Midfoot arthritis.Physio and exercise?

Claudette

I have midfoot arthritis, one foot only, one joint advanced and 3 others with arthritis showing. This followed an inversion trauma 2 and a half years ago. It has has been a long journey, primarily of grief and a difficulty with "acceptance". I've never stopped trying, almost relentlessly, to understand and improve upon my symptoms. I've had some very painful and difficult flare ups where crutches were my only option.
My feet have been, since the arthritis began, imbalanced in that my injured foot has had a stiff high arch and my uninjured foot pronates inwards at the arch too much. Over time I managed to get the injured arch to come down a little. Then, this year, with the help of a physio I have been working on improving this balance by using a wobble (balance) board very, very gradually. My balance is improved (not perfect) now but I have exchanged my original situation for more pain, especially nerve pain and stiffness.I had also, to go against the advise of the consultant, and wear much less arch support as I have slowly come to believe that this was making many of my foot muscles redundant. Most noteably, however, I still don't manage to exceed my approximately 30 minute maximum walking time without either soreness, stiffness and worsening function.I think I'm getting a little swelling now. Before my wobble board physio, I continually felt my walking step contained a flick/twist because my foot was going down wrongly and I had a big problem with my 2nd and 3rd toes becoming numb, then painful.
So my question is....Am I making things worse by trying to improve the balance of my feet? Is it better to be balanced even if it creates more pain(although who knows if my pain would have been getting worse anyway)? I certainly have improved my strength with the wobble board. No-one seems to be able to advise me from the medical people I have consulted with and my time with the physio has now ended although I could pay to go back at any time. I don't think my midfoot arthritis follows the normal pattern, especially as it is only one foot, caused by inversion and I have very high arches naturally and flexy feet prior to the injury.

Airwave!

Think of it like a set of weighing scales, on one side is rest, less pain and the other exercise to mantain ligaments, tendons and muscles. At times its a delicate balance act to get it right. As you have learnt what is right one day is not right the next.

Each step can be different, so go with what your body is telling you. During the hot weather I felt good and went for a walk every day.

Claudette

Thank you, Airwave. I wish someone could tell me what to do. I find it hard to dissect my instincts from what I've been told I should be doing. The consultant didn't make much of my imbalance. He was only interested in his MRI pictures...and he told me to wear insoles.The only way I seem to be able to address my imbalance seems to be to wear less arch support. I have discovered that there is hardly any chance of my foot pronating too much, which I assume is a more normal problem...but I can't help "hanging on to the words" of the professional. I do the daily wobble board exercises along with mild exercises to maintain my arch....but when my foot is stiff(eg mornings) the arch retracts -goes higher. Then over the day the nerve pain, numbness and soreness over the ball of my foot build up.

If anyone else on this forum has midfoot arthritis I would appreciate hearing about their symptoms and experience.

dreamdaisy

I have flat feet caused by arthritis so cannot relate to any of your problems as mine are different. No-one can tell you what to do, they can guide and advise but ultimately it's down to you because everyone's situation is unique. How things are and how they feel vary on a daily basis, sometimes more than once a day. Anton Chekhov wrote 'When many solutions are offered it means the problem is unsolvable.' Having been playing this game for over twenty years I know that's true. DD

Claudette

Thanks once again DD.
Yes, your situation is different. I am not saying I envy your long term suffering but I'd like a little piece of your "acceptance of your situation". Clearly, life has spoiled me up until this happened and I didn't realise it. I have to get used to living with the unknown and with pain. It is hard when, not so long ago, I was so active, never stopped and always prided myself on walking everywhere. We had a break in Suffolk last week. On one of my very short walks I saw a couple older than myself and my husband walking ahead of me. I was filled with envy at an ideal I thought my life would allow me into my old age. I thought, if we couldn't do anything else active together we could always walk. It costs nothing, provides exercise, company, time together and things to see. Who knows if the idyllic couple I saw had secret arthritis or something equally disabling and their walk was also been short? Maybe I always want what I can't have.

dreamdaisy

One of the many secrets to leading a contented life is not to want what you can't have and learning to make the best of what you do. When things were better you had no challenge to face, nothing to overcome because your fundamental good health saw you through. No doubt back in those days illness was something temporary, an inconvenience and when you got better you probably thought 'About bl**dy time' rather than 'Thank you and hurrah!'.

The OA is a setback but you are allowing yourself to remain in the vortex of self-pity by continually focussing on what might have been, an utterly pointless exercise but kinda to be expected because you have no experience of an ongoing health matter. I do not regard myself as being ill, I have arthritis as do around ten million other people. It's not special, it's not unique, illness is a side-effect of life. In myself I feel well and that is the thing I focus on but I am fortunate in that I have never known or experienced the curse of good health. I knew aged eight that my life was always going to be challenging, difficult and hard work but so what?

Khalil Gibran wrote in The Prophet 'The deeper sorrow carves into your being the more joy you can contain.' That is one of my key phrases to get me through but you have to be prepared to allow yourself to feel joy. You are stubbornly denying yourself that opportunity . Other phrases I like include:

Before you start climbing the ladder make sure it's propped against the right wall.

Never try to teach a pig to sing. It wastes your time and annoys the pig. (That's a good one for when I am trying to do too much.)

I do not care that other people are living a better life than me when it comes to health matters. I do not care when I go to the gym that my efforts are so puny and paltry compared to everyone else in there: I doubt they could cope with my reality, at least I am giving it a good when physically challenged. I marvel that so many walk about with ease, can sit in comfort not feeling their joints twanging away but I have my health as good as it can be, I have a husband who loves me, I have friends who like me, I pursue my hobbies and interests to take my mind off me because, basically, I am not anything or anyone special. My life is as good as it can be, I am making the best of a bad lot because hat makes me feel better. DD

Claudette

I'm pondering upon one of your statements...stubbornly denying myself the ability to feel joy.This may actually be true. I'm working that one out. Yes maybe some truth here but I need to be able to do this.A bit like not being able to capture "happiness, the elusive butterfly" which only comes to settle on your shoulder when you are not waiting for or expecting it. Maybe the denied joy is a little like that.
Thanks for your insights. Off for a swim now....quite often feel worse for the rest of the day after that, but at least it will do my blood pressure some good.

stickywicket

He who binds to himself a joy
Does the winged life destroy
He who kisses the joy as it flies
Lives in eternity’s sunrise

William Blake, 1757 - 1827

dreamdaisy

Only when I let go of what I was can I become what I might be.

Don't look back, you're not going that way.

If you don't want to solve a problem tomorrow don't create one today.

What is lost on the outside shall be won on the inside.

The body itself is a disease.

It's never too late to be what you might have been.

It's a case of mind over matter: I do mind but that doesn't matter.

Airwave!

Claudette, I often try to point out that it is almost immaterial what is causing the pain, at the end of the day it is pain and we all have that. In order to lead a life we can't afford to beat ourselves up over something we had no choice over, it happened, get over it and get on with life. I say this with a soft voice.

It is usually noticeable with newly diagnosed arthers who need to let go of their diagnosis and learn to carry on living with pain, but haven't reached the acceptance of the facts. Remember pain is pain, don't centre on what causes it, move on.

We are more than arthritis, we are stronger and it is us who determines who and what we are and how we will live our lives! I feel very strongly about this. It is the right way to deal with arther, we matter not arther.

Good luck.

palo

Hi Claudette,

It is entirely normal to be seeking answers and to feel that you can do something to get back what you once had. Sometimes you can't no matter how hard you try and when your mind is ready to accept that it will and you will move on. Focusing on trivia is one way of managing avoiding the bigger issues, but at some point acceptance will be achieved.

I feel there is a little death with every piece of functionality one loses, and it is never easy to let it go. The many losses I have had have taught me that there is always something worse that can happen so I always focus on only today and on remaining happy as I have no other choice, I am more than the sum of my problems and underneath them I will still enjoy what I can from life.

Remember happiness is not a destination but a choice...

Good luck. It has taken me many years to get to this place so to someone new to adversity do not worry if it comes so hard at first..

Claudette

Thank you Airwave, thank you DD, hello again and thank you Stickywicket, thank you Palo.

Strangely enough I had quite a good day the day I went swimming.That was yesterday. Maybe it was those few stretches I did in the pool before I got out. Who knows? My feet are certainly more balanced. I live with stiffness in my bad one which causes pain eventually. The wobble board has certainly addressed the balance and this gives me a little peace in my mind. Before this my foot never knew which way to go down and was trying to balance all sorts of different ways.
Also, and more importantly, I am trying to accept how things are now, without looking into the future. I have often caught myself feeling good about improvements which seem to be happening only to have all those hopes dashed when things take a turn for the worse. Conversely I have got myself into a state because of how bad things seemed and allowed it to spoil my day and probably make my pain worse.
One of the hardest things is feeling I am unable to do something which someone I know wants me to do. After all, I look the same and do appear to be walking about but my arthritis has happened quite rapidly after a sudden, simple but awkward injury. For example, my friend came to stay and wanted to visit the city museums and galleries. Three years ago I would have given the trip no thought including the train journey and walk to the venue and more! I hate being a different person. I hate having to sit down while she walks about so I try to be the same. Then she's none the wiser about how I'm feeling and then I suffer later. Actually visiting a museum I've already been to is not my fave thing to do anyway but I have to weigh out my standing and walking time carefully and make a decision about how I am choosing to use that time. It might have felt selfish to say I didn't want to do it so in this case I went along with it. What am I trying to say here? Having to say no to things more feels hard and uncomfortable. I suppose you work out a way to come to terms with this too?
Anyway, time for a bit of wobbling on the board!! Then off to bed. Good night.

stickywicket

Claudette wrote:

Having to say no to things more feels hard and uncomfortable. I suppose you work out a way to come to terms with this too?.

You just keep saying it. Feelings don't come into it. I said it about a dozen times today and, in the end, she got the message.

Claudette

Thanks Sticky,

Yes, more of the same last night...an unusual occurrence- went out to someone's 60th in a function suite. All that standing up at the start as people arrive was doing me in. I find I can't concentrate upon what is being said because of a pressing need to sit down. Having said that - yesterday turned out to be a big pain day all round without the usual relax time in the evening. I still can't work out what makes it particularly bad some days. I puzzle over it, try to work it out. I suppose that's a natural reaction. What I do know is that when it gets that bad my emotions hit a bad high. Last night the alarm in my head about the pain and being an unmoving sitdown person kept me awake fretting. I do know that this is where I need my "acceptance" most. I'm writing this to you but also partly to myself!
How are you keeping?

dreamdaisy

If Ii know that something socially challenging / gruelling is coming up then for me the key lies in preparation. I rest for a couple of days beforehand and up the pain relief the day before to build in a greater buffer. I'm used to amusing myself while others do what they can do, I always have a puzzle book and my Kindle in my bag and actually get quite cross if I am interrupted at a crucial moment: can't they see I'm busy? DD

stickywicket

I agree with all that DD has written. In addition, when you write

Claudette wrote:

when it gets that bad my emotions hit a bad high. Last night the alarm in my head about the pain and being an unmoving sitdown person kept me awake fretting.

you have to remember that your emotions are not to be given free rein to wander where they will though I accept that late at night it is harder to control them. But, if they are taking you into undesirable areas then grab a book, preferably comedy. If you must mentally go over the day's events select the best, the good, the funniest, the ones that make you feel upbeat. Where's the sense in making yourself miserable by fretting over stuff that might never happen? Will power is a muscle. We must use it or lose it.

How am I? Good enough, thanks

Claudette

Thank you so much Sticky and DD,

I like your attitudes. Maybe I'll develop something similar given time.I like the "Can't you see I'm busy attitude" and also the " Grab a comedy" idea. I certainly need to develop more of a sense of humour, or a least an active interest in humour. I'm too serious and analysing all the time.
Just a question about the osteoarthritis now which I don't understand properly ....Foot was very stiff today after a swim in the morning, various trips to shops in the car, a short cycle and a short(20 minute) walk. There was no let up in the stiffness.Walking was difficult as it wouldn't roll out at midfoot where I needed it to. Tonight whilst standing to cook the tea I got the nervy pains leading from toes and in my front ankle. These are familiar. I think it has suddenly loosened up. Does this sound familiar? Do I substitute stiffness for nervy pains when the stiffness eases off a bit? Sorry if you don't know the answer. I just want to understand
a little more - to have a little control over this disabling thing.
...And once again thank you for showing me that you can be happy and do enjoyable things for yourselves in spite of it!

dreamdaisy

This is very hard to answer because I am affected to a far greater extent than you, which is why you can achieve more in a morning than I can in an entire day, (or two or three depending on how bad things are. I don't analyse the pain, 'it's there so deal with it' is my attitude and one way to deal with it is to manage my time better and rest more. Because my OA pain is exacerbated by overdoing things, and any resulting inflammation localised, it's not rocket science to work out that stopping when I think I can do more will enable me, in the long run, to do more albeit over a longer period of time. So what? That aspect of thing is also called ageing . . .

I think that one cannot force a sense of humour, it's either there or not. I don't know what your life experience has been until now but I suspect that long-term health setbacks have not been involved, leaving you woefully underprepared for this. OA is here and here to stay, so start looking up and out, stop looking down and in. We all know that the latter ain't helping but whether you can achieve the former remains unknown - again with the negativity from you, 'maybe I can,' when it could be 'I will.' We can't do it for you. DD

Good health prepares you for arthritis like lace-making does for round-the-world yachting. (an altered-by- me quote from Kathy Lette)

I have arthritis, so what? Do less, be more. (DD)

stickywicket

I can't imagine living without humour and I'd certainly prefer my own fun-filled albeit very arthritic life to a very healthy but very serious one.

Our approaches to arthritis are hugely different. You ponder the intricacies of your pain and want to understand it. I, on the other hand, have scrap books of things that make me laugh out loud and I read them on the really bad days to get as far away from the pain as possible.

Pain, to me, is the spoilt little brat which says “Me, me, me! Look at me!” all the time and is best dealt with by doing exactly the opposite. Let it scream. Let it throw a tantrum. It has my feet, knees, hips, neck, hands, elbows and shoulders but my thoughts are my own and it can only get into them if I allow it to. The door is locked and barred. I'm behind it having fun with those I love.

Claudette

Thank you DD and Sticky,
Love the lace making not preparing you for round the world yachting. I have had lots of painful (albeit mostly emotional) things in my life. Emotional pain and physical pain are certainly related......OK - I will move on, find joy again...just taking my time about it....still trying to accept the speed at which this thing has hit me.

I love your attitude Sticky. I want to be like that. No doubt your family admire you for it too. I'd love to make my family proud of me for achieving/ being that strong and resilient person. I used to be funnier...but I've lost that relaxed spontaneity over the past two years. I wasn't a stand up comic but I certainly laughed more and found the funny side of things. I want it back. I'm different now but underneath the same me is there.

Think I'm having a flareup. No physio exercises tonight, no little walk.

daffy2

Claudette, reading through your posts again the phrase that springs to my mind is 'Let go'. As others have said being catapulted into this situation is deeply upsetting and unsettling, but at this stage trying to analyse everything and look for cause and effect, while understandable, will take up valuable time and energy which might be better spent just letting it happen and getting used to what is happening. In due course patterns may emerge - but even if they do they won't cover everything, and you'll still need to accept that the unpredictable will happen. Finding what works for you for pain will be valuable, as it will give you some semblance of control.
Not letting the arthritis take over is a necessary aim, but that doesn't have to mean achieving goals, setting targets, engaging in a battle, all of which can set you up for failure. Tackling the mental elements of your situation will be much harder than dealing with the physical but in the end will be far more rewarding and useful - it takes time though.

stickywicket

Bless you! I don't think my family admire me at all or, if they do, they conceal it very well I'm just Mum to my sons. I had arthritis long before they arrived so they don't think twice about it. Besides, they know all the bad bits of me

As daffy says, just let go. And, as my Mum always said, can't means won't. It infuriated me as a kid but I've grown to be grateful for it.

Claudette

Hello again,
Should I stop trying to improve/ increase my walking time? I feel like I am fighting a losing battle. I'm asking this as some people may have been in this position and come to a conclusion. I always want to do the right and the most sensible thing which helps my arthritis and mobility. If walking makes my toes seize up after 15 to 20 minutes and following this I can't place my foot down properly to walk...should I be trying to maintain this walking in an attempt not to lose what I have? It doesn't feel right to carry on walking when the function goes wrong and I then usually get swelling afterwards.
I can cycle for longer, 45 minutes or even an hour as long as I place my toes on the pedal and not my arch. I can swim but sometimes feel worse afterwards in terms of stiffness. I experimented again in the gym doing just 5 minutes on the rower, then stepper, then cross trainer(in reverse direction only) and got away with it in this instance.
For the past two days I took out a stick with me and walked only on grass but still got the same result and my additional lower back pain(I can only conclude that the stick is causing this...as I remember this happening before, even though I'm using the stick on the opposite side).
In short, how do you know how much to do and how much not to do? I so much want to do the most sensible thing and this includes keeping as fit as i can but don't know how to decide upon what this is.

daffy2

If the 15 or 20 minutes walking you do now causes problems which are not improving does it make sense to do even more? I understand your concerns about losing mobility but this isn't an elite athlete situation where the body has to be pushed to the limit to achieve the best result.
It's good that you can cycle, especially if you are now forced to use a better foot position - the arch shouldn't be on the pedal, the ball of the foot is the bit to use - but consider perhaps concentrating on enjoying the trip rather than how long you can keep going. Anxiety about performance will cause tension which isn't conducive to the body working well.
If one stick seems to cause difficulties then consider using two - proper walking poles set at the right height for you - or possibly trying Nordic walking if there's any in your part of the world?

dreamdaisy

Do what is right for you and finding what that is takes time. I never set targets because that way lies failure which is unhelpful, un-necessary, unwanted. I often do more than I originally thought I could because I am not focussed on the how long, how far, how many. What I achieve on a better day wouldn't even register on your scale as achievement but that doesn't bother me because I am proud I did it. I am not what I was but that doesn't mean I can't do well, even with my reduced physical circumstances. Take pride in what you have done, not how long you've done it or how far you have gone. Take pleasure in the doing. DD

stickywicket

Don't be so anxious to 'not lose what I have' that your whole life consists of preserving it.

The rule of thumb is that exercise will hurt but, if it still hurts two hours later, you're overdoing it.

Exercise never reverses damage done. It only helps to preserve the movement we have.