Help! Mystery pain & swelling - I'm kinda scared!

I'm wondering if anyone can help me figure out what's going on. I am starting to freak out because I'm having some really weird pain and I have no clue as to the cause. Maybe a tendon or ligament? And I'm assuming this is cycling related, but it didn't hurt on my last 3 rides. I've been doing longish rides (like 30-65 miles, usually lots of climbing) 3 days a week, plus a little bit of time on the trainer. The pain has been there for almost a week now, and it's gotten a lot worse in the last two days.

So here's what's going on...when I get up in the morning, I cannot put any weight on my left foot. There is excruciating pain in the sole of my foot towards the back of my arch, and it kind of shoots up into my ankle. After I'm upright for a few minutes, the pain starts to subside, and pretty soon I can walk with no pain. But if I sit down for a while, the pain will come back. Then if I walk for a bit, it goes away. However, now the pain is moving up the inside of my ankle. And tonight, my ankle is swelling pretty good and it's a little red. If you press on my foot where it hurts when I start walking around, there is no pain. But if you press on my ankle and up my leg, it is tender to the touch, like if you have bad shin splints. Also, now my baby toe and the one next to it are swelling. If I point my toes like a ballerina, it hurts. But I can move my foot all over in other directions and it does not hurt.

Does anyone have a clue as to what's going on? I'm worried about a blood clot! I do have a small old healed up cat scratch on my foot but it never got infected. It does make me worry about some weird infection though. Now that it's the weekend, I can't go to the Dr. And I'm starting to freak out! Help!!!

I wish I could see your foot. It kind of sounds like you have an ankle problem or big time pronation which has given you something like plantar faciitis and irritated the bejeebers out of your "stirrup" muscles on the left and right side of the ankle (posterior tibialis, peroneals, and such).

The swelling toes could be from pronation, which makes your feet act wider across the toes in your shoes and rubs the pinky against the inside of the shoe. Is the swelling constant, or only after you've been on your feet a while?

Your best bet is to see the doc.

If your foot feels hot and is red, the swelling spreads, and if the pain is in your CALF (not the inside along the peroneals, but the meaty juicy calf muscle itself), go to the ER immediately!

If it's bad enough to keep you awake at night, or to wake you from sleep, go to the ER!

Keep an eye on it. If you can get in to an urgent care clinic in the morning or call your doc's office and speak to the weekend on-call for his practice, that would be good.

Better to get it checked out, especially if it's freaking you out.

Then after you are cleared by the doc, look into some wide toe-box bike shoes, more float for the pedals, good insoles, and a medial forefoot wedge.

+1 what Knotted said. As much as this sounds like a tibialis posterior tendonitis which is not an emergency, there are some nasty things out there that can cause these types of symptoms and should be checked out by a doc. Again, watch the swelling, if the whole lower leg gets swollen, warm, red and painful it's off to emerg. Otherwise, call your doc's office and see what they suggest.

These two ladies are very wise, follow their advice! And it really doesn't sound like a clot.....

My sweet-heart, soon-to-be-M.D. but kinesiologist by training, automatically said "plantar fasciitis?" But it's a much better idea to see your doctor! There is lots of hope for you out there.

He's a big time cyclist and gets some of that type of pain sometimes if he's been doing a lot of climbing.

Good luck. *gentle hug*

I said plantar fasciatis, too, because of the pain on waking, then I read the rest. But it could be that your ankle is injured, which is causing you to compensate in your sleep (pointing your toes), which is causing that tendon to get all comfortable like that. Then when you stretch it out in the morning to walk, yowee. It doesn't cause swelling, though. The swelling means go to the doctor.

Hope it's nothing serious.

Karen

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Originally Posted by Tuckervill

I said plantar fasciatis, too, because of the pain on waking, then I read the rest. But it could be that your ankle is injured, which is causing you to compensate in your sleep (pointing your toes), which is causing that tendon to get all comfortable like that. Then when you stretch it out in the morning to walk, yowee. It doesn't cause swelling, though. The swelling means go to the doctor.

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Yeah, docs tend to hear/read the beginning of the "problem" and not always go to the end.

When you see the doctor you may want to start your story with the swelling to prevent them to jump on the plantar-fasciatis conclusion too quickly.

Thanks for the excellent advice everyone! The good news is, I just got up (yes, I slept in a little late!) and it's not any worse this morning and the swelling went down quite a bit overnight. But I still couldn't walk on it for about 10 minutes.

I'm very relieved to hear folks say it doesn't sound like a blood clot! I guess I'll take it easy this weekend, take my Motrin, and go to the Dr. on Monday if it's not any better. It just seems so weird to me that I didn't do anything in particular...like twist my ankle...to cause this.

So I guess I shouldn't try to do a long ride this weekend? Just kidding...I think I'm off the bike for a bit. What a bummer. I was trying so hard to get to 3,000 miles before the end of the year. :(

Plantar faciitis is a symptom of something else goofed up in the ankle/foot. Something is irritating the system. If the doc says "plantar fasciitis" and leaves it at that, ask him what he thinks *caused* the pf. Ask about physical therapy, especially with someone who knows cyclists and feet.

If I'm constantly hitting myself in the head with a hammer, and go to the doc cuz my head is bruising, and he diagnoses me with "a bruise" and gives me an ice bag but doesn't take the damm hammer out of my hand, well.... that's like a doc telling you "plantar fasciitis" and leaving it at that.

Edit: it is extremely common to have this kind of thing happen with no particular event causing it. Often it's an ankle or foot posture issue, added to a footwear issue, added to an activity issue, added to the vagaries of fate, and finally the straw that breaks the camel's back.

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Originally Posted by KnottedYet

Edit: it is extremely common to have this kind of thing happen with no particular event causing it. Often it's an ankle or foot posture issue, added to a footwear issue, added to an activity issue, added to the vagaries of fate, and finally the straw that breaks the camel's back.

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These words are very valid for so many situations of life....

My plantar fasciatis symptoms were exactly like what you described -- and were completely cured by custom orthotics (which I wear in the bike shoes) and stretching the calf many time a day.

On the other hand, radiating calf pain can be a symptom of pulmonary embolism - which my sister-in law survived by the skin of her teeth (and a really great EMT and ER) last year. So do be careful please.

I come from a long line of amature physicians, so take this with a grain of salt:) .

Hope you are feeling better soon.

Hey Sara, I don't have anything to add to the the actual discussion, but wanted you to know I'm thinking of you!! If you start to feel down about not quite making your 3000 miles, just think of me. I've only got 1000 for 2007!!

Hmmm, the saga continues. You're probably all bored to tears with my whining, but whatever is going on with my foot/ankle, it's not going away, so I'm off to the Dr. tomorrow morning. I really want to know what is going on. Someone at work told me that her husband walked around in moderate pain for 3 weeks with a broken bone in his foot before he finally went to the Dr. for an x-ray. So I'm hoping it's not something like that!

Starfish - wasn't most of that 1,000 miles climbing straight up the sides of mountains? :p

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Originally Posted by sara

Hmmm, the saga continues. You're probably all bored to tears with my whining, but whatever is going on with my foot/ankle, it's not going away, so I'm off to the Dr. tomorrow morning. I really want to know what is going on. Someone at work told me that her husband walked around in moderate pain for 3 weeks with a broken bone in his foot before he finally went to the Dr. for an x-ray. So I'm hoping it's not something like that!

Starfish - wasn't most of that 1,000 miles climbing straight up the sides of mountains? :p

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let us know what the doctor says. And yeah, I second what you said about Starfish!

If it turns out that it is plantar fascitis or something involving the tendons in the ankle, I would make sure to get into a physical therapist. I let something similar to what you are describing heal itself for over 10 months by resting and using anti-inflamitories - I started to feel better and began exercising again only to have it return in full force. Square one. I went to a physical therapist about three weeks later who manipulated several of the tendons in my arch, ankle, and toes. He broke up scar tissue and taught me some very strange, but effective stretches. I felt relief that evening. I went back a few times after that and was SO PLEASED with the results. Now if anything in my feet start causing problems, I get right in.
I also second getting custom insoles, although I used some that I purchased at a web site called Sole Custom Footbeds. I trimmed them to fit my cycling shoes, put them in the oven for a few minutes, took them out, slipped them in my cycling shoes, and stood on them for a few minutes while they made a custom mold to my foot. I love them.
Just my $.02
Let us know what happens!

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Originally Posted by Flybye

I also second getting custom insoles, although I used some that I purchased at a web site called Sole Custom Footbeds. I trimmed them to fit my cycling shoes, put them in the oven for a few minutes, took them out, slipped them in my cycling shoes, and stood on them for a few minutes while they made a custom mold to my foot. I love them.
Just my $.02 Let us know what happens!

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I don't really have foot problems, and I have never been to a PT, but I also have those Sole brand footbeds that you stick in the oven first. I like them, too.

So I went to the Dr. today. She thinks tendonitis and maybe plantar faciitis too. I'm still waiting on x-ray results. And I'm off to PT starting Thursday. I'm compiling a list of questions for the PT, including info on insoles. I'm quite happy that she gave me a PT referral. Not only do I want this to heal, I want to know how to prevent it in the future!

A new experience for me today...Pitting Edema! Eeeew! I almost passed out this morning when I pushed on my ankle with my finger for a few seconds and the indentation stayed there...and stayed there, and stayed there. The Dr. didn't seem too concerned about this. But I'm not pushing on it anymore because I am completely grossed out.

I sure hope I can get back on the trainer within a couple weeks...I already feel like I'm getting fat. My ankle is nice and fat but I don't want the rest of my body to follow suit!

Thanks again to everyone for all the great advice and kind words. I'm still a little worried that the x-ray might find something, but I should get those results in the morning.

Another fat ankled pitting edema sufferer here. They may put you on diuretics which should help.

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Originally Posted by sara

I sure hope I can get back on the trainer within a couple weeks...I already feel like I'm getting fat. My ankle is nice and fat but I don't want the rest of my body to follow suit!

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Don't know if you swim or not, but if you do, you can always just "pull" -- swim without kicking. Great workout!

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Originally Posted by zencentury

Another fat ankled pitting edema sufferer here. They may put you on diuretics which should help.

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It's a comfort to know there are others out there with pitted fat ankles. My trusty bag of frozen peas has helped. And I got my x-ray results and there's nothing broken in there. As for the diuretic...can I just drink more coffee? I really like coffee. Hmmm, I may have to try this.

Starfish - I wish we had an indoor pool around here, but alas, we barely have an outdoor public pool around here! I have my first PT appointment tomorrow and I'm hoping they say I can spin on the trainer sooner rather than later.