165 Lilly Rd NE, Suite B, Olympia • 360.455-8014


Bunion surgery rehabilitation

Morton’s Neuroma–why does it happen, what muscles out of sync?

On our website, Comstockpt.com and MusclesInSync.com, you’ll notice a tab which is called Muscles InSync (TM). It describes muscles getting out of sync with injury, and how we look to get the timing and coordination of the muscles working well again to get you better. How does this idea relate to Morton’s Neuroma? And….how can it help you if you have Morton’s neuroma?

First, what is Morton’s Neuroma? mortons-neuroma2 It is tangle of nerves which bunch up between the bones on the bottom of the ball of the foot. It causes a lot of pain when you walk and put pressure on the ball of the foot when you walk. It is a lot worse when you wear high heel shoes or heeled boots.

What Muscles get Out of Sync causing Morton’s Neuroma? The foot, when you put weight on it spreads the weight in the “foot tripod” position. Here is the foot tripod:

If your foot puts pressure down on the ball of the second toe, instead of the first toe, you end of lifting the outer toes too early, and the weight of your body can spin on the ball of the second toe. Below is a video from The Gait Guys which demonstrates the foot tripod

Which muscles are out of sync if you have a poor foot tripod? In the foot, the adductor halluces muscle, transverse portion (runs under the ball of the foot) supports the piece of the tripod which runs from the big toe to the little toe. adductor_hallucis

The Gait Guys are of the opinion that the extensor halluces brevis also plays a role in tripod support:

Try these two exercises slowly for 2 weeks and see if you can achieve a good tripod!

Physical Therapy in Olympia, Tumwater and Lacey, Where should I go?

There are many fine physical therapy clinics in the Olympia, Tumwater and Lacey area. How do you chose where to go?

You can choose based on location. A friend of mine told me today she chose to go to physical therapy at a clinic close to her house. What would prompt a close choice versus reputation? Maybe she needed to go 2 or 3 times per week. If someone needs to go to PT 2 or 3 times a week for a month or so, then going close to your house would be very convenient, HOWEVER, ask yourself the question: does your condition warrant 2 or 3 times per week?

Recently a former patient returned for a new session of physical therapy. She is a fairly frail 80 something year old, and was sent for BOTH headaches AND shoulder pain by her physician. Her prescription from the physician was directed to be 2 to 3 times per week for 4 to 6 weeks. She may have thought she needed to come that often, but…….when I evaluated her headache AND shoulder pain, I determined that both problems were mainly caused by the same anatomical structure.

I gave her an exercise program based on this one problem, and added customized and specific exercises for the shoulders and neck. As of Friday (January 30) 100% better in the headache and 75% better in the shoulders. She came for 6 visits at 1 x per week.

So the bottom line is, unless you actually NEED to have therapy 2 or 3 times per week consider going somewhere that uses less visits more effectively and you may save yourself some time and money.

The therapists at Comstock Physical Therapy, Joyce Mills, Lori Waterman and Linnea Comstock have extensively studied the body to make our exercise programs very effective and efficient. Give us a call if you would rather go to PT once per week instead of three times a week!

Walking a lot on vacation? Got sore feet? What to do…

Does the amount of walking you do exponentially increase when on vacation?  Such spots as Las Vegas, Washington DC and New York require a lot of walking and if you have a desk job or don’t walk a lot, your feet will hurt if you don’t  prepare.

How to prepare?

#1:  Do you have flat feet (do your feet pronate).? If so, you can purchase over the counter arch supports and use them on and off during your trip while walking a lot.

#2:  Are you feet week?  Practice single leg balancing for 30 seconds 3 times per day on each foot/leg to build up foot strength and improve your balance.  Better yet, if you have a gel disc at home or the gym use that–it will challenge you more.

#3  Make sure to alternate different types of shoes during the day to stress different parts of your foot.  One day I wore tennis shoes with orthotics in the morning, and wore sketcher flip flops in the afternoon.

#4  Learn how to massage your feet and lower leg muscles to take the kinks out.


Happy walking!

Bunion Surgery Rehabilitation needs Foot Strengthening

Have you ever had bunion surgery?  It can be a long rehabilitation process. Often people shift the weight onto the second toe when walking after bunion surgery, instead of putting full weight down onto the big toe right before pushing off.  The patient has been walking this way for a very long time, and now shifting the way one walks is pretty hard.

Part of the problem is that people who have bunion surgery developed a bunion partly due to having too much pronation (flat feet). If you have flat feet, your arch will get too stretched out and you will push off your second toe instead of your first toe. Even after the bunion surgery you might continue to push off your second toe–and that will be aggravating. What exercise can you do to strengthen your foot to reduce flat foot and prepare for a bunion surgery?

While you are sitting you can raise you feet up like are coming up on your tip toes. That will start to strengthen the arch, and give your big toe better range of motion.

You will also need scar tissue mobilization to help the big toe be able to bend down and up as you walk.

Good luck with your bunion surgery!

Physical Therapy

165 Lilly Rd. NE, Suite B
Olympia, Washington 98506


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