Let me preface my problem with stating that one of the main reasons I took up tri training this year was that I was tired of fighting one injury or another all the time when I was simply running alone with my 50-65 mile weeks. I suffered with ITB, achilles, and plantar problems. All were remedied quick except the ITB, but that’s a whole subject itself.
The problem i’m having now, and I can’t tell if its from biking or running because I didn’t do anything out of the norm in the last few days, is that on the outside of my left ankle starting about 4-5" above the ankle and going down over the bony prominence of the ankle i’m having pain, especially during ankle flexion (walking, heel raises, etc.). It tends to be its worst after sitting for a while. Once its warm i don’t feel it much. That leads me to believe its some sort of tendonitis. Has anyone out there suffered from this problem? I’ve been recently getting over some shin spilts which would be on the opposite side of the leg. I’m wondering if compensating caused this? Another possible contyributing factor is that I have extremely flat feel but i’ve been able to manage that with Superfeet inserts for the last several years.
Does anybody know potential causes and or treatments? I figured some slowtwitchers would know the answer.
I’m pretty sure its not compartment sysndrome because usually during activity pain gets worse with that, mine goes away; thus, I’m pretty sure its some sort of tenditis. Thanks for your help. I’m still all ears.
You can PM me if you want, but you have to specify outside of the ankle (peroneal tendon) or inside of the ankle (posterior tibial tendon) - treated slightly different (except for the rest part)
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I have had similar injuries and have spent many hours trying to diagnose the problems. The lower leg takes a beating for many runners. Especially larger runners. I am at my lightest around 185lb. Therefore I have found that I need to pay special attention to my lower legs. Find a way to stretch your calves, sloes, and any other muscles in your lower leg as best as possible. Also, look into massage therapy to help loosen things up. Consider stretching exercises as well. Besides this all the basics apply as well. Be careful not to increase volume or intensity to quickly. I believe this is personal to what each runner can handle. Go slow… learn as much about yourself as possible.
It’s on the OUTSIDE of the ankle, the pain starts above the bony prominence. it’s a diffuse pain so its hard to pinpoint. I’m wondering if it started because I may be compensating from shin splints on the INSIDE of the leg; essentially, the opposing muscle/tendon group. It sounds like you know something about this, please tell me what you think. I’m highly interested.
Google peroneal tendonitis to get you started as it is hard to dx over the net
The lateral lower leg muscle(s) work to stabilize your medial foot when running or pull it out when sitting if you fire them. People with a flat foot (like you) often have more problems with the peroneals than others.
I recently had a similar issue with the tendon on the outside of my right ankle. I felt some pain after getting up from my desk, out of bed, … The pain ran was from the ankle bone to about 4-5 inches up the outside of my leg. At the time I was training for a spring marathon and was rotating through a couple pairs of shoes. It turned out that if I used the older pair for a couple days in a row, the pain would surface the next day. After checking out the shoes, the back outside corner of the heel was starting to wear through and showed signs of the cushion failing. I stopped using these shoes in the rotation and the ankle/tendon has been fine ever since.
The weather was bad a few weeks ago so I figured I would use the older shoes for a short morning run. How bad could one short run be?! After lunch and sitting at my desk, the ankle was sore again. Those shoes have been permanently retired.
I don’t know if this has anything to do with your ankle, but mine was easily fixed. Good luck!
Well its definitely peroneal tendinitis. That’s the offcial diagnosis. So what would be your treatment to getting me back on the road? I googled it and found out lots about causes, but not much about how to effectively traet it to the point of getting over it. From past tendinitis problems I know that total rest never works. You have to actively treat it. Is this the case with peroneal? Can I still swim and bike? Besides R.I.C.E., what else do I need to do? Everyone always talks about treatment to fix the pain/effects but not how to fix the problem long-term/causes. What’s so strange this time is that i didn’t do anything out of the ordinary. No sudden increase in training duration or intensity. Nothing. I can’t even pinpoint when I hurt it. Furthermore, A year ago i was consistently running 50-65mi weeks, now i’m lucky if I run 3-4 days for a total of 30 miles. I’m not old or big. I’m 33. I’m 5’11" and weigh 165lbs.
I hope you don’t mind giving free advice to a fellow slowtwitcher I’m so perplexed and depressed.
No problem - best bet is to PM me though. First off though, peroneal tendonitis (like most) is slow to heal, sorry. Some type of rest/immobilization is going to be required - how long varies tremendously. You can likely swim though. Spinning should be fine, biking too as long as you mostly stay in the easy gears and spin. No big gear hammering, standing on the hills, etc.
I would suggest that you seak out treatment of a professional that specializes in sports medicine that also can analyze your biomechanics while running and perform muscles tests Etc. to narrow this down. rroof is an orthopod and knows his stuff that is for sure. You could try a more conservative approach to this injury using a sports Chiro for instance. They may utilize Graston technique, ART, Kinesiotape and give you specific exercises to perform to enhance the strength of the muscles that control the amount of pronation you have. the Tib. Posterior, Tib Anterior, Flexor hallicus Longus and Peroneus Longus and a few others as well all play a large roll in the control of overpronation. You stated that you have “flat Feet” and that would lead me to believe that you are a moderate to severe overpronator. pronation of the foot is what acts as a shock absorber when your foot hits the ground but with too much (overpronation) it can cause many, many injuries including: Peroneal group tendonitis like rroof suggests, anterior or posterior shin splints, ITB inflammation, lower back pain and even neck pain JUST TO NAME A FEW! I wish you the best of luck whichever avenue you choose.
