tenosynovitis treatment

baprince

After a few weeks of rest, I finally got a diagnosis of tenosynovitis in my foot.  I've been doing all the OS bike workouts, but I haven't run in weeks.  Since my foot doesn't hurt on the bike, I assume I'm not making things worse with these workouts.

My ortho doc, wants me to get back into running slowly 1' on 2-3' off, but right now, the pain isn't diminishing even with rest.  I'm happy to do the workouts his way, but it certainly won't make me any faster, just healthy.  Has anyone successfully treated this condition more aggressively (PT, meds, etc)?  Any guess on how long it will be before this goes away with just rest?

Carrie Chavez

I need more info to help you. Where exactly is your pain? How was the diagnosis made- MRI? Besides rest- what are you doing for it? What part of running hurts it? What caused it?

Carrie Chavez

With tenosynovitis- the inflammation in the tendon causes the sheath around the tendon to stick to it. Then the tendon can't glide in the sheath. This needs to be freed up manually with hands on release.

baprince

Thanks Carrie. Yes, diagnosis from x-ray followed by MRI. I (and more importantly the doc) could clearly see the fluid around the tendon. I'm pretty sure it is the posterior tibial tendon, and I feel the pain right above the arch in my foot. (I don't have access to the MRI image or I'd try to post it).

I would describe the pain as kind a dull ache. With a couple days off, the pain basically goes away, but after a run it gets worse for a day or so. I ran through it for a couple weeks, but as it didn't get better, I decided to give it a rest. After 2 weeks off, I ran moderately hard on Thanksgiving morning, and with the pain the followed I've been off running since. Right before I did the xray, the doc pressed on the spot where I have the pain and that caused pretty intense pain for at least an hour or so.

I'm not sure what caused it. I had no issues training for an October 2 HIM (switched to Newtons in July) after a May Marathon and July Oly, and the pain started as I started the Nov OS. My guess is the cause is "overwork" from OS, but the volume and intesity of the first few weeks didn't seem like they would have caused this issue.

It has been a couple weeks since the MRI. I was thinking of having the doc prescribe PT, or I've heard of some steroid treatments. Thanks for any advice.

Carrie Chavez

I would go see someone who can free up your calves and feet, assess your shoes, running form and look for other areas of restriction up the chain: hip, knee, back etc. Don't wait. I am bummed you have waited this long to see someone who could get their hands on you. Do you have a trigger point kit?

A Physical Therapist with manual skills, a chiro with manual skills, deep tissue / ART, a clinician who knows Graston, a massage therapist. All good options.

Don't delay. Use insurance for what they will cover and then go out of pocket. It will be worth it.

baprince

Thanks Carrie. I'll start treating this more aggressively.

baprince

Quick update: went and saw a chiro with ART training yesterday, and I'm already feeling better. Got out for an easy run this morning, headed back to the doc again tomorrow. I'm looking forward to getting back to OS workouts.

Nemo Brauch

I had this many many years ago. Rest was the first step and then manual therapy like Carrie describes which in my case also included electro-accupuncture therapy. It's likely an overuse injury and as Carrie says- you gotta fix the whole chain and figure out where the weakness is which caused this to happen in the first place or you'll be back to square one pretty quick. Good luck!