Ankle Pain

[Neil_D]

Hi Docs,

Well, I thought I'd come here to see if the vast knowledge base at BRS can help. I've developed an ankle pain on the inner side of the right leg. I can't remember the first time I was aware of it but it must be over 5 weeks ago.

I've been running on a reduced schedule and had a 5 day break then went on a 14km run yesterday and the pain was there most of the way but not enough to stop me running.

The ankle is swollen around the bone area but I don't feel any pain if I press around with my hands. I feel the most pain decending stairs when I take my weight on the joint.

I've been barefoot running now for over 2 years and have clocked up around 1800km or more so it is not a transitional type problem. It's the first 'real' problem that I have had.

I'm wondering if it is the tendon that wraps around the ankle that starts in the calf and ends on the upper part of the foot. I may have over-stretched it while at the gym doing on of my squatting calf stretches. After reading the article on stretching offering no benefits and may be counter productive I'm wondering if that has anything to do with it.

Currently I'm icing it and using a compression bandage and resting, any ideas would be welcome.



Regards

Neil

 

[Dr. Andrew Klein]

Hi Neil,I'm assuming the

Hi Neil,

I'm assuming the pain is behind the ankle. The tendons for the toe flexors as well as the posterior tibialis run behind the bone and under the foot. It sounds like you have developed a tendonitis in one or all of those tendons. When you descend stairs you eccentricly load those tendons and cause them to strain giving you pain. There is also a nerve that runs along with those tendons called the posterior tibial nerve. It is important to get the swelling down because you can eventually damage that nerve, though it is unlikely since you have been BFing for as long as you have. Continue with the compression and massage the structures out daily, including all of the calf, anterior shin muscles, and the bottom of your feet. I use a rolling pin to do this. Icing should not be necessary any longer unless you re-aggravate it. Rest a little longer too, and start back with shorter runs. 14K was probably too long.

Good luck and let us know how you are doing.

 

[Neil_D]

Hi Andrew,Thanks for your

Hi Andrew,

Thanks for your input there.

The ankle is still puffed up, sometimes it is hard to tell as it right around the main lower leg bone (the one that you see as the ankle). There is no under foot pain, just on the inner side of the ankle, when decending stairs

As I mentioned, I'm really not sure how I did it, it could have been any of the following: Stretching at the gym, running downhill or a severe cramp I got in my ankle.

I've started on anti inflammatory tablets and am using a compression bandage.

I can't feel any pain when probing around the ankle, there is no soreness in any tendons but I can feel it if I try one leg balancing or doing small jumps.

I went on a short 4km test run along the beach over the weekend and could feel the pain, not severe but it's there. I'll continue with the rest and see how it goes over the next couple of weeks.

Many thanks.



Neil

 

[Neil_D]

Hello Andrew,I still have

Hello Andrew,

I still have some swelling in the tendon. I did more research and believe you hit the nail on the head with your diagnosis.

At first I thought it was a sprained ankle but I couldn't think of anything that would have triggered that. I am now leaning towards the theory that it was the leg exercises I did at the gym after coming back off holiday that were the root cause.

I did some calf dips and hamstring deadlifts which gave me really stiff calves for around a week. I still ran even though I was not happy with my form. In hindsight I think this was the cause of the tendonitis. I had hoped the running would have eased the calf soreness.

When I first felt the tendonitis I then had the great idea of going to the gym and repeating the folly, more deadlifts and calf dips and again ran with stiff calves, that's when it really blew up.

Since last time I have been on minimal running, only around 15km per week. I've ordered some KT Tape to support the area when not running.

The pain has lessened but is still there.

Regards



Neil

 

[willow1484]

It could be an

It could be an impingement...I have one of these, just got an MRI done and may end up having to have it cleaned out. Only hurts if I step wrong on the joint and all my weight is put on it, or if I hop down off something. Otherwise, no pain in the lsightest. Hopefully you figure out what it is.

 

[Deleted member 217]

It could be a small tear or

It could be a small tear or thickening to the posterior tibial tendon. Generally, tendons take 6 weeks to heal. I would try massage and do some range of motion exercises - if you rest completely, you risk the tendon becoming thick with scar tissue.

 

[Neil_D]

Hi Doc,I am doing ankle

Hi Doc,

I am doing ankle rotation exercises, I have to be careful as sometimes it will go into a cramp spasm. I have been doing barefoot walks of around 7km without problem, it is only when I run that it becomes an issue. I am awaiting the arrival of a portable ultrasound unit I've purchased to see if I can speed up the recovery and reduce any scar tissue. It still appears to be swollen but that may be the thickening you mentioned.

Many thanks for your help.



Regards



Neil