Doctor Jo's blog

 

Foot Cramping

I got a message through my Ask Doctor Jo YouTube Channel and the person wanted to know what to do about foot cramping. Well, there are several different causes of foot cramping.  It can mean different things if you are getting foot cramping after exercises or increased activities, or if you are getting them without increased activity.

Cramping can be caused by improper footwear, so that would be one of the first things I would look at.  You can ask your doctor or therapist for any suggestions based on your foot type.  Foot cramps can also be caused from dehydration or lack of potassium.  Increasing your electrolytes with any kind of sports drinks or increasing your water intake might also help.

There are also many kinds of prescribed medications now that have cramping as the most common side effect.  Many of the statin drugs (cholesterol medications) can cause cramping or weakness.

In the end, some people are just more prone to cramping than other people.  The foot is made up of muscles, tendons, and fascia that can cause cramping.  Many of the tendons are actually attached to the muscles in your lower leg, so stretching the calf area for bottom of the foot cramping and stretching the anterior tibialis/top muscles for top of the foot cramping is the best place to start.

If you are cramping in your foot, and your toes curl downwards, then please go check out my plantar fasciitis video. Most likely you don’t have plantar fasciitis, but the stretches will help with the muscles in the back of your leg and on the bottom of your foot.

If you are cramping and your toes curl up or flare out, then please go check out my shin splints stretching video. That will help stretch the muscles on the top of the leg and foot.

Nerve Pain, Muscle Pain, or Joint Pain?

Q: How can I tell the difference between nerve pain, muscle pain, or joint pain?

A: It is very important to know what kind of pain you are having. A frustrating answer I hear when asking someone to describe their pain is,  “It just hurts.” Fortunately or unfortunately, depending on how you look at it, there are many different kinds of pain. If you are able to be specific about your pain, it can greatly help your clinician better diagnose you and eventually help you to feel better.
 
So back to the question. There are many types of pain. The most common are nerve pain, joint pain, vascular pain, and muscle pain. Nerve pain is commonly described as sharp, bright, burning, or shooting. Joint pain can be dull, achy, and very localized. Vascular pain is usually diffused, achy, and poorly localized.  The most common type of pain is muscle pain.  It is usually very hard to localize, dull and achy. It usually is aggravated by an injury, and sometimes even refers to another area.  
 
So please pay close attention to the kind of pain you are having so you can easily describe it to your health care provider.
 
Have Nerve Pain? This video may be able to help.
 

 

Take Your Meds as Prescribed

One frustrating comment I hear often is, “The doctor prescribed pain medication, but I don’t want to take it and get addicted.” Or something like, “I just don’t like taking pain medication.” Another one that gets me is, “I have a high tolerance for pain.”

Okay, I am not here to promote taking medication in excess, but pain medication definitely serves a purpose. Contrary to popular belief, it’s not only to stop the pain, but it’s also to help the healing process. In response to the first comment, unless you have a very addictive personality, and you are taking your medication more than prescribed, you will not get addicted to your pain medication. Your doctor should be monitoring how much you are requesting and will perscribe more than necessary.

Unless you have bad reactions or side effects to pain medication, you should take your them as prescribed. I understand that some people simply cannot tolerate the medication, and it might make them nauseous or extremely drowsy. That’s the time to let your doctor know, and something else should be prescribed.

Even if you have a high tolerance for pain, pain medication blocks the receptors going to your brain telling your defense system to kick in. When you are in pain, especially after a surgery, inflammation and swelling will continue, and this slows the healing process. If you are unable to sleep because of the pain, this will also slow down the healing process. When we are sleeping, our bodies are healing. Therefore, poor sleep equals poor healing. Also, when you are hurting, it is very difficult to do stretching and exercises.

So in the end, please take your pain medication as prescribed and probably about 30 minutes to an hour before you start your therapy.

 

Mobilize, Stretch, and then Strengthen

Here's another email question. This one if from Kendra L: “Hey Dr. Jo!  I watched your video for back extension stretches (above). I’ve been doing my stretches and I feel really good, but the pain always comes back. Am I doing something wrong?”

Hey Kendra, thanks for sending in your question! I’m glad you’re feeling better, even if it is only temporarily. You have started out on the right track! Now you need to progress to the next level. The key is to mobilize, stretch, and then strengthen. It’s important to remember that stretching will definitely help with the pain, but if you don’t strengthen the muscles too, you will never fix the problem. Also, you have to be very consistent with your exercises. Doing them just in therapy is not enough. That is the whole reason for a home exercise program. So please check out the swiss ball strengthening exercise video for your back.

If you don’t have a swiss ball, they are not very expensive and you can get them from your local Wal-mart or order one from Amazon.com. Try some of the simple beginner exercises first, and if those don’t increase the pain, you can progress with the exercises to get your core very strong to protect your back. I hope these help your back to continue feeling better. Remember, be safe, have fun, and I hope you feel better soon!

No Pain, No Gain?

I received an email the other day from Jackson M. “I am recovering from a hamstring strain, and my dad keeps saying, ‘No pain, no gain.’ Do you agree?”

Hey Jackson! Thanks for sending in your question. Hopefully the video above will help with the strain, but as for "No Pain, No Gain," I actually hear people say that often, and it usually makes me cringe. I am sure you will hear different answers from different therapist or trainers, but for the most part that is not my philosophy.

Let me explain. There are certain times, like after a surgery – rotator cuff repair, total knee arthroscopy, etc – that you do have to follow that mentality. That’s one of the reasons doctors prescribe such powerful pain medications. When you have a surgery, there is a small window before adhesions (scar tissue) build up. You have to push your way through the movements for your body to be able to heal properly. These are the only times I would tell a patient “no pain, no gain.”

In most other situations, I do not believe this is true. Pain is your body’s way of saying, “don’t do that.” Pain can also lead to increased inflammation and muscle guarding. Both of these can slow the healing process and actually increase pain. Now I am not saying you are not going to be uncomfortable or feel pressure, maybe even some burning sensations, but when your body tells you to stop doing something, you should probably listen.

Again, this is why it is very important to let your therapist know if something is truly painful. Remember, we can always modify a stretch or exercise and progress as the pain decreases. Please go check out the hamstring stretches video to help you along in your recovery. Have fun, be safe, and I hope you feel better soon!

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