use them to pick up a pencil on the floor. (On the other hand, use it or lose it! Do it anyway, occasionally, just to prove you still can!)  I've got short, plump toes and have never been able to pick up a pencil, so it gives me a lot of exercise trying (and failing) to curve my toes around the pencil enough to lift it!
Pencil (or pen) on the floor. Use your foot to turn it and then try to curl your toes over it to pick it up.  Keep trying with both feet.
I have to say, I get bored after a few repetitions and find the next exercise rather more interesting ...

Scarf/Towel Drag
This is a great one for doing while you're sitting watching TV, because apart from using each foot alternately, it doesn't really need any thought.  Place a scarf or towel stretched out lengthwise on the floor in front of your feet.  The aim is to use your toes to grab a bit of the scarf or towel and drag it towards you, trying to keep your heels more or less in place, until the length has been scrunched towards you. For me at the moment, a tea towel is enough!

I have a smallish ball (about twice the size of a tennis ball) which I roll around under my feet, bending and stretching my toes as I work it around. Also a good one for sitting in front of the TV.

Point and Flex/Good Toes and Naughty Toes
Stretching the ankle to point the toes away from you, then bending it to bring the toes towards you, the full sequence explained here

Foot/Ankle Circles
I like this range of motion exercise very much and do it frequently. It was one of my standard exercises along with point and flex for the couple of weeks when I had my feet mostly up. Seated or standing, hold the foot off the floor, circle both clockwise and anticlockwise a number of times, drawing a circle with your big toe. Repeat for the other foot.

Alternate heel lifts
This can be done standing, with the full weight on the feet, or sitting to take some of the weight off. With the feet in parallel and flat on the floor, lift one heel and push the ankle forwards so that you are on the toes. Be careful not to sickle the foot (i.e. allowing the ankle to curve out sideways, putting more weight onto the little toe). Lower the heel and repeat with the other foot. Work alternately and speed up as the feet feel warmer, switching feet so that there is a moment of suspension when both feet are on the toes and only ever one heel on the floor.

Working through the Foot
Dancers in my classes will be familiar with this one. Again, it can be done sitting, but it is more effective standing up.
With feet parallel, lift one heel so that you are on the toes (as in the previous exercise) then push off with the toes to lift the foot slightly.  Note, it is not a kick, and be careful not to cheat by lifting the foot.  Place the toes back down, then the heel. Repeat on the other foot.
You are aiming to peel the foot off the floor from heel to toes, then smooth it back onto the floor from toes to heels.When it gets to peeling the toes off, imagine that you are going from a low heel to a very high heel, then onto ballet point (but without putting any weight on the toe, very important!), and reverse from high to low heels as you stick the foot back down.
You can repeat this in first turnout and second positions, and speed it up so that you are padding from foot to foot with the knees bent. One of my lovely contemporary dance teachers, Erica Stanton, taught me this as an effective warm-up for the legs and feet and it really is!

Bends and Rises
This is a standing exercise with two levels of difficulty.  In both, there is a balance challenge as well, so remember to check your posture!
In the simple version, you stand in parallel, bend both knees, straighten them, then rise onto your toes, and back down again. Bend and stretch. Simple.
The more challenging version has a circular feel to it:
Bend both knees, lift your heels, straighten knees, lower your heels.
Repeat a few times, then reverse:
Lift heels, bend knees, heels down, straighten legs.
Repeat a few times.

Well, I'd better go and do some instead of sitting here writing about them ....

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