Long term management of peroneal/anterior tib tightness

[VeloVT]

I am currently working on recovering from an injury that the PT diagnosed as a peroneal/anterior tibialis muscle strain. About a year ago, I had peroneal tendonitis in the other leg. My calves and peroneals are generally tight, even though my calves are the one area I really do stretch religiously when I exercise.

According to the PT, my biomechanics predispose me to lateral muscle/tendon issues, including peroneals, IT band, etc. It seems true since I've had a lateral lower leg injury on each leg in the past 18 months, and I have had IT band issues in the past (though they've been ok lately). I'm thinking that if I am going to keep running (which I really, really want to do), I'm going to need to come up with a long term way of keeping these muscles/tendons strong and flexible and loose. Unfortunately, none of them are really easy to stretch well.

Does anyone with similar issues have suggestions? Stretching routines, rollers, etc?

I think if I could afford weekly deep-tissue massages I'd be all set :rolleyes:... But unfortunately I'm not there yet :o.

Thanks!!!

[Zen]

Couldn't your PT tell you what to do for it?:confused:
did he/she at least tell you this (http://www.itendonitis.com/peroneal-tendonitis.html)?

[VeloVT]

Yup, got all that info. Went through the tendinitis a year ago, after PT 2x/week for two months, I pretty much get the basics. (And I'm friends with the google, too).

I was hoping to hear the experiences of some folks who have had similar issues, have tried a variety of approaches and hopefully, have found something that has been helpful. That is, I'm not looking for something helpful in healing the acute injury, but something that has over time proven helpful in preventing future injuries.

Thanks!

[TahoeDirtGirl]

All I can say is that you need to do strength training as well as stretching. And don't slack on it. Because I'm sitting on my butt wishing I could ride for the second straight week in a row and getting depressed.

Your PT should be able to tell you what the deal is muscle wise. But if they are as poor as the ones I'm going to (insurance wise) then good luck. I am fortunate to have found a woman that is a Dr in PT and I pay her $50 a visit just for manual deep tissue for an hour.

I was also fortunate enough to become a personal trainer and chose the NASM certification which puts emphasis on getting your posture right before going on to working out with weights.

Without watching you do an overhead squat or anything else, it's not just your lower body you need to pay attention to. I'm going to take a stab and say that your knees go in if you squat. In that case, you overtight muscles as well as weak ones. And then it just goes down the line. When your knees go in due to the overtight adductors and weak gluteus medius/maximus to name a couple of muscles that are involved. You need to definately have a weight training program when you are kicked loose from PT and they should help you with that.

My issue with alot of PTs that I have seen is they are used to see people that are less active than we are. When I told them that I was doing up to 100 miles per week and half of them were mtn bike ones, they didn't know what to do. And they advertised all over the place they dealt with 'athletes'. They have athletic trainers, which for you, is your best bet. Athletic trainers are used to injuries and can help you. I'm a personal trainer and I can help prevent injuries but athletic trainers (which are certified through a national certification and you HAVE TO go to a school that is certified to train you as well, it's not at all like a personal trainer!) are good for when you are injured and really want to get through it as well as train to keep from being injured. Ask when you go to your PT visit if they have one there, they usually do. And then ask them to evaluate you and get rid of the imbalances once and for all.

It's not a general blanket "I did this, this and this" at all, everyone is different. You might find out you need orthotics or you might have one leg that is slightly longer than the other and need to address that. For that one, it's not as easy as a lift in one shoe when biking but you actually need to address it between your shoe and your pedal when you ride! So you can see how it's a journey and boy, it just never seems to end...it's hell getting old :(

[Zen]

I'm on my fifth physical therapist.
I had to go through four mediocre PT's before I found one with enough knowledge and creativity to go beyond the basic strength/stretching exercises.

[TahoeDirtGirl]

I'm on my fifth physical therapist.
I had to go through four mediocre PT's before I found one with enough knowledge and creativity to go beyond the basic strength/stretching exercises.

Good deal. I lost count. I did find this woman that you pay out of pocket-she works out of her house, I don't mind paying. I have one last visit with the 'medical insurance' one, why...I have no idea...but I like the out of pocket on because she just digs away at the adhesions for an hour and doesn't pawn me off on doing exercises that I do at home anyway...

I just wish I could ride.

[aicabsolut]

Regular massage therapy. Some of it you can do yourself after a ride on the anterior and lateral calf. To get at the stuff higher up that may be contributing, you can use the Stick or foam rollers or do self massage, but I find (in my experience) that my hips and glutes are often a big contributor (makes my pelvic symmetry off), for which I need someone else's hands working. In fact, massage and ultrasound performed by my PT helped the most in fixing my peroneal tendonitis. She said the muscles were plenty strong. Then we focused on fixing my pelvic alignment and fixing muscle imbalances up there. I know when my calf starts flaring up that I've usually been having more hip and ITB issues that I need to address, but I can keep the calf from getting really bad by digging in with some menthol-y muscle rubs.