Dumb heel and/or ankle!

[sundial]

I can deal with body parts that wrinkle, sag or pooch.
I don't mind if my hair is a tad thinner.
But darn it, I hate when body parts decide to go on strike--without warning!

I've been on my mtb in Nov/Dec/Jan and aside from being a weenie on occasion, I've not had any problems. Then I get on the road bike for the first long ride of the season and I was thoroughly enjoying it for the first 40 miles. I felt strong, my cadence was 95, and my av. speed was 17.2 mph. Then out of nowhere my achilles tendon on the right foot goes haywire in a big way with pain and swelling. A lump developed in the middle of my tendon and I had to wear clogs for a couple of days because of the swelling. :eek: Funny thing is, I could stretch it and it didn't even hurt. :confused:

So I called the ortho doc Monday and explained to his nurse what happened this past weekend. She suggested I do some stretching exercises (which I have been) and to consider using a heel cup. I'll give it a try but I'm not optimistic. I won't get to see the doc until next week if it's not better. :(

I hate getting old(er). :rolleyes:

[Brandy]

sundial...I had some achilles issues last week because of some sloppy saddle swapping and bike fitting on my part. Long story short, my saddle was too high, I angered my achilles and was off the bike for two days. Lots of rest and icing and I felt better when I rode on Monday.

Could your saddle on your road bike be too high?

[sundial]

Brandy, it doesn't feel like it but I can lower it just a little and see.

[rocknrollgirl]

That is how I feel about the current misbehavior of my knee. Blam out of nowhere. What the heck....It is frustrating.

[sundial]

Rocknrollgirl, it is frustrating, isn't it?

Brandy, I lowered the seat on my bike and took it out for a ride. My achilles knot was starting to rear it's ugly head again so I headed back. I'm beginning to wonder if I am due for orthotics. :rolleyes:

[KnottedYet]

You might only be due for a medial forefoot wedge (like are built into Specialized Body Geometry shoes, or you can have put into your shoes at a shoe repair shop).

If your forefoot doesn't get the weight transfer pattern heel-toe like it does when walking, it doesn't always get set up to be a rigid lever. So it kind of collapses (pronates) throwing your foot/ankle/knee/and sometimes hip out of whack. Sometimes the poor achilles tendon will jump in at this point and try to stabilize the system. Since it really can't do that well, ya get tendonitis and other nasty boogers. (if the achilles doesn't even try, you can end up with knee pain as it is the next joint to take the stress)

A medial wedge (3 to 5 degrees) in the forefoot stabilizes and approximates a rigid lever.

Most PTs can give you a wedge of the correct angle for you, for free (billed as part of your treatment) A shoe store or shoe repair shop will charge you about $15. Bike shops sometimes do it as part of a fitting.

If you want UNOFFICIAL NOT-MEDICAL-ADVICE DO AT YOUR OWN RISK hints of how to fake a wedge with a piece of typing paper, PM me.

[sundial]

Hi Knot, thanks for the information. You're always helpful when it comes to these things.

I wear Specialized BG Sport mtb shoes with Frogs on my road bike and Tahos with BMX pedals on my mtb. I haven't noticed a knot developing in my achilles (or pain!) when I wear the Tahos, but I think I do remember having a tinge of discomfort with the mtb shoes last summer. Then of course it got really nasty on my first long ride of the season. So I'm wondering if I have to ditch the BG Sport shoes for something else? :confused: I'm going to try the heel cup thingies but in all honesty I think I will probably need orthotics. My right achilles decided to chime in with my bad right knee. :(

I was thinking about my shoes and I recall that there is one pair of Adidas that causes me the same problem. I don't have problems with Merrells.
My knot goes away usually in a day. Then when I wear certain shoes it comes back.

Ahhh, the joys of expired warranties. http://www.mysmiley.net/imgs/smile/characters/character0032.gif (http://www.squidoo.com/clearpores-review-site/)

[Wahine]

Sundial, where exactly is the knot? Is it close to where the achilles attaches to the heel or is it higher up, more like where the achilles starts if you were referencing the portion closest to the knee as your starting point? Or someplace in between? Is in more in the muscle above the achilles?

And do you have any numbness/tingling in the lower leg or foot?

And yeah, what Knott said about the wedging.

[sundial]

Hi Wahine, my knot seems to be at the same altitude (??) as the ankle bone.
When I run my fingers down both sides of the achilles, it's tender. It is more tender on the lateral side of the tendon and only rears it's head when I ride my road bike or wear a certain pair of Adidas shoes. Then I get a knot which feels like the size of a macadamia nut. I do not get pain in the ball or arch of the foot and I don't experience tingling. My knot goes away after a day or two. When I got home from cycling yesterday and really stretched the tendon, it felt like twisted rubber bands creaking together. Does that make sense? No pain, just that weird friction sensation.

I just bought Blue Spot heel cups to try and the doc wants me to wear them on the affected foot. I feel like I'm wearing a stacked shoe, lol.

I'll get on the bike in a day or so and give it a whirl again. Maybe, just maybe, the heel cup will help.

Thanks for asking and hopefully we can figure out a solution together. :)

[Wahine]

It does sound like localized achilles inflammation. Which brings us back to the search for the cause. Could be alignment (see Knott's post above), I would suggest going for a deep tissue massage to make sure there aren't any nasty trigger points in your calf that need to be worked out.

You might want to try these:

http://www.networkfitness.com/Network%20Fitness%20-%20Trigger%20Point%20Technologies%20Products.htm

If you're thinking about it I'd go with the starter set.

Is there any possibility of direct pressure on that part of the tendon causing swelling? If that's the case, it needs to be relieved.

Keep posting and let us know haw you're doing.

[sundial]

I have a wonderful medical massage therapist I go to. This will give me a great excuse to go see her. :) I wore the heel cup today but only on the right foot. Am I suppose to wear it in both shoes? The doc didn't specify in his special instructions. :confused:

Can one see a PT without a Rx?

[Veronica]

If your forefoot doesn't get the weight transfer pattern heel-toe like it does when walking, it doesn't always get set up to be a rigid lever. So it kind of collapses (pronates) throwing your foot/ankle/knee/and sometimes hip out of whack. Sometimes the poor achilles tendon will jump in at this point and try to stabilize the system. Since it really can't do that well, ya get tendonitis and other nasty boogers. (if the achilles doesn't even try, you can end up with knee pain as it is the next joint to take the stress)



You know, I wonder if this is what is going on with my knee. I had a bunion removed when I was twenty. I developed them because my foot doesn't get rigid when I walk. The podiatrist said it was a bio-mechanical issue, right up there with the hammer toes I've had since I was a baby.

Anyway, I've noticed lately that my right knee has a tendency to lean towards the outside when I ride. If I ride long enough like that, it hurts. :rolleyes: If I think about it, and keep the knee pointing inward, I've been able to make the pain go away. I call it lazy knee syndrome.

Yes, I'll be going in for a bike fitting soon.

V.

[Wahine]

I have a wonderful medical massage therapist I go to. This will give me a great excuse to go see her. :) I wore the heel cup today but only on the right foot. Am I suppose to wear it in both shoes? The doc didn't specify in his special instructions. :confused:

Can one see a PT without a Rx?

Put the heel cups in both shoes. You don't want to mess with your blance in your pelvis or someplace else by walking around lopsided.

As for the Rx that varies from state to state and from one ins. co to the next. Call your insurance and ask, then call a PT office and check with them.

[sundial]

Ok, saw the ortho doc today and he said I have...........tendonosis. http://www.mysmiley.net/imgs/smile/scared/scared0011.gif (http://www.emailblacklistcheck.com) The tech x-rayed my ankle and there was no calcification. He said I have scar tissue that has been there for some time. He prescribed a air heel thing to wear and to try a different set of heel cups since my Blue Dot ones didn't help on my last mtb ride. We went over the stretching exercises and he wants me to try a compound that is to be applied twice a day on the site. As for orthotics, he wasn't interested in going that route and wants me to meet with my favorite bike shop guy to get fitted with a Sole (a shoe insole that is heated, placed in the shoe and worn during cycling while it cools to fit the foot). If I continue to have problems, he'll prescribe ultrasound therapy.

I hope I can get relief through the heel cup and such and not be sidelined for the upcoming cycling season. I'm just now getting into the groove of things. :(

[KnottedYet]

Can I make just one observation from my experience with folks who have used the heat-molded insoles?

You take an unhappy foot, and you make a mold of it. Then every time you take a step (or pedal stroke) on that foot you force it back into that unhappy position. Reinforcing the mechanical problem over and over again.

The heat moldable insoles are great for folks who don't have mechanical problems, I'm not against them for healthy feet.

[OakLeaf]

How does one go about finding a good pedorthotist?

I've just had bad luck in the past and I know it's because where I live, anyone who deals with feet does nothing but cut toenails for obese diabetics. An athlete's foot (ha, ha) is completely foreign to them.

I'm not thrilled with the idea of having to travel 75+ miles one way for however many trips it takes. (How many trips should I expect it to take?) But if I can get a really good pair of orthotics I'll consider it worth it.

[sundial]

Oakleaf, I wonder if a prosthetic lab could help you? Course you'd need a doctor's Rx to visit them for a fitting.

My doc actually wasn't excited about orthotics. He said they are expensive ($300 and up) and most insurances won't cover them anyway.

I'd rather have a good PT work on me. Maybe Knot has a suggestion about how to locate someone in your neck of the woods. :)

[sundial]

Just wanted to give a follow up on my achilles problem.

I tried using a different pair of mtb shoes on my ride and it helped my achilles somewhat but I ended up with knee pain. :mad: I felt I was nearing the end of my rope and decided to follow up with being fitted with an insole that my ortho recommended. So I went to my LBS and they fitted me with a heat molded insole. I gotta tell you I was very skeptical but I had tried everything else and on every ride my achilles would cause me grief.

I rode a pretty good distance using the Sole and I had no achilles pain! I rode the last 3 days and I am finally pain free. It was the best $40 I spent. :) I'm so glad to finally have relief.

[KnottedYet]

Hoooray!

Is this what you have? http://www2.yoursole.com/

[sundial]

Yes! That's it!

[sundial]

I dusted off the road bike and took her for a 20 mile spin yesterday. About mile 10 my achilles started getting cranky. I don't know how just out of the blue it could go cuckoo when I've been mountain biking all along and have nary a pain. :mad: So I took some ibuprofen and went to bed early. Today I felt froggy again and decided to take the road bike out for a short recovery ride. By mile 3 it started hurting. I'm wearing the same shoes with Soles and my achilles apparently holds a grudge. :rolleyes: Funny how it never happens on my mountain bike. :rolleyes: I'm bummed because I want to start putting in road miles. :(