Tendonitis / Tendonosis in Left Ankle
OK WSMMs, I have one for you (and apologize in advance if it's buried in the wealth of Medical conversations in here!)
I finished up last season with the New York City Marathon in November, with no issues. Took Nov / Dec easy, and didn't do anything (that I can think of) to set off the current issue.
I started the Jan OS group, and have had a nagging pain in my left ankle, on the outside, just blow the "knob". It doesn't seem any worse during runs (if anything, it's better during runs), but does swell slightly afterwards. I barely notice it in routine activites, but I can press the spot to ID (and show to others). I also can get it to flare in some stretching positions, especially when the ankle is torqued. I've also had slight heal pain in the AM, primarily on the left foot, but a little in both. I understand that this is a sign of plantar fasciaitis.
A friend is a PA for an ortho group, so I talked to her about it a few weeks ago, and she said likely tendonitis and suggested NSAIDS a careful wathcing. After a week with no change following these suggestions, I went to a Sports Med Doc, who diagnosed Tendonitis / Tendonosis. Although not impairing me, we agreed on taking a week off running and NSAIDS / ice / stretching. A week passed, a little less sensitive, so I ran today, and it felt much the same - not bad, but not better. Followed the run with ice, ibu, and elevation. Feels OK.
Have had suggestions of Podiatrist, massage, bio-freeze ... What do you experts think?
BTW - taking an EZ year with sprints and Olys. 1/2 marathon in 3 weeks, Escape From Alcatraz May 2.
Comments
Have you tried sliding your cycling shoe cleats all the way back in their mounting holes? This doesn't directly answer your query but I've found that doing this alleviates a lot of lower leg problems. It did for me.
Thanks Bill,
Since the problem is only felt in running, I don't think bike is the driver. I will take a look at it , though, since all the pieces are connected!
Mike
Speaking form both a personal and professional POV.
You are doing everything right except giving it time. Most folks hate to hear this, but I recommend a minimum of 3-4 weeks of the above being done consistently every day to really allow adequate time for healing. I don't recommend NSAIDs every meal if you don't have pain every moment of the day, but just as needed and after exercise. I would say that icing several times per day, stretching and then strengthening exercises for the entire foot and ankle and calf region. You may need a physical therapy referral. But it sounds like you have 2 professional opinions that agree on the diagnosis. Time is a factor in all helaing, and everyone wants to be better yesterday.
I do think that massage, either professional or self, can help. If you aren't already, then massaging the bottom of the foot with a ball is great. You will find tender points.
There is a lot of good info Linda and Leigh posted about strength work for the foot region, it is here in the Medical Forum.
For many years I suffered through ankle pain due to multiple sprains playing soccer in my teens and 20's. I have been through just about every treatment. What has helped me the most has been to get professional massage to loosen the scar tissue in my ankles, then for me to strengthen the area. I rarely have pain these days (except for the occasional twist and it is never as bad as it was in the past). If I do develop pain, it usually is due to lack of diligence on my part.
Best of luck.
Hey Mike.
Sounds like peroneal tendonitis to me (the outside under the knob part). Typically can happen as a result of uneven loading of the foot (for example, tight calve results in supination (inward tilt) that tweaks PF + peroneals all in one shot).
If it were me:
1) get it dug out asap. you can take nsaids till the cows come home but it won't do anything for you if you're still active. do you have a sports massage/ART/graston person in your area?? key areas to work on will be gastroc/soleus/post tib/peroneals and PF. If you don't have a person or know of anybody, ask your training buddies or hit up the Active release and grastontechnique websites. They list providors who will like havely websites for you to check out and see who's more sports inclined.
2) sliding the cleats back/dropping your saddle a hair is a good idea in the mean time. Quality bikes load up the calves big time. While it probably had nothing to do with your initial injury, it can certainly prolong the recovery by keeping a certain level of strain on the area.
3) stetch your calf/solueus and PF like it's your job in the mean time. for good measure, work on the hip flexors, hammies and adductors as well. repetitive overuse injuries can be really cranky once they hit the chronic stage as all of the contributing muscle groups right up the leg keep pulling your foot/ankle back into that problem position.