If all that is true, consider getting and extender plate for your cleat or at the very least move your cleat as far back as possible and see what helps. Also if it is tendinitis a specific active approach is best.
I have only seen this (pain with cycling) in very acute running achilles tendinitis and usually move cleats proactively with chronic injuries (non-symptomatic on the bike). A differential diagnoses is key as you describing a suspected “subtalar tendon injury” is a bit of a tell. Good luck.
I’m currently coming off of postibial tendonitis as well. For me, the pain was caused when my foot pronated. A quick fix is custom orthotics (which got me through IM Boulder) but those are just a bandaid and not an actual solution to the underlying problem.
The way I am getting over this injury is: time off of running, taking calf stretching seriously (after a 10-15 walk, swim, ride), doing foot crunches and a bunch of other “calf” muscle strengthening exercises. I went from serious pain while just walking to no pain in 2 weeks and have 2 more weeks of strengthening and stretching before I run again.
What are you currently doing mobility wise for this?
PM me if you would like my strengthening routine which is another website my PT recommended.
Trail running greatly aggravated my PTT as well. Cycling on the other hand never really caused pain.
Its funny you mention that because I have some hip imbalances as well. The best resource I have found to address these for running is Ready to Run by Kelley Starrett. As much strength training as I have always done (with an assumed proper form), it was surprising to know that a slightly lopsided kinetic chain can cause such large problems when you ramp up the mileage.
I have issues with that tendon too, which used to be aggravated by cycling before I switched to a midsole cleat position. They still bother me when I run, and when I MTB with a front-placed cleat. Orthotics helped a lot with running, although it still is an ordeal.
Nice to see the other fixes too. I’ll have to give those a shot.
Other thing that helped for me was dry needling. I’m very skeptical when it comes to anything along those lines, but I feel like it may have been one of the things that helped me be able to run.
I was diagnosed with a stage 1 partial PTT tear based on an MRI and symptoms back in October 2014. Probably caused by running and increasing miles too fast. First noticed symptoms back in summer 2013 - by the time I went to doctor, tendon was noticeably swollen. No surgery (thank God) but lots of PT and about 4 months of time off from work via disability. Finally got so sick of sitting around doing nothing that I began to experiment with cycling (running was out of the question). At first, cycling was painful, but I figured out that if I could take my foot out of my cycling shoe first, then remove the shoe from the cleat, it really helped in not aggravating the tendon (twisting my foot out of the cleat with the shoe on was painful for the tendon: that twisting motion was no bueno). It was my left foot, so once I clipped in at the start of a ride, I stayed clipped in until I got home. Also wore a rigid night splint every night for months, and tried to refrain from too much walking. I was eventually able to ride 200 miles/wk, and lose quite a bit of weight and increase fitness. Happy to report that symptoms are now gone (walked for hours at the county fair last night with no problems) but I doubt I’ll be doing any serious running any time soon. It’s a tough injury in that there’s no miracle cure, and surgery is an iffy proposition, with no promises for success. The best treatment is rest and PT, which can take months and drive a normally active person crazy. Give it some time to heal up, then ask your PT or doc if it would be ok to start limited cycling (be conservative, start small and gradually add miles). Cycling is probably the safest activity you can do, and it worked for me, but take it slow, and make sure it’s ok with the doc/PT.
I started getting PTT in about 1989; I was 24. I tried soft orthotics, then started making rigid orthotics for myself. I wound up getting a credential called a Certified Pedorthist just to learn about orthotics, and I also briefly made rigid orthotics for others.
What I learned and my personal experience: Ice works great, as does compression just above the ankle. (I buy 1-2" waistband material from sewing shops, cut it to about 1 yard long, and use it as a wrap when PTT flares up. I wrap my lower leg between the bottom of the calf and top of the ankle.) Rigid orthotics are a must for me, both in my running shoes and cycling shoes. Without them I got to where I could only run a few miles, 1-3 days a week. With them, I’ve ran sustained periods of 100+ mile weeks. Rigid orthotics do not work like most people think; in fact, just the opposite. They do not “prop up your arch, allowing muscle atrophy”. They in fact work by being uncomfortable if your foot comes in contact for them for any sustained period; usually causing blisters that are only avoided by good (non-pronating) form. They are a constant and painful (literally) reminder to adjust form to prevent pronation. Some people will only need the orthotics for a short period. But others (like me) need them forever.