Midfoot arthritis.Physio and exercise?

Claudette

Thank you for your kind and helpful thoughts upon which I am reflecting and acting upon. I took out the walking poles again yesterday for about 25 minutes on grass.I used them several months back but concluded at that time that all these walking aids were making my back worse. Anyway, I don't think these poles are responsible for that and they do allow me to place less weight upon my troublesome toes...that was yesterday anyway....and on my return I concluded I was no worse...so I thought that was a good result. Even this morning I wasn't too bad. I felt worse as this morning progressed. I had to walk a little on concrete (I've got it into my head that the hard surfaces make it worse even though I am wearing trainers with insoles). Anyway, I felt the need to go out for 15 mins on grass with the poles this evening and foot (+ other foot somewhat) not good.
In truth, I'm feeling emotionally wrecked, feeling disabled and sad....that maybe things are escalating fast. Over the past week I decided to use insoles again as my pain got bad even standing for a short time. These have helped a bit. They are not custom made but along the lines of some once made for me which(then) felt too restrictive and extreme. I'm wearing odd insoles, one with a high arch to correct the excessive pronation in my good foot, the other neutral but supportive. However, when I do something new like this, sometime later, get the urge to change it. My feet can't stand being kept in one position, it seems.

Although my balance is "better" and my back is better for that, my muscles are all straining to maintain it. On Wednesday I am "re-entering" the NHS physio/orthopaedics system for a first assessment. Goodness knows where this will take me this time....but I don't expect answers or anything like that. Advice or help would be good but I feel so complicated. My foot balance and muscle action keeps changing and different parts of my foot are taking the strain different days. It feels confusing and overwhelming and scary.

If you read to the end of this lament you have done well! I'm moaning again and sorry for myself. I haven't found out my pattern, what I can do, which insoles work and I am still struggling with being seen as different to what I was before...trying to be the same, having half days of hope here and there, hope that things are stablising, only to have hopes dashed...in short - "all over the place". Sorry to be so miserable. I annoy myself too.

daffy2

No need to apologise Claudette, one of the major functions of this forum as I see it is to offload our concerns rather than having them stewing inside our heads. You are worried, confused and unhappy, so no wonder you're feeling miserable.
I sympathise with the thing about not knowing what is setting off what in terms of the way you use your body. I've had scoliosis for 50 years now and am only too well aware of how a relatively small change in one bit of the structure can have effects elsewhere - and also that what I'm experiencing isn't always due to that. Too much to sort out sometimes!
I would agree with your observation about hard surfaces - I learnt a very long time ago that walking on pavements could make my back very sore, whereas tramping over fields etc could be enjoyed for as long as I wanted.The hard surfaces issue has been made much worse by the advent of OA, and although thick soles etc can mitigate to a degree, it's only the difference between doing the errands trip to town without having things hurt before I make the return journey....
I hope that "re-entering the NHS system" can come up with something helpful for you - if nothing else having an objective view of the way your body moves is useful - it's hard to do yourself!
Your comment about your muscles straining to maintain balance made me wonder if you have you ever looked into Tai Chi, Alexander Technique or similar? Regardless of what label gets attached to badly functioning bits, being able to allow the muscles to work effectively without imposing compensatory strain by trying to maintain what we perceive to be our balance(which is often a complete misperception), is helpful.

dreamdaisy

Moaning is a popular activity on here which no doubt makes the moaner feel a little better which in turn is a good thing. You shouldn't bore friends and family with the same stuff all the time because they are helpless, so are we but we understand why arthritis is an all-absorbing topic when one has been untroubled by health issues. It's a lot to comprehend and the impact severe. I admit it makes for depressing reading but I can choose whether to do that or not.

I was lucky in that a physio gave me information on how to use aids correctly: you have to pay more attention to posture and not lean on them as they are meant to be used for balance and stability, not support.

No matter what you do or don't do things will hurt. That's how it is. I find walking on pavements more painful because the impact on the joints, no matter how supportive the footwear, is more noticeable. Grass is softer so kinder but has its own pitfalls with uneven surfaces, clumps of grass and hidden dips. I no longer walk on sandy and pebbled beaches, the resulting pain increase is not worth the romance. I do feel for you, having the trouble so localised must be harder than having it everywhere, I wouldn't change places for one moment. I try not to remember the halcyon days of one joint being a nuisance - mind you that was so long ago I can no longer relate to how things were and that is a pointless exercise anyway. None of us are what we were but we're still who we are.

I am away on holiday and things are far worse than normal. So what? I'm getting out and about, seeing new places, taking more cocos and eating figs like they are going out of fashion. I ensure I do all the driving because being a passenger is more uncomfortable, I am using my rollator all the time to ease my joints (which it does until I have to cross cobbles ) as they are having to do more as I navigate my way round an unfamiliar house and landscapes. I refuse to be cowed by the demands of this malarkey.

You are still denying yourself progress in dealing with this by continuing to analyse every little pang and twinge. Life is far too short to give the disease the satisfaction of overcoming your resolve. DD

Claudette

Thank you DD and Daffy,

...for letting me moan, It was interesting DD, what you said about the aids being for balance/stability, not support. I don't have any issues at the moment with these things. When I say my balance is wrong what I mean is that I have limited strength on the outside front quarter of my foot, It often feels like it is totally weak....like today. I'm wondering if wearing the supportive insoles renders it weak if I take them out. I took them out today as the base joints of my 2nd, 3rd, 4th toes felt sore and swollen...probably overused(more arthritis?) while the supportive insoles guard only the midfoot and heel. I was feeling alarmed and worried. So today the swelling has improved a bit but I've got this floppy outside of foot. Even walking 50yards was an ordeal. I'll see what my NHS assessment brings tomorrow but trying not to expect too much.

Your coco mix and figs sounds lovely, especially the figs which complement well... but have got me thinking you are somewhere nice like Italy! Enjoy your hol.

Daffy...I did Tai Chi several years ago, pre injury days. I just don't know if I could do the standing for that long. Would have to come home to sit for rest of day. I'd love to be able to work up to something like that though. I did consider the Alexander technique but my walking just feels like a struggle at the moment so I don't feel I'd be starting from the right premise. Tomorrow afternoon I've signed up with a free 1hr personal trainer session in my gym, where I usually just swim. I want to ensure that I work out things I can do to use my upper body....for those days when my foot/feet feel out of action, but she might come up with some other ideas like these you have mentioned though.

dreamdaisy

I am being more active thanks to being away and negotiating a different living environment. This requires an increase in pain relief which leads to constipation, hence the figs.

We don't let you do anything, the forum is a safe place for people to write about their frustrations. Another role of the forum is to give support and encouragement which we try to do. DD

stickywicket

Claudette, I keep wondering something which to me seems very pertinent but which to you might - rightly - seem very impertinent. I'll go ahead and ask and you must, of course, feel free to just ignore me. No offence will be taken.

1. How much of each day do you devote to walking / swimming / cycling / exercising and evaluating and pondering on these?

2. What is you aim in all this?


DD, ah yes. Due to a possibly failing THR or, with luck, a kidney infection, I too am on the round-the-clock cocos with figs diet. Arthritis? I'm only in it for the glamorous lifestyle

Claudette

Thank you Sticky Wicket.

First I must relate the outcomes of my visit to MCAS, the NHS musculoskeletal referral place. This is my second time of "entry" into this system but all my notes are retained and they are many. The man who assessed me this time seemed very determined in his diagnosis about both of my feet and has given me an action plan. However, even if this plan will make improvements it is not going to be quick, not one month, he said, not two..maybe 8 months.
I have osteoarthritis in most of the joints across my midfoot, yes. However, I feel most of the pain and lack of function is in my toes, particularly around the area of my 2nd and 3rd toes. This is, surprisingly, the one midfoot joint not affected by the arthritis. My joints don't tend to ache at all. I do assisted calf raises(just 10!) everyday. Anyway, he right away said I have equinus feet(yes, feet like a horse). I thought I had just very high arches but it seems my problem( which can be acquired due to limping or similar or even wearing high heels too much) is that my toes drop down lower than my toes...so that all of the pressure gets placed in this area and the tendons/muscles(?) running right through the plantar fascia on the base of your feet which are tight, then all the way through your calves and even to your back. I recognise this now. He said I have to do 3 things. 1) calf stretches...but not to expect results after one ore two months, more like 8..and to be gradual and tentative about this as overdoing it could make more pain than is good for it.2) wear some soft insoles which lift my heel up but also support my high arch to enable me to walk more easily..or so he says. He's making these for me(no custom orthotic required) next week! 3) Shoes. He says I need shoes which elevate at the heel area such as Flit Flot shoes but with support in the arch as well. Who knows if any of this will work. I even feel I have already dabbled with some of these ideas.
As for the arthritis he says he can't do anything about that and that no insole may ultimately help....but, you see, all along I have come across people -physios, the consultant etc who didn't think my description of functional problems, numbness in toes pulling sensations in the one toe didn't match the arthritis diagnosis very well. There has been that tendency for people to say they just don't know why I experience these things with my increasing steps.I'm hoping I can just get a little improvement...and trying not to get too expectant.

Sticky...yes, no offence taken. Yes I am a little obsessed about needing to stay exercised but I am no exercise fanatic! This stems from 1) Having my kidney taken away 4 years ago...which was a total shock but the diagnosis came back as non cancerous. In trying to come to terms with this I tried to become informed about my new "condition" and learned I will be more prone to high BP. So resolved to take, if nothing else, the recommended guidelines for physical activity...30mins a day of something, often walking. Then injuring my foot made this impossible to achieve. 2) I've been very down, have tried the anti-depressants but the side effects were scary. Physical activity, I have found, lifts my mood a little and certainly helps me sleep.
I try to do something now most days but don't always achieve it and it is harder in the winter. This could be cycling 30-40 mins or swimming for about the same. Yesterday a free session with a personal trainer gave me upper body exercises to do. I began some blood pressure meds anyway, a low dose at the moment...but this makes me feel a little safer. I have been told | I have CKD...another shock but this is an inevitable result of having one kidney and being 61 I suppose.
Another reason I feel compelled to keep trying to exercise is that I am married to a very physically active man who travels back from work every day on his bike...about 20miles! I need to try for him, if that makes sense.

stickywicket

Thanks for the explanation, Claudette. I can understand your urge to keep your BP down. I have to take BP meds too - a combination, I think, of age, many years of meds and the enforced lack of decent activity of RA. (I keep searching for ways of getting out of breath with exercise but my body packs in before my lungs which, I guess, could be seen as a good sign

I hope the new physio will help. Eight months is a long time to wait for any improvement. Probably best to let him / her decide how things are going at follow-up visits rather than trying to evaluate things for yourself. Good luck.

Claudette

That is a good sign about your lungs Sticky. I somewhat recognise it in myself too. I want to do more than, exert that energy I used to. Just trying to get there or near to there has got to be good anyway. We have to say well done to ourselves for our achievements but, most of all, keep trying. I think if I give up I'll be in deep depression.

dreamdaisy

I don't feel the need to keep with anyone, everyone I know is in far better shape than me and I cannot see the point in making myself worse than I already am by being foolish. Again, being years ahead of you, I know what's what whilst you are still learning, I am used to amusing myself whilst others do their thing and it doesn't bother me that I'm not joining in. Give them one day of what I contend with and they wouldn't be able to think straight within an hour.

I tried your analytical approach to my pain yesterday but not for long. It boiled down to this: stuff hurts because I have two kind of arthritis and, because I am away, I am being more active than usual. QED (as my Pa used to say). DD

dreamdaisy

Arthritis is a question of mind over matter: we mind but that doesn't matter. DD

Claudette

That's mad DD,
...I mean -to follow my analytical approach. I'm not a good example. My foot sensations are extremely confusing though. A few stretches done today and yesterday and now outer quadrant of my foot feels semi paralysed, also up my outer calf and towards my back. Not pain as such, no swelling. It doesn't match what people say about arthritis. I can only hope that some new orthotics may help because I don't know what is going on.
I do hope you enjoy your holiday. I found it hard when we went away also because I was more active than usual. I like to draw and paint and play the ukulele. I should have done that a little more but I feel that I don't want to spoil it for my husband. I can't seem to get this sorted in my head. Also I end up feeling lonely. How do you cope with those sorts of things?

stickywicket

Would it really spoil things for your husband if you each did your own thing on some days? Mine enjoys getting away from me on the golf course or hiking which leaves me free to do my own thing(s) too. That way we enjoy each others company more when we're together.

You seem to have hobbies which lend themselves to solitude so why not enjoy them? Anything that absorbs our attention helps to prevent loneliness and also acts as a useful distraction from pain.

dreamdaisy

You do know what's going on, you have osteoarthritis but you are not used to living with it. It wasn't madness trying to view pain as you do, I wanted to gain a better understanding of how it impacts on life because being so used to it I easily make the changes and adjustments required to cope with it, know the warning signs so know to ease up etc. What surprised me was how much mental effort was required to analyse whereas it took far less to become involved in a logic puzzle (at which I am rubbish but I am teaching myself and slowly improving).

I thought drawing and painting were seated activities so have not one clue why you are not longer doing them - perhaps because your mind is so focused on negatives rather than positives? As for feeling lonely I rarely do, one of the many benefits of being the only child of older parents. I am used to amusing myself, I don't mind organised social amusements but relish the peace and quiet of the solitary. It's been a time of adjustment over the last sixteen months as my husband retired and is now around. I went from 12 -14 hours a day alone to company 24/7. That has been lovely, however, even though I have had to change my lifestyle to include him. Mind you, he's done the same. DD

Claudette

Thank you for replies recently received. I've been quiet whilst I have been adding in my calf stretches for equinus feet, feet where the forefoot drops lower than the heel. This is in addition to my high arches. Also I awaited the not custom made orthotics with a raised heel area to help reduce pain with this acquired or inherited condition. They came sooner than expected -last Friday. Anyway I have been having all sorts of other things going on now - lower back pain while my long term. slightly outwards bowed leg adjusts to being made more central with the calf stretches. I was coping alright with that as it was only intermittent. However the insoles feel like |I am walking on lumps. I'm trying to persevere but little by little. Not feeling any better and I am noticing more the numb feeling in the outer quadrant of my forefoot. I know there's a Morton's neuroma in there most likely caused by faulty biomechanics which never responded to the cortisone treatment. I'm wondering if this causes the weak, numb feeling. It is very disturbing. I can't help trying to work it out. The thing is the midfoot joints where the arthritis was diagnosed are not troubling me much. When I think back to a year ago I think my muscles may be generally stronger but the pain and numbness is worse. Sorry to bother you again with my trouble. I often feel hopeless. I'll have to contact the NHS man again and try to see if things can be altered or improved. You are probably going to tell me to stop trying but I never seem to maintain a balance upon this foot and I have virtually given up walking on it for more than a few hundred yards. If something could be made to stabilise my foot I wonder if I might be more settled. Fed up with myself today. I was feeling a little hopeful re the new insoles. Now I feel otherwise. Thanks for reading. I wouldn't blame you for skimming it. I go on too much. Just need to get it out.

daffy2

Hi Claudette, just a quick reply as I have an engagement with a post concert G&T(I need to decompress before bed!), to say no need to apologise for posting your frustration and feeling fed-up. As you say, sometimes you just need to get it off your chest, and it is a struggle if you're always trying to hit a moving target.

Claudette

Thank you Daffy,

Struggling to cope. This is mainly because of not understanding what is going on with my foot. I rang up the NHS service I'd used to tell them that wearing the insoles (or was it doing the stretches?) gives me distinct muscle weakness on the front half of foot, toes 2 to 5. It feels like it is caving away. My leg muscles seem to struggle to maintain an upright position in this leg...and this weakness is present without real pain.Then pain develops if I walk on it a bit but the weakness still remains. I even dreamt (twice) about turning the car up on to a hill which was on a mountain and found I hadn't got the handbrake on and I was slipping backwards. I was struggling to get the handbrake on. (This is my muscles trying to work) Anyway, the NHS people told me to stop wearing the insoles and to go back in next Monday to see the Physio...but I'm nearly losing hope. Something is stopping the nerves working in my foot properly, I'm sure. I don't know how this might relate to the arthritis at all but I no longer get aching joints, only nervy pains when the toe pains start to migrate.

I phoned the Samaritans just now. I needed to get it out. My usually hardworking husband has recently been signed off work with depression (which is a major 1st for him!). He says it is because of work problems and I do believe him but I also feel there is no doubt that my sadness, fear, negativity is affecting him.

I don't know who to turn to. I often feel overwhelmed. My 87 year old mother drives me mad and has every ailment under the sun...and likes to tell me about them all. I don't feel very supportive towards her....as I'm struggling with myself.

I know something is wrong with my foot...that is, I think, apart from its arthritis but so far I am getting nowhere.There is some sort of nerve impingement. I have to try hard with medical professionals, to stay calm or they categorise me as crazy...and yes, I do often feel crazy.

Thanks for listening

Claudette

Thank you Lovely Grace111,

...for your encouragement. I'm ashamed almost about how long this has been going on...as if it is my fault...but some how in my crazy head I blame myself for not being more assertive about my needs, and for sometimes(not always) being too emotional(because it has got me that way).You are right. I do know something is going on besides the arthritis, some sort of nerve impingement but I just need to go forward and calmly and persistently ask. Life has actually been so difficult for so long, things changing with more exercise (usually getting worse), weakness/numbness that feels very wrong, without a lot of pain, then increasing pain with just standing or walking...that even if I just get an understanding of what is actually going on that would be something. The next best would be some improvement and some some sort of way of knowing how to control things best. Anything else would feel like a miracle.

But thank you so much for your encouragement. I will calmly and persistently fight this battle for understanding. It sounds like you have done something similar. It is heartening to know others can fight and wait too. It means a lot to feel understood by someone. I'm not being a wimp about this. Something is clearly wrong and without explanation. Thank you for reminding me to find positive things while I wait along this road. My husband has depression as I mentioned but I love him and I think he loves me. I am lucky in that.
Thank you for your hug too. This is something I often send in texts to people. It means so much.