I did an Iron distance in early September. Took a few weeks off. Started running again - never got up over 30 miles per week though. Ran a 5k in October and destroyed my left calf. Took a week off and let it heal. Started running again - once again did not make it up over 30 miles a week. Developed an annoying and eventually painful injury in my left ankle. Diagnosed with Posterior Tibial Tendinitis. I was prescribed prednisone which did absolutely nothing for it. Then I started taking mobic 15mg/day and have been on that for the last 1.5 months, which obviously has not helped.
I have been cycling and swimming (does not cause pain), but absolutely no running until a few weeks ago where I started out at 5 minutes and have progressed up to 20 minutes over a 4 week span. (3 runs per week) Once again, that annoying pain is coming back and it is driving me insane. Literally, I think I am going crazy over this injury. I just want it to go away so I can start running again and get into some real training for the upcoming tri season.
I am willing to try anything at this point to make this injury go away as it has been lingering since October and I have not been running on it.
Does anyone have any thoughts about have a cortisone injection for this injury? I might also try a medrol dose pack (which is similar to prednisone, but seems to work better for me). Or, a friend has told me about toradol, which is a potent anti-inflammotory used heavily by NFL players.
Any thoughts or advice would be greatly appreciated. Thanks!
If or prednisone didn’t work, the Medrol dose pack likely won’t either (especially if just 4mg pills x 30 over 5 days).
Nothing special about Toradol - just an injectible NSAID (prev oral doses rough on the GI system and not available any longer I think).
Have to be real cautious about a steroid injection around the PT tendon. Although likely helpful (and it probably would be), it can also weaken the tendon and presumably in a type-A triathlete, you will get right back into running/training when feeling better. A bad combo. You are describing PTTD (posterior tibial tendon dysfunction) which is a real pain and is treated on a continuum depending upon where in the timeline you area.
I’ve been struggling with a Post tib injury for about two months. I worked with a PT and had some success with that. I injured it after trying to transition to 5-fingers two days after a PB half marathon. Whoops.
That said… Two weekends ago, I ran Goofy, and had success with KT Tape. My pain was in my arch, but it’s the same tendon, so I’d imagine the tape job is much the same. KT has a new kind of tape out which does not split in two and is stronger and more adhesive. I tried this for Goofy. Worked like a charm. Everything else hurt, but not my feet! Link to new tape: http://www.kttape.com/store/KT-Tape-Pro/
Welcome to the club. A bigger club than I thought.
I too injured my right PT this past September. Did the typical mistake too. Not enough rest then running too soon. Put me back to square one like where you’re at.
Impatience was my undoing. I was doing the RICE but also at the same time stretching and strengthening work. IMO a mistake. Once I got the sympoms under control, then I started the streching and strengthening. In other words, don’t undo the healing. What seemed to really help me was to get really serious about the icing. Volume, not intensity. Ice baths at 46F, not 34F. At those higher temps, was able to keep the entire foot immersed for 15 minutes a time. Kept repeating through the day. Hit totals of up to 2 hours.
Have started running. Am going to train for a 50. But lots of power walking and easy running. 50% of my weekly total will be walking at around 14:30 pace. The idea is to build the strength slowly. Once a week am doing 800 repeats at an easy “hard pace”, 8:00/.
I still get some discomfort in the arch but does not impact performance. So am up to grade one. Finally after almost 4 months, the right ankle looks just about like the good one in that when I fully point the toes out, I can see the tendon in the right ankle about just as well as the left.
Patience is the key. And there is hope. In early 2008, Constantina Tomescu Dita injured her PT. Her doctor immobilized the ankle in a cast for two weeks. Then she started her rehab then training. In that year, she won the Olympic Marathon at age 40. It was the greatest marathon I ever saw with her launching a suicide break at mile 13!.
Unfortunately, this can be a long injury to recover from … I was training for Boston, over did the intensity and didn’t transition slowly enough to a new pair of shoes (w/o my normal powerstep supports) … I basically lost 5 months of running because of it and am starting at zero this year. Had an MRI and xrays done but both came back negative. I went down the rest and PT route but wasn’t happy with the results. What ended up helping me was working on strengthening my feet by very slowly starting to run in Newtons … like <6 miles a week slow. I started wearing my 5 fingers more often and doing calf raises. I avoided the injection route on the advice of the PT and an MD as something that could potentially do more long term harm than good.
Now, that Ive got this under control, I just need to figure out to do with this Achilles pain in my other foot!
I had the same on my leg ankle when training for last year NYC HM.
I’m a severe over pronator what supposedly has caused this injury.
Except for getting more supportive shoes i’d done some PT plus stretching and strengthening.
Strengthening included some one leg standing (eyes opened\closed), heel walking, balancing on a PT balance board.
Now I run with lighter shoes than those monster NB motion control I had plus custom made orthotics.
I use the Vibram FF as a strengthening tool for my feet for 20-30 minute runs once\twice a week.
I keep stretching my calves and Achilles and I mostly run with no reminders for that injury.
My friend who is podiatrist as told me cortisone is dangerous for this tendon because it might lead to a tear.
2x the balancing. Plus calf raises. But again not until the symptoms are under control.
Went through those dark days where the thought of never running again was so ever present. But then the turn is made and hope is then there. And then to be able
to start running again, priceless.
My wife suffered with PT tendinitis for years on and off. Never really went away and the compensation led to many other injuries. I am a runner but she is the more serious one and ran D1 in college. In the mean time I suffered with significant chronic back/neck pain for over 10 years even though I was an athletic trainer and worked for orthopedics in Physical Therapy. I resolved my back pain after working with a MAT (Muscle Activation Technique) specialist (they basically address the weaknesses that are causing your body to compensate… creating stress on areas such as PT). I was intrigued enough to spend a couple years taking classes and studying hard so now I am an MAT specialist myself! My wife now runs 1:25 1/2 marathons and is pain free as long as I do maintenance work with her. She was told she would need surgery to fix it and they also tried orthotics. The inserts made it worse and create other issues as well.
One other thing. Do you wear high heels much? How much heel/toe drop off is there in your running shoe? High heels did a TON of damage to my wife’s body and I am still trying to resolve the damage that was done. She now runs in the Vibram 5 fingers or in NB MIinimus but we had to gradually work towards that. Be careful with making that change too fast if you are used to supportive running shoes… I have one client who was an elite iron man but suffering from chronic hip pain and they put her in Orthotics. She actually found out about MAT through one of these forums. I worked with her a few times (she lives 2 1/2 hours away) and taught her how to progress to less support. She now runs in the brooks minimalist version and is ranked top 10 in the world for international iron man (for her age group).