Can you do too many stretches?
Posted on February 16th, 2011 by garyf
Hi folks. Been out of my cast & in 2 shoes (PWB) for 2 days now. I’m doing stretches and moving the foot to get my ROM back and although it’s VERY early days…..so far so good, no swelling other than what was there when my cast came off which should hopefully go down in due course. Can you do too many stretches and excercises at this stage? Obviously the main thing on my mind at the moment is making sure I strengthen the AT & calf without re-rupturing. I have a physio appt in 2 weeks but any advice you can provide would be appreciated
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Short answer is #ELL YES!!
Stretching and strength-building exercise can both be overdone, with serious consequences. Over-stretching in the plantarflexion direction isn’t often a problem, but over-stretching in the DORSIflexion direction (toes up or knees forward) can over-stress the AT, either causing an injury (including re-rupture) or stretching it into “healing long”, i.e., TOO long. Several posters here have needed and gotten follow-up surgery to shorten an AT that’s healed too long, and the rehab is comparable to “ours” from an ATR, maybe harder.
Overdoing the exercises also risks most of those same outcomes, esp. injury which can include re-rupture. I’ve told my semi-sad story a few times recently, and you’ve probably seen it: 17 weeks after the surgery to fix my first ATR, I’d JUST gotten to the point where I could walk normally barefoot, with no hint of a limp. I had PT that day, and toward the end, my PT told me to do some 1-legged heel raises. I said that I shouldn’t, because I was sure I couldn’t do 8 of them. (That was my RoT for exercises and “reps”.)
She said “so just do as many as you CAN!” Nobody should EVER say that to me anyway, but also nobody should ever say that to a recovering ATR patient. I did maybe 4 pretty-good 1-leg heel raises, then we finished the session and I put my footwear (2 shoes?) back on and went home.
I forget when the pain started (at the back of my heel), but it was definitely AFTER I’d stopped doing the heel raises, and it lasted a MONTH, during which I could NOT walk straight and I returned to my hinged boot. It was a pure month-long setback in my rehab, all from maybe 60 seconds of over-exercising, without any immediate “listen to your body” pain.
One or two posters here have re-ruptured while doing 1-leg heel raises, after being instructed to do them by a PT.
All those experiences make me fond of simple incrementalism: Don’t ever do a LOT more than you’ve done in past days — or if doing it before caused a problem, of course. And I’m also MUCH less fond of dorsiflexion exercises in general, than most PTs including my own this second time. As soon as your dorsiflexion range is close to your other ankle’s, I’d stop trying to “improve” it. (Murphy’s Law #11: If you fool with it long enough trying to perfect it, you’ll bust it!)
Thanks for the reply Norm, very informative. I’ll make sure to take it nice and easy. I had read about your setback but didnt know exactly how it had happened. This is what worries me that I might get a PT that pushes too hard, some seem to think they know our bodies better than we do which can result in disastarous consequences!!! By the way, hopefully my ‘widget’ should now be displayed in the sidebar - let me know if it’s not. Hope your recovery is going to plan following your heart surgery.
Ps - I’ve read about ‘lumps’ on the tendon due to scar tissue but I can actually feel a slight dent, just above the heel - is this normal??
That’s just how mine felt at your stage, but as the swelling decreased the lump became evident and the dent was actually just the tendon at normal thickness, it scared the living day lights out of me. I woke up on Christmas eve and felt this lump I’d never noticed. It took my physio to explain what had happened. According to my physio, lumps and dips are very normal, some decrease over time others will stay. I have massage on mine to try to decrease it, but the tendon functions well despite it. Carry on healing.
Cheers LL that’s put my mind at ease. Hope everything is going well with your AT recovery - you’ll be doing PE and yard duty in no time!! Healthy & happy healing
Hi Gary, I’m a Sunderland fan - honest!!! Been supporting them for about 20 years.
I think you asked me about driving. I’m not much help on that I’m afraid as for the first 4 weeks my firm hired an automatic for me. I’m now back into my manual and have driven it 3 times - managing OK but I would still be a bit worried if I had to do an emergency stop.
I saw my physio about a week after getting out of the cast and she concentrated on getting me walking as close to a normal gait as I could. Before that, I was just shuffling. I was also standing with the bad leg out behind then leaning forward as far as I could with my heel still on the floor. She wanted me to “push through the pain barrier” but I was aware of all the comments on here and I pushed it forward very slowly.
Good luck with your physio - you’ll find it makes a massive difference very quickly.
BTW, my limp is almost gone today!!!
Ah Aileen - We have a ‘Makem’! Nice one, seriously I love the banter at work and I’m delighted we’ve fleeced you for 4 points this season! Ive been a ‘toon’ fan for 30 years and have seen you lot beat us at St James (darn that Quinn & Phillips!!). Can’t believe Benty went then Carroll followed suit. Both clubs are going to be fine this season though . I don’t want to jinx myself but everything is feeling really good. I’m walking with a slight limp as I haven’t got the toe/calf/AT strength to push off and walk normally but it will come I know. Been in the car today, didn’t drive it just ‘pretended’ to do an emergency stop then started the car and revved the accelerator - it felt fine so taking it for a spin tomorrow. Can’t wait for physio to start so I can try to get back to a bit of normality!!
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Gary, it wouldn’t hurt to practice slamming the brake pedal with your heel. In a real emergency stop (God Forbid!), you’d probably push harder (with all your muscles, including your calf) than you’d ever practice it. Re-rupturing while at the wheel and hurtling toward some hazard (GF!) could be even worse than “just” re-rupturing!