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Posterior Tibial Tendonitis

Cary BlancoCary Blanco
in General Training Discussions

Okay Medical WSMs ...

Posterior Tibial Tendonitis, while I don't have symptoms right now, from time to time I do things that cause it to manifest itself on my left foot.

I know I need to be careful pulling my shoes off (I can be lazy with not untying the laces). But I want to know if there's anything I can do to stretch/strengthen the area to have it occur less often.

At the NYC Marathon this past year I aggravated it while changing in a portapotty a two hours before the race and ran the 26.2 with no dorsiflexion in my left foot. It didn't bother me 'till mile 20 or so, but I still would have liked to not to have had it be an issue. Besides being more careful and picking better places to change, I'd like to minimize the possibility of this happening again.

thanks,

cary

 

Comments

  • Leigh BoyleLeigh Boyle

    honestly, if you're able to flare up your post tib/calf just by twisting your foot while changing, taking your shoes off, etc....that means you've got some crazy tight calves and post tibs. And by that I mean abnormally so.

     

    What's your stretching routine look like and how often are you doing it?? foam roller/stick?? what kind of stuff do you have at home??

     

    why do you say post tib? have you been treated for it? diagnosed? where does it hurt?

  • Cary BlancoCary Blanco
    Thanks so much for the reply Leigh.

    I was diagnosed with Posterior Tibial Tendonitis by a podiatrist. (If I had to self diagnose I probably would have incorrectly guessed Tarsal Tunnel syndrome.) He recommended rest while I was symptomatic and did not discuss anything further (other than easing back in to activity).

    It does not happen "all the time" maybe once a year, but that's often enough for me to want to prevent it from happening.

    I previously did not do a lot of stretching. Now I stretch out my quads/hams/calves and IT band before running. Also, I'm hyper-flexible, palms to ground when gong to touch toes, etc.

    Interesting that you say I've got tight calves, cause they do get super tight when I put the volume/intensity on.

    As far as stretching "toys", I've got TP Massage Balls, a TP Footballer & block.

    I've watched your extremely informative lower leg video, should I get a stick as well to work the posterior tib?

    thanks again!
  • Leigh BoyleLeigh Boyle

    Hey Cary, happy to help. image

    The trick with post tib stuff is finding out what the cause is. Typically, running is the big culprit especially with faster people like yourself. A high cadence/short stride where you don't fully load the foot results in you running with your arch up towards the sky (foot supinated). To maintain your speed, the push off gets twisted around and your post tib gets put to work.

    In other words- when you land on your foot you should fully step on the foot (regardless of heel or forefoot landing) and then stay on it all the way through the stride (full hip and knee extension) and then push off your big toe.

    are there orthotics in the mix? shoe type? has it bothered you at all biking?

    You're good to go with the trigger point stuff (you can get at the post tib much more effectively with it). the key is frequency.

  • Cary BlancoCary Blanco
    Leigh.

    I started getting PTT symptoms before I started running, although I'm sure my running form needs massive tweaking. I'll work on my landings. I have super-high arches that may contribute to things as well.

    Yes, I started with custom orthotics about a year ago, but I don't use them when running, just everyday use, never got around to putting them in to the run mix. I run in Newton's neutral trainers, and most of the time things feel fine.

    As far as cycling goes - even if i'm symptomatic, it never bothers me (hurts) while i'm riding.

    I'll start stretching daily.

    thanks again.
  • Leigh BoyleLeigh Boyle

    Good luck and keep us posted. PTT stuff can be complicated because so many variables come into play both athletically and just through normal day to day stuff, nevermind seperating it from bike and run. image

  • David FlintDavid Flint

    @Cary - you mention being 'hyper-flexible, palms to ground when gong to touch toes, etc.' - I'm the same and always thought I had great flexibilty until my physio said that a great deal of this was due to bending mid-back, i.e. I was 'cheating' in order to reach the floor - I was tight & very un-flexible in the lower spine and had tight hams.

    For me it was a diiferent proposition if I bent from the hips first, i.e. engage core and keep a straight back - just a thought that helped me

    Also, weak glutes.........

    .

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