Ankle Pain

[HillSlugger]

I've been biking 4 days a week and running 2 days a week. I felt fine after yesterday's run but later in the morning my right ankle started hurting me. The pain is worst when I'm walking, eases up when I'm standing, and pretty much goes away when weight is removed from that leg. It doesn't hurt/feel the same every time and sometimes seems to start as almost a twinge. It eases some if I stretch out the muscles or shake out the leg. I'm guessing that it's some sort of muscle thing and not bone/joint or ligament. It felt OK for cycling this morning.

Any idea what I'm dealing with? Is this something I need to see a doctor for? Should I completely rest it, or just lay off the running?

Thanks, Nicole

[Offthegrid]

Sorry to hear you're in pain. It stinks when you like to be so active.

Is it swollen?

I might try the r.i.c.e. deal for a few days and if it didn't get better I'd head to a doc. But take it easy in the meantime.

[HillSlugger]

Sorry to hear you're in pain. It stinks when you like to be so active.

Is it swollen?

I might try the r.i.c.e. deal for a few days and if it didn't get better I'd head to a doc. But take it easy in the meantime.

It doesn't seem swollen.

The pain feels almost like a burning and radiates down the outside of my foot to the arch area.

[Velobambina]

I had a bad case of tendonitis in my right ankle this past Fall when I added too many miles (running) too quickly. I did some rehab exercises that I found in Jennifer Rhodes' book -- sorry can't remember the title, but it's an excellent anti-injury handbook (Peak Fitness? something like that). Plus, I wrapped it in an ace bandage, stopped running, and took advil. I kept riding, though. It took about 2 weeks til it got better. I'm still doing some of the rehab exercises to keep my ankles strong and I'm back to running with no ankle woes.

[makbike]

Nicole, it is possible you have a good old fashion case of tendonitis? I've had two cases of in my left ankle the past two riding seasons. It appears, after my recent bike fitting, that each case was due to three things, incorrect cleat placement, incorrect seat placement and the simple fact that my left leg is shorter than my right leg causing me to hyperextend my left leg/ankle.

To treat both cases my chiropractor had me ice the area 5 -6 times a day, use some gentle stretches. Also, this year my foot doctor added some arch supports to my inserts along with a low dose of an oral antiinflammatory. I was told it was okay to keep riding as long as it did not hurt while on the bike.

Hope this helps and your heal quickly.

[KnottedYet]

It doesn't seem swollen.

The pain feels almost like a burning and radiates down the outside of my foot to the arch area.

Is it in the shin area (inside or outside) too?

sounds kind of like the "stirrup" of muscles and tendons that hold up your arch and the critters in the bottom of your foot are getting grumpy.

what kind of insoles are you wearing in your running shoes? Superfeet? 10 Seconds Stablilizers? Playmakers? Custom orthotics?

If they are off-the-shelf, you might want to have a podiatrist take a peek at your feet. If they are custom orthotics, your orthotist should be able to adjust them without charge or at very minimal charge. If you are just using the insole that came with the shoes, please consider going to a very reputable shoe store (call a podiatrist's office and ask who they recommend) and getting decent insoles. Superfeet or something similar. The person selling the insoles should look at your bare foot, then look at your bare foot standing on the insole, then watch you walk with the insole in your shoe. If they just hand you the package and try to ring you up, find a better shoe store.

And please DON'T get the heat-molded "customized" Superfeet. (REI often sells them) They just mold your grumpy foot and force your foot to maintain that grumpy position every time you take a step. Get neutral footbeds. The only person who should be molding anything to your grumpy foot is an orthotist or podiatrist.

Are you wearing really good running shoes? Do you need new ones?

[HillSlugger]

Is it in the shin area (inside or outside) too?

sounds kind of like the "stirrup" of muscles and tendons that hold up your arch and the critters in the bottom of your foot are getting grumpy.

what kind of insoles are you wearing in your running shoes? Superfeet? 10 Seconds Stablilizers? Playmakers? Custom orthotics?

If they are off-the-shelf, you might want to have a podiatrist take a peek at your feet. If they are custom orthotics, your orthotist should be able to adjust them without charge or at very minimal charge. If you are just using the insole that came with the shoes, please consider going to a very reputable shoe store (call a podiatrist's office and ask who they recommend) and getting decent insoles. Superfeet or something similar. The person selling the insoles should look at your bare foot, then look at your bare foot standing on the insole, then watch you walk with the insole in your shoe. If they just hand you the package and try to ring you up, find a better shoe store.

And please DON'T get the heat-molded "customized" Superfeet. (REI often sells them) They just mold your grumpy foot and force your foot to maintain that grumpy position every time you take a step. Get neutral footbeds. The only person who should be molding anything to your grumpy foot is an orthotist or podiatrist.

Are you wearing really good running shoes? Do you need new ones?

My shoes are ASICS Gel Evolution II, new in October. I've been running with whatever insoles they came with. I went to a good running store and was told I was an over-pronator which surprised me as I have decent arches.

I started on ibuprofen, every four hours, on Tuesday and did the full R.I.C.E. treatment last night. Something seems to have worked since my ankle feels much better today. I will definitely skip my Friday run, but I'm not sure how much extra rest I should allow before I run again.

I know that insoles can cost quite a few $$ but I guess it's a good investment towards my long term health. I typically add extra arch support to all my shoes.

What about going back to the running store for insoles?

[Velobambina]

I got my Superfeet insoles (the ones that Knotted mentioned) at Pacer's in Clarendon, where I purchased my shoes. They are the green ones and cost about $35. I, too, am an overpronator and even though my shoes are the "motion control" type, the insoles made a difference. They were worth the money. :-) Good luck!!

[aicabsolut]

Sounds like your peroneal muslces and tendons (outer calf muscles which become tendonous at the ankle and foot). One runs down the outside of the foot and attaches to the 5th metatarsal. The other runs under the arch at the back near the heel and ties in on the bottom at the inside of the foot. If they're too tight or inflamed, you might be able to see them protruding just under your outer ankle bone and maybe a little farther forward towards the 5th metatarsal.

Usually the inner ankle ligaments are the strongest (like the deltoid ligament), and it's not uncommon to have peroneal weakness. You can help it with physical therapy exercises, massage and/or ultrasound, nsaids, rest, and icing. Sounds like you could also use more medial arch support for that foot as well to keep those outer muscles from getting strained.

Kind of funny that running is doing this to you, since cycling lights mine on fire in my right leg from time to time. :rolleyes: .

[HillSlugger]

Biking isn't bothering my ankle at all (did 24 miles today). I'm going to skip another run this week and try again on Friday.

I did the R.I.C.E therapy during the first 48 hours and am now continuing the ibuprofen.

I went to the running store and bought some green Superfeet insoles. I had a tough time deciding between green and blue. The arch support felt good in both. The deciding factor was that the blue's were thinner than the existing insoles and made the shoes feel too loose.

If I have problems again after running on Friday I guess I'll go to a sports medicine doc. :(

[KnottedYet]

I have lovely arches, but I also over-pronate. I found that wearing the Superfeet all the time in all my shoes made the most difference.

The nice thing about wearing them in all your shoes is that your feet/ankles strengthen themselves while wearing the insoles. And they are strengthening in proper position.

If you have a true structural dysfunction (as opposed to a muscular one) plain neutral footbeds like Superfeet won't solve all your problems. You might need "posted" footbeds or orthotics. I used to do posted footbeds for a podiatrist's patients. If the posted footbeds didn't solve the problem after 3-6 months (with PT, too) he wanted them to come back for orthotics.

("posting" is just wedges and lifts that are gummed on the back like stickers, and the PT or podiatrist sticks 'em to the underside of the Superfeet. If after a few weeks you hate them, you just peel 'em off. No harm done. $15 down the tubes, though.)

[aicabsolut]

My physiotherapist did that on top of my ancient molded gel orthotics. The original wedges were getting mashed down so she stuck some new stuff on top and tried a few other things. Much easier to change that than it is for me to deal with my completely useless pair of epoxy-like hard orthotics which can only be ground down so far and adding on is tricky.

[Brandi]

It doesn't seem swollen.

The pain feels almost like a burning and radiates down the outside of my foot to the arch area. Google bone spurs. They can cause that kind of pain you are talking about. I have read that calcuim helps. If you are not getting enough the body will leach calcium from your bones causing bone spurs. They are hook shaped lesions. I would take time off from running. You could try biking and see if it hurts it. At least biking is low impact. I am going to the dr's today for foot pain.

[HillSlugger]

I had a few twinges of discomfort while running errands on Saturday but everything feels good since. I will try running again on Friday and hope that the insoles will make a difference. I'll let you know how it goes.

[HillSlugger]

I got out this morning for my first run since my ankle pain on Tuesday 1/2. I added Superfeet green insoles to my sneaks hoping that will solve the problem. I have no ankle pain but halfway into my run I felt like the inner arch edge of the insole was stabbing my right foot. Now I have a blister. Not sure what to do now :( I've got lots of time to my first triathlons but right now, between feeling inept at swimming and my foot/running problem, I'm feeling like the Iron Girl (or any triathlon) is a crazy dream and that I've wasted my registration fees. :( :(

[Offthegrid]

First, the Superfeet take a while to get used to. I only wore them a few hours at a time to start.

But I think you should get thee to a podiatrist or sports doctor. A little investment now save you a lot of pain later. I suffered with shin splints and heel pain for weeks when I did my walking program last year, chalking it up to being fat and out of shape. But when I finally did see a podiatrist, $20 foam orthotics took the pain completely away in less than a week. (I've seen been unhappy with the custom orthotics, but that's a whole other story.)

[HillSlugger]

I think you should get thee to a podiatrist or sports doctor. A little investment now save you a lot of pain later.

I've made an appointment with a sports medicine/ankle & foot guy at the practice that took care of me years ago when I tore a ligament in my thumb. Unfortunately, I can't get in to see him until a week from Tuesday.

The green Superfeet insoles are not quite as wide as the shoe itself. I guess that's why I was feeling the edge of it. I'm going to put the original insole back in and see what happens between now and then...

[HillSlugger]

I'm going to put the original insole back in and see what happens between now and then...

I did a two mile run today (after an 11.5 mi ride). No ankle pain, just the "normal" stuff I usually feel after a run. I guess that's good news.

[HillSlugger]

Well, the doctor says that my problems stem from my over-pronation (worse in the right foot) and that going with an arch support insole was the right idea. Unfortunately, it was too narrow for my foot. So, I've agreed to a custom orthotic. Does $400 sound like a decent price? With my insurance apparently it's about 50-50 whether they'll cover the cost. If they won't, I guess that's why I have a medical flexible spending account. My feet and health are worth it. :rolleyes:

[KnottedYet]

The place I work charges $375, so $400 is probably ok. Be sure to take the Superfeet back to the store that fitted you and tell them they are too narrow. The person fitting you should've checked that. Wouldn't hurt to ask if they carry wider ones of a similar nature to use until your customs arrive. (it takes us about 4 weeks to get the customs) Ask your doc how long it will take.

Feet are precious! Money spent on good shoes and the right insoles/orthotics is money well spent in my opinion!

[HillSlugger]

Forgot to mention that the doctor also suggested icing my ankles after each run.