Anke pain
I was wondering if anyone has had any history with something like this. I woke up Monday morning with some pain in my right ankle. I had run the previous morning but was pain free the entire day. It got better throughout the day so I didn't think too much about it. The next morning the same thing so I figured i would take another day off form running.
I was able to do a nice easy run pushing my daughter in the stroller pain free the next day. Rode the bike the day after that with no issues. Yesterday i tried to do a 16 mile run. The initial 6 miles were fine at an easy pace but once I needed to step up the pace the ankle really started to bother me. Eventually I had to stand down and walk it home.
The ankle is pretty tender now and I included aq picture of it below, apologies in advance! I think the right ankle is swollen, especially below the ball. I am trying ot figure out what I could have done to it. I don't remember twisting or spraining it. Nothing high impact. Just scratching my head hear.
So am I wrong, does my right ankle look swollen? Sorry picture not great, taken with my iPhone. If so what is my next move? Don't mean to sound dumb but I don't go to the doctor. Never a broken bone, don't get sick, so I am not sure what to do. Do I go see a general practitioner or a specialist? I would really like to figure out what is wrong because I am signed up for a half marathon next weekend and a full in November that I would like to do.
Thanks in advance.
Sorry forgot to mention symptoms. Walking is usually fine, small amount of discomfort. Putting additional weight on it does not feel good. So I tried to do a one legged squat. Left leg is fine, right leg and I have some pain as I start to descend and also some shaking as my stability is not as good with that leg. There has to be something because my right leg has always been my dominant leg due to years of pitching and pushing off with that leg/
Thanks again!
Comments
P
Tucker,
sorry about your problems at the current moment. It must be painful to not be able to finish those long runs.
Do you mind if i ask a couple of questions:
where is theexact location of the tenderness? does it radiate anywhere from the point of max ttenderness? is it localized to a specific point? when do you get the pain typically in your runs - during push-off, landing? does it radiate? is it always swollen? - i can't tell much from the pics honestly. Is the swelling on one side, or both sides. Medial = inside of the ankle; lateral = outside of the ankle.
do you have a similar history? any recent changes in shoes, or surface? any specific position of your leg that causes more pain than the other, eg pointing your toes in, vs out and up?
keep me posted. would love to help
-hb
Take a pic of you pointing to exact area of pain.
Carrie
Hasan and Carrie thanks! I will attach photos pointing to the area of most discomfort plus the other ankle as comparison. Again sorry for the quality of camerawork. The iPhone isn't the best camera.
For the questions:
The tenderness is the area around the ankle bone. Almost like a smiley face underneath the bone. That is the area of most tenderness.
It does not radiate anywhere. The pain is greatest as I land and load for the next stride. At that point the pain is mainly localized just below and forward of the ankle bone.
I stopped in my local running store today to show my guy there. His comment was that I have pretty bony feet and ankles and could definitely see the swelling on the medial side of my right ankle.
I have no history with ankle pain. I remember spraining my ankle once in college, but that was years ago. Have never had any issues healthwise from training.
I have been running in Newtons for months and months. The only thing i can think of differently is that I have a 2 month old pair of K-Swiss shoes that I run in once a week, typically an easy run. I did run in them Sunday, the day before I woke with the pain though. Nothing new in the surface, same old boring routes.
I am not getting any change in pain by pointing toes anywhere.
Bad ankle
Good ankle
Thanks all!
Hey P, 2 pairs of shoes. Newtons I would say I bought in April. K-Swiss bought about 2 months ago. I try to run my easier runs in the K-Swiss and harder in the Newtons. Maybe not the best of plans but had seemed to work well. As for increase in mileage, not really that much. I'm in the 7th week of the marathon hack where the long run was supposed to be 16 miles. Haven't had any issues prior to this week. In the weeks preceding starting marathon training I would say at a minimum I was getting in 12-15 miles with a max around 20.
Are you an over pronator? I am picturing your ankle rolling and causing stress to the medial side maybe? Strange that it did not hurt day of long run. But pain the next day. Makes me think inflammation settled in overnight. If it were a stress fracture you would have had pain in the long run. So no there. Sprains and strains and tendonitis can present itself later, delayed onset. So I am guessing it is one of those.
For now to treat the symptoms. Ice like it is your job. Coban wrap around ankle during the day and wear shoes with some medial support. Your calves may be tight and the ankle is rolling more to get more dorsiflexion ?? I am just thinking out loud here.
Someone else chime in. Just trying to brainstorm.
Post tib tendonitis?
Sprain medial ankle?
Maybe arch collapsing, ankle loose in medial ligaments causing instability like in your single leg squat?
Ok, will wait for feedback.
Carrie
tucker, a couple of more questions:
how much do you weigh? age? any inserts in the past? what kind of foot do you have, landing - midfoot vs hindfoot?
WE're definintely onto something here;-)
-hb
I have flat feet, and yes it looks like my feet roll in when I stand around, walk and run.
Weigh 193 and am just about 6'2". 35 years old. No inserts at all.
My footstrike is more mid to fore foot. I actually when I bought the K-Swiss the guy told I was way up my forefoot when he watched me run.
Thanks again all.
Tucker,
look slike what everything you said is pointing towards a diagnosis of posterior tibial tendinitis. what does that mean? you have an inflammation within the posterior tibial tendon, which runs in the area of the inflammation. It actually helps in 2 ankle motions: plantarflexion (moving ankle in the plane away from body as if pushing on gas pedal), and inversion, as if pointing toes towards the other foot.
another simple diagnostic test would be to try resist those 2 motions (ask somebody to help you out), and it should elicit similar pain.
risk factors specific to you: 1. FLAT FEET 2. FLAT FEET 3. FLAT FEET. ironically speaking this is the only time when forefoot/midfoot landing is bad, but please don;t do anything to change that.
,being a bit on the heavier side for a runner (I'm there with you btw!!!!
solution:
immediate: RICE - rest, ice elevation, antinflammatories.
however, we do not just want to mak the symptoms, but prevent recurrence. arch supports are a must. not only in your running shoes, but also in ALL your other shoes; remember, even if you are not running, you are still putting stress on that tendon with every step, and you want to try to give it some time to heal up/
please keep me posted of the results of the last diagnostic test. would be interesting to know if that is the definitive diagnosis ;-)
sweet job with your differential, I guess we were both exactly on the same track.
And Hasan, you trying to say I'm fat?
Ooops. did i really write that?
I better start running.....
and btw, I want to shed my weight for one reason to get faster - apparently in the 2000 South Africa Ironman, weight was the single most factor which affected final time in the Race!!!! yep, believe it....
And hey, ankle feels great after icing. Who would have thought? Or is it the beer.....
So what does that tell me?
I have been doing RICE. What else should I do? I'm guessing no running but is cycling ok? Should I go see someone local? You mentioned arch supports. Do you mean custom orthotics? I have a mess of running shoes that are stability shoes but the last time I ran in them they didn't make me feel so good.
Thanks Hasan!
start off with your ankle pointing down, and your toes pointing AWAY from the other foot as much as possible. have somebody put their palm on the inside of your foot, so that it pushed out maximally, and you will try to point your toes towards the other foot, resisting the motion of the palm of the examiner. it is imperative that you start off with the ankle plantarflexed (gas pedal position), and the feet pointing away from midline.
RICE is probably all you need for now. gradual return is what you need, for both cycling and running. swimming, you can do, but no breast-stroke.
ORTHOTICS: no need for sutom-molded orthotics; all you "might" need is an over-the-counter arch support (and this is more important in your regaular shoes). Although there are no published studies documenting the efficacy of orthotic devices in the treatment of the various stages of your condition, there is certainly a population of patients who report a decreased level of symptoms associated with the use of such a device. It's worth the try!!!!!
Running shoes; please don;t change the shoes that you've been running in, especially into something that you don't feel comfortable.
One last question, did you grow up all your life with flat feet, or is it more of a recent thing? how does the "flatness" of your right foot compare to the other side? it'simportant to keep a mental note of what it looks like now (maybe even a picture). flatfoot can progress in a certain population of patients with this syndrome.
please keep me posted.
It's my pleasure helping out fellow ENers!!!
keep me posted
-hb
Will stretch it out thanks.
Always had flat feet and according to the guys in the running store I really collapse in while standing.
Arch supports purchased.
So are you telling me that I should not run a half marathon on Sunday?
Sorry to hear about the ankle, Tucker. You definitely score bonus points for getting the inside swollen like that without an injury! It's either inner joint irritation (very possible to grind the bony surfaces and damage cartilage if your stride is off or your rotating your foot- which won't hurt until something breaks down so you may not notice it) or muscular. There are three major tendons that wrap around behind that inner ankle bone so any or all of them could be irritated and swollen (the post tib is one of the three). Either way, it doesn't change the immediate treatment. Things need to loosen up so that you can see exactly what is happening on the joint front.
So time to talk treatment. personally I would say no to the 1/2 on Sunday and to keep your eye on the November race.
That being said, time to call in the cavalry. Who's in your area?? Time to find a graston person (http://grastontechnique.com/LocateaProvider.html) or hit up a sports massage/ART person (http://www.activerelease.com/index.asp?) ASAP. You've got some work to do as far as loosening up that area. If you're lucky, there's a PT or chiro who's specialized in one or both of these. A PT will also be able to tape up your arch to provide relief there. I just don't know northern Jersey well, so you'll have to do some google searches and see who's in your area and what they have. Most clinics have full websites now.
The treatment goal for either is simple- get full mobility back in your calf and the inside of your lower leg. At home you should be rolling out your calf and following it up with gentle stretching. Ice ice ice. Multiple times a day 10-15 minutes. Break out your compression sock as well and make sure you're wearing that to work everyday.
As far as the arch supports and orthotics...until things loosen up, save your cash. Throwing all kinds of arch stiffness into an inflamed area won't feel great and won't be an indicator of what you'll need later when things are feeling better.