Monday, November 30, 2009

A Big Pain In My ... Ankle

Ok, there's been way too much pablum about running sleeves on this blog lately. Time to get back to more important topics, like ME! ;)

I have been dealing with foot pain since Hundred in the Hood in late September. For the first few days, I believe it was my right peronus brevis giving me woe. In fact the pain at the base 5th metatarsal was so bad, I wondered if I had actually fractured it. But five days later, it was good as new. And when I started running again it didn't hurt at all. What did hurt was the inside of my right ankle. But I just kept running and it too went away only to be replaced by a mirrored injury on the left. Same injury, same treatment, right? So I just kept running, thinking it would go away in time, but it didn't. Once warmed up the pain subsides, so I could run on it okay, but after the run, it would hurt a lot.

Finally, I admitted it was time to do something different. So in the beginning of November I took eight days off - really OFF - no running or even cross training. But at the end of eight days, things didn't seem much better, so I did what any ultra-runner would do: I said, "Screw it!" and started running hard again. But I am certainly not ignoring the injury. This is my Plan of Attack:

1)Web-Based Learning: The first course in medical school is anatomy; it makes up the bulk of the first semester. The concepts involved are ridiculously simple, but the volume of info is over whelming as the student is challenged to learn all the muscles, origins, insertions, innervation, and blood supply along with all the other organs, bones and ligaments in the body. By the time we got to the last section - the lower leg - my brain was saturated. Plus, it never had its own exam, just 10% of the final, so I crammed just enough to get by. So my foot anatomy was tenuous to begin with and 15 years of disuse didn't help, so it was time to turn to the source of Knowledge of all things good and evil: the Internet! I've been brushing up on my anatomy these past few weeks.

2) Special Exercises: From the internet I got some special strengthening exercises. They hurt like Hell, so I figured they must be working. By the third day, I couldn't take it anymore so I went back to the internet. I think my original diagnosis of posterior tibialis tendonitis was wrong; now I think it is the anterior tibialis tendon. As much as I hate being wrong, this made me happy as PTT sounds catastrophic leading to foot collapse and tendon rupture, but ATT is basically just the tendon version of shin splints. This makes more sense, too, as I had those big goose eggs on my shins after HH. So I am walking on my heels some, but mostly I stooped the special exercises.

3) Shoe Inserts: A lot of the web stuff talks about orthotics for ankle tendonitis. I had orthotics made in the spring but never used them because my issue was drug related and not due to bad biomechanics. So I got out my orthotics. They blistered the arches of my feet so badly my skin looked like bubble wrap. I let them heal, taped my arches and tried again - more bubble wrap. So I put the othotics in my slippers for walking around the house and taped little foam arch support "cookies" in my shoes. Seems to help a bit.

4) No Cute Shoes: High heels are a no-no, so my cute shoes are all hibernating for the winter. Just flats and old lady clogs (Dansko's) for the time being. Oh the sacrifices for running!

5) Barefoot Running: It's not like I was looking to let out a primal scream as I tossed away my shoes to run like my Neanderthal predecessors, but it did seem pretty obvious that my foot tendons were my "weakest link. " So I was ready to buy into the hype and give it a go. The first day a half mile felt pretty good and I was encouraged. The second day a mile didn't seem all that wonderful. My third try was after some intense intervals. My ankle hurt like crazy when I took off my shoes to run. So I gave that up.

6) Seek Professional Help: Obviously, I have no idea what I am doing (see #1-5 above!), so at long last I have admitted defeat and called the physical therapist. I have an appointment Thursday.

Despite the pain (again, mostly after a run), I am running pretty well these days and even hit 70 mpw last week and am aiming for the same this week. So if the PT doesn't have the answer, I'll just continue with my awesome home remedies. ;) Also, let me know if you know the "cure" for anterior tibialis tendonitis, as I am obviously open to trying many different things.


Alaskan Assassin said...

Hope you get feeling better.

I am taking your advice and still am planning on running the HURT.

You have had a breat year so far. Take some time to heal up.

Alaskan Assassin said...

great year. I meant to write great year. I need to proofread.

SteveQ said...

I tore all the tendons in my ankle at the same time (well, one led to another... but all in the same 50K). There's two approaches: 1) Stop running until it's healed. 2) Ignore it. I chose the latter, as all the tears but one were minor, and I got lucky.

Wish there were some miracle cure I could suggest.

Goes On Runs said...

pam. just found your blog. this is kathy adams (sweet). i too have found running after having babies... but not like you. i am way blown away. how fun to see what you have accomplished. it will be fun to see the training for western states. :)