Is it possible to correct Flexor Hallucis Longus Tendonitis and if so how?

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Is it possible to correct Flexor Hallucis Longus Tendonitis and if so how?

by Shawna

I joined the military with no foot problem that I was aware of.

I was required to run many times every day for 6 weeks. I not only ran "accidently" in sneakers for flat footed people but also in combat boots.

I have very high arches. I'm 23 and no history of injuries. It is occuring in both of my feet. I've been tossed from doctor, to doctor, to physical therapist, to podiatrists, to some more doctors and back in physical therapy.

The podiatrist seemed to be the only one with a clue and then I PCS'd to another base.

I have custom made insoles to support the arch.

The doctors first believed it was plantar fasciitis and once the podiatrist said Flexor Hallucis Longus tendonitis they agreed with him.

I've had the extremely painful shots into the tendon protruding from the bottom of my arch.

I've had little electrical pads stuck to the bottom of the arches with constant low charges. I've had massage therapy. I've done different stretches. I've had ice(very painful). I've also had heat. The heat and massaging felt pretty good but it was just temporary relief. The cold even just weather seems to tighten the tendon and make it very stiff and painful.

I now have running shoes for high arches but it is still painful to run and my feet hurt for days after. I cannot wear my insoles in my running shoes because the pain becomes almost unbearable.

The insoles in my boots don't seem to be doing a whole lot. They were made for support of my arches not comfort.

My most recent doctor suggested memory foam insoles and to just discard my support insoles.

The physical therapist said the other insoles weren't working so try soft ones.

I have heard there is debate on long term and short term effects of soft insoles. Is there some kind of treatment I can mention to the doctor or physical therapist or stretches that will make a difference or maybe just some insoles you can suggest?

I'm desperate. They are putting me through physical therapy one more time then they are going to discharge me medically if I don't show improvement.

I don't know if I left anything out.

Please let me know if you need more information or if you can suggest anything.

Thank you-- Shawna

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Joshua Answers:

Hi Shawna.

The quick answer to 'how' did you get this tendonitis is...'you suddenly started running everyday, multiple times, in flat shoes and combat boots'.

Lots of other variables, of course, but that seems like the obvious, general on. But you knew that.

I'm not going to investigate the direction too far.

The other quick answer is 'Yes, it is possible to correct Flexor Hallucis Longus Tendonitis.

Tendonitis is Tendonitis.

I'm going to go with what the podiatrist said. Flexor Hallucis Longus until I see/hear otherwise..

Soft inserts, hard inserts, I don't know. I've never really heard much great about them. Granted, I mostly only work with people that everything else has failed them.

The one line you said of built for support and not comfort....that seems like a bad idea. The body does not like discomfort or pain.

Thanks for all the details by the way. Details GOOD.

Not surprised by anything about the rest, doctors and PT and such. Hopefully the new PT you get will be able to get better results and do things differently than you've experienced.

Questions:

1. Describe the massage you received for this. Where did they work, how did they work, etc. Details.

2. What about icing was painful? How did you ice, exactly. How did it hurt?

3. Describe the pain. Where exactly. When exactly (ie, only when you're on them, even when your off them, at night in bed, etc)

Answer the above, and we'll go from there.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com

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Is it possible to correct Flexor Hallucis Longus Tendonitis and if so how?

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Dec 18, 2009
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PART 2 - Response - Is it possible to correct Flexor Hallucis Longus Tendonitis and if so how? NEW
by: Shawna

They massaged from the edge of my heel up to where my toes begin. It was a circular motion with low to moderate pressure. Mostly focusing on the swollen tendon. I do this myself at times. It seems to relieve pressure(the throbbing).

The heat was like a heated ultrasound wand with jelly moving back and forth along my arch. The ice was shaped like a small cup but rounded on the end. I was instructed to slide it back and forth along the arch. I'm not exactly sure why the ice makes it hurt. It is most likely that the tendons are swollen and the ice makes them want to tighten rather quickly.

If I stay off my feet all day they don't hurt. My job requires me to stand a majority of the day. Just standing makes them hurt. I can't stand still for more than 5-10 minutes without teetering back and forth from one foot to another.

Jumping and running obviously hurts the most.

Walking for a prolonged amount of time also makes them hurt. This may not be helpful but running barefoot in the sand does not make them hurt.

Depending on the distance it may be a very dull ache after. The stretches range from laying down with a piece of rubber wrapped around the bottom of my foot and extending my feet, to pressing half of my foot against the wall and moving my waist towards the wall and the same but bending my knee and moving it towards the wall and holding it for 30 seconds.

I was instructed to do this for 5 minutes 5 times a day.

The stretch with the rubber doesn't bother me but the stretch with my foot against the wall just makes the top of my foot that connects my toes to my foot hurt more than the arches. I stopped those because then my whole foot is killing me instead of just my arches.

Dec 18, 2009
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PART 3 - Is it possible to correct Flexor Hallucis Longus Tendonitis and if so how? NEW
by: The Tendonitis Expert

Joshua Comments:

Just from what you've said, they've missed a vital part of all this. Seriously missing the boat.

They're working the tendon, but not the muscle that attaches to the tendon.

You HAVE to work the muscle and connective tissue. It is TOO TIGHT, connective tissue is shrinkwrapping and trapping it too tight, and that is putting constant tension on the tendon and attachements, and then the whole ecology of the foot/lower leg is responding to that.

Here's what you do, intensely for the next week.

1. Get a 5 gallon bucket and ice dip as described on the How To Reduce Inflammation.

As many times as possible per day. Morning noon and night if possible.

2. Do the massage, and even ice massage if you want, up the tendon to the muscle. For right now, don't worry about the tendon. Worry about the muscle. Trace the tendon up to muscle, and work the entire body of the muscle, and anything around it.

You do it, and/or get a friend or massage person to work your entire lower leg and especially the FHL belly and attachments and surrounding tissue.

Shift your focus from the foot to the lower leg.

Much of the time, where you hurt isn't the source of the problem.

3. Read this Magnesium for Tendonitis page and then my Kerri's Magnesium Dosage to find out what kind of mag and how much to take. Work up to your tolerance level and stay there.

It will be worth it for you to also get this Magnesium Oil and apply it to the FHL/lower leg area, and the foot too. (It's the best and cheapest you will find.)

I'm not saying the above is a total answer, but it's the answer for right now to lower your pain levels.

Go full tilt at this for the next 7 days.

* Ice as much as possible.

* Massage in little bits, frequently and repeatedly, even while you're standing there at work, reach down and rub the FHL for 10 seconds. Repeatedly.

* Magnesium, and increase your protein intake too.

More questions, more answers. And, updates please.

Nov 21, 2010
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FHL pain in foot NEW
by: Anonymous

I came across this site while looking for info on FHL tendonitis. I thought that what I had was plantar fasciitis, but none of the treatments (strassburg sock, golf ball rolling, etc.) have helped, plus the pain/tenderness is only on the medial part of my arch stretching from under the big toe to below and behind the ankle bone.

My question is what else, besides what you've listed above, can be done for this?

I'm a runner, would putting the foot in a boot for a few weeks help?

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Joshua Comments:

Ahhh! No! No Boot!!!

Granted, that's just my personal/professional opinion.

You have pain because something(s) is TOO TIGHT. IF you immobilize it in Das Boot, then it gets no lengthening or shortening, and connective tissue shrinkwraps the half squeezed sponge of the muscle even more than it already is.

Then you'd have a too short, too tight structure that puts even MORE tension on it's connections with every step.

So no, I don't suggest immobilization in the boot.

Sure, I have other things I could suggest. But my question to you is, have you done what has been suggested in this thread?

If no, do them and check back in later.

If yes, then describe what exactly you did, and the results.

Jan 15, 2011
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barefoot training and kickboxing, now arch pain NEW
by: Fipzee

hello, I stumbled acrosse this page while searching for answers about my strained arches. Very good advice here!!

I have been training Muay Thai kickboxing for the past 3 years and have returned to training after a 3 month layoff. We train barefoot on a padded floor, however after 3 sessions in a week and a half i had to stop because of what felt like a pulled arch. I do have fairly flat feet and wear custom orthotics in my shoes and haven't had issues training before. I think it's due to the return to barefoot training. During the 3 months off I was still running and exercising though.

It has been 1 week and I have been icing and doing self massage, no stretching yet as it is slightly painful when stretched still. My question is should I be stretching the arch during recovery and about how long would you estimate this will take before I can get back to training? (only thing i've been doing is swimming in the meantime)

p.s. I am a 37 yr old male

thanks for the help!

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Joshua Comments:

Hi Fipzee.

I wouldn't worry about the arch so much, I'd work on the back of the lower leg.

It's a big shift to go from shoes to barefoot training. So while you feel it in the feet, and it possibly is the feet, but I bet it's more a function of lower leg structures that connect down in the feet.

Release those tight structures, happier feet.

Yes?

Feb 09, 2011
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It's working! (slowly) NEW
by: Fipzee

Hi, thanks again for your advice. I have been stretching and rolling my lower legs daily. I have also been stretching the plantar fascia and i try and do strengthening exercises like walking on toes etc. I think all this is working. It has been 4 weeks now since hurting the arches and they definately feel better but not 100%

I wouldn't say i have anymore PF "pain", however they are a little tight in the morning and maybe slightly tender when pushing my thumb on it.

I'm wondering when is a good time to start back with short runs? I not even considering kickboxing for a while.

thanks,
Alden

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Joshua Comments:

Great!

Are you rolling/working/stretching the backs of your lower legs? I'd hit that before running. It's great to open up the plantar fascia, but if you don't open up the back of the lower leg.....

Mar 01, 2011
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Posterior Tibialis Tendonitis Misdiagnosed? NEW
by: barefoot

Just came upon your page here. I too have had very similar symptoms and been in the same situations as Shawna. I too have high arches, been in the military, have issued custom made insoles which I do not wear because of discomfort. Love to be barefoot at home, not a big fan of wearing shoes and socks after hours. Recently about 4 weeks ago was on my feet for several hours in boots shoveling out from the two feet of snow here in the Midwest. Later that evening I went to stretch up my foot and felt a severe 2" inch tear on the inside of my ankle. Saw my Ortho and told me I had PTT, was referred to PT 2 X 3 weeks. During PT of Massage, Ultrasound and Icing experienced much pain and discontinued therapy after 2nd session. Went back to see Ortho and felt that a Richie Brace and returning to PT would help. My ankle is still pretty active as far as pain level of 7+. During PT was told I have tight muscles and still guarding. I am considering having a MRI done to see if something was missed. Would very much like your opinion on my situation. Thanks!

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Joshua Comments:

Hi Barefoot.

It would be very useful to know whether or not you actually do have a tear or not.

It's either VERY tweaked and unhappy, or there's a tear.

The treatment methodology is similar for both, but depending on the specifics of the tear, or if there -is- a tear or not to ligament or connective tissue or tendon, that does change the game as far as how one looks at what's going on in your feet.

Aside from that, yes absolutely your muscles are tight and guarding.

What are you doing about that?

Also, when you say 'inside the ankle', does that mean in the meat of the foot, or on the bony area on/below the ankle bone?

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Is it possible to correct Flexor Hallucis Longus Tendonitis and if so how?

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Is it possible to correct Flexor Hallucis Longus Tendonitis and if so how?