Ah, Spring Break had begun, and I ventured to physical therapy really early, well, because I could 🙂 It was a basic session except that this time, Travis did this massage where he moved his fingers perpendicular to the tendon. This method has a name, but I forget as I was lax in updating that week. Not so lax because several personal ventures took a not so great turn toward stressing me out, but I digress…

At this appointment, Travis decided to continue the home tendon strengthening using the blue band. He also had me do some cool stuff where he placed orange markers on the floor about 3 feet apart in a straight line. I had to do two quick steps between each set of markers. Whew – I was definitely sweating after this one!

He also had me stand on one foot and bend down to reach toward markers on the floor. The difference between my right an left sides was striking to me. My right side was solid. My left side very wobbly. Well, that’s why I’m here.

Anyway, I left for Vegas the next day. Needless to say, I did my exercises each day, and I rode the stationary bike in the hotel, too! Ha!

Travis suggested that two appointments this week would definitely benefit me. So, I dutifully made an appointment for Friday, which was tricky because I had to go in the middle of the day. I teach school for those who are curious, and leaving in the middle of the day is not so straight forward.

Anyway, I managed all that and arrived at the PT office. Boy did Travis mean business today. We started out immediately on strengthening the posterior tibialis. I had to stand toes only in the pigeon toed postion on a step. From there I raised both feet, then lowered on the left foot only. 10 reps, 3 sets. Whew! That was hard! I am happy to report that the tendon did not seem to mind this exercise.However, I discovered that my left hamstring was really burning during this exercise. This is an old problem where my hamstring does the work of my glutes or inhibits my glutes from firing or something. I am not sure of the cause, but I know that my hamstrings are a little too helpful when ever I am running or doing exercises.

This revelation led into some investigation of how the hamstrings and glutes were firing. Travis had me do some exercises, and yes indeed the left hamstrings were much more engaged than the right ones. He said he could add an exercise to help engage the glutes more. Here I diverge: when I went for PT in 2001, one of the main focuses was on getting my glutes to fire. The right leg was successful, while the left leg was annoyingly non-compliant. It is a very big disappointment to me, and when I think of trying to treat that again, it really makes me sad. It such a let-down when it didn’t work all those years ago. I don’t know if I can there again. I know I have to, but I’d like a little success before hitting that obstacle.

Then, we moved onto core strengthening. I have done side-body planks before, but all I had to do was lift my body, hold it four seconds, and release down to the floor. Travis decided to up the ante on this one. His exercise was lift the body into the side plank and hold. While holding, lift the top leg five times. Wow, talk about challenging. I found that my right side was significantly stronger as when I got to five, I actually lost count and could have kept going. On the left side, though, the exercise was more challenging and getting to five was really tough. I like this exercise, and I think I am going to practice it outside of the clinic. Five leg lifts per side, 3 sets.

After that, he had me do some bridges while holding one leg out for a few seconds, then release down to the floor and go again with the opposite leg held out. Ten of those, 3 times.

Next, I had to balance on a board while Travis threw a fairly light medicine ball at me. Fifteen throws, 3 sets. By the third set, I could feel it in my left ankle. The right foot felt good.

Finally, I had to stand on the flat side of a half cylinder made of foam (i.e. the semi-circular part was on the floor, creating an uneven surface). Then, I stood with my back to the resistance band. I took the two ends and held them in both hands. The exercise was to punch forward with both hands at the same time while balancing on the foam. Ten of these, 3 sets. After that I turned around and grabbed the resistance bands and pulled back (doing a rowing motion), while still standing on the foam. Ten rows, 3 sets.

I must admit that I only made it through two sets of the last exercises. My posterior tibialis was seriously done. It felt more worked than inflamed.

After I returned to school, I noticed that my tendon did not like to walk long distances, which made the walk home not very inviting. I ended up getting a ride from my absolutely wonderful husband. Then, I iced.

Over the weekend, I am going to continue to do the blue band exercises and alternate the sweeping foot and the pigeon-toed exercises. I am also adding the plank. I really need a whole workout regimen at the gym as currently, I am really just floundering along without any real direction.

Ok, so, I did not do so well on the PT exercises from last week. You see, I’ve got all these great excuses, like papers to grade that are still not graded, but they make me feel bad. Then, there was the Gala on Friday with free wine – boy Friday and Saturday were out after that. Sunday and Monday, I did do my exercises, and I found that the green band was really easy.

So, when I told Travis that I needed the blue band on Tuesday, I was hoping that he thought that I had done my exercises everyday (Oh no, he might read this! – ah well, I’ll just do better this week!).

Speaking of Travis reading this, he showed me how the podiatrist finds “neutral” or subtalar neutral on a foot! He is so fantastic. I told him that I did not remember my doctors doing that to my feet to find subtalar neutral, but I do believe I was incorrect. Upon further examination of my memories, each foot doctor did find subtalar neutral on my foot. I am still wondering if I was able to hold said “neutral”, but I have already been there and talked about that. Back to my story. (I do plan on adding some information on the technical aspects of some of this information.)

I had my second ASTYMâ„¢ treatment, which should be my last. My posterior tibial band still is a little inflamed this evening, but I did complete my exercises with my blue band! I also got one new exercise that is just dragging my left foot toward my right foot, while sitting, and then lifting the left foot off the ground instep up. It is surprisingly tiring.

That is truly all for now. I am still walking or riding my bike to work while wearing either my super stiff running shoes with orthotics or my Dansko’sâ„¢. I am also continuing to ride the stationary bike at the gym. I hate the stationary bike – almost as much as I hate the treadmill. I know I’m not supposed to “hate” something, but I just want to run barefoot! Not ride a stupid bike!

So sorry to have skipped a week, but I must admit to being very bummed about the whole tendon inflammation situation. I have been through this process so many times only to have the same problems come right back. Thus, it has been really tough to keep my focus and determination.

So, last week, at my PT visit on 3/17/10, Travis tried the ASTYMâ„¢ treatment. ASTYMâ„¢ is truly one of the strangest treatments I have had. Most PT involves really painful digging into the inflamed area to help it release. So, when Travis mentioned ASTYMâ„¢, and then one of the other therapists was asking one of her patients if they had experienced any bruising after the ASTYMâ„¢, I was frantically thinking, “Ok, I’ve done this before. It cannot possibly be any worse than the IT band treatments in Atlanta. I hope…”

It wasn’t bad at all! As a matter of fact, ASTYMâ„¢ is relatively mild – of course, I am not that painfully inflamed at present. It might be different for someone who is really tender on tendons or muscles.

Here’s how it works.

1. A smooth balm is used (this can be shea butter or something of that nature).

2. The ASTYMâ„¢ tools come out of this tiny little black bag. They are all made of a clear plastic. One is small, about the size and shape of a finger. A second one is larger and shaped like a spoon, and the third is a wide flat device that reminds me of a kitchen scraper.

3. The therapist then takes a tool (each one is designed for a different area) and just runs it along the direction of the fibers in your muscle or tendon. This is done over the entire length of the group of muscles that feed into the part that is inflamed. For me, that constitutes my ENTIRE leg! Yes, for my one tiny little posterior tendon in my ankle, Travis treats my whole leg: front and back. This process takes about 15 minutes.

4. After the ASTYMâ„¢, you stretch. Travis described it as follows: when the muscle is inflamed, the fibers can look something like spaghetti – all jumbled up. ASTYMâ„¢ encourages the fibers to straighten out, and then stretching pulls them into the more correct position.

5. ASTYMâ„¢ is supposed to stimulate healing to inflamed areas of tissue.

How did I feel after it? I felt pretty good. I had to do four stretches – two hamstring, one for my calf muscle and one that looked like the calf muscle stretch except that the leg stretching was bent. This one hurt like crazy. The posterior tibial tendon ignited like the phosphorus on the end of a match. Whew!

Did I bruise? No, I did not. Not even a little.

That night and the next day, my posterior tibial tendon was more tender than before as well as a few other parts of my leg (a tendon on the outside of my calf – don’t know the name, not looking it up at present). However, this went away quickly and my posterior tibial tendon did feel better by the weekend.

My takeaway workout was awesome – just three little moves all designed to strengthen my poor little tendon in my arch as well as  the muscles on the outside of my foot (also not looking the name up now – will edit later :-)).

If I get really excited, then I might just post my exercises. Hmmm….something to keep you coming back. Muwahahahaha!