Do you have pain on the inside of your ankle?

I'm pretty sure this was the problem I had back in the late 80s/early 90s. Back then I didn't have a bike but I walked EVERYWHERE. I mean everywhere. Didn't have a car and I was a poor grad student who walked for exercise, errand running, everything. Walked 30 minutes to work and 30 minutes back in Chicago winters, walked for an hour along Lake Michigan just for fun, walked 10 blocks to the grocery store with my granny cart and 10 blocks back home again.

After a while I started having pain in my right ankle on the inside and it got worse over several years. Of course I still kept up with all the walking. I tried custom-made orthotics and reached the point where I had to wear sneakers with orthotics with every outfit including business suits. Finally after it got so bad that I couldn't even walk one block (by this time I was living and working in Manhattan where you really walk everywhere), I had surgery. I was 29 and the doctor said once he made the incision and got a good look at the inside of my ankle, it looked like it belonged to someone in their 60s. He removed the damaged section of tendon, replaced it with tendon from a different part of my ankle, and then moved my heel bone inward about a quarter inch to take the pressure off so the injury would not happen again.

After a long recovery (complicated by internal scar tissue) and much physical therapy, my ankle is basically fine now. It still hurts occasionally but I try to wear shoes that have decent arch support on most days and that helps. I have store-bought (not custom) orthotics in my bike shoes and my sneakers. Regular exercise and stretching is also important to keep things flexible, since the surgery left some scar tissue inside my ankle.

I never had any ankle pain due to bike riding, until this summer when I started having some minor pain after long rides. A couple years ago I started having knee pain due to my patella tracking wrong, which I think is related to the heel being moved surgically, so my theory is that I've developed a bad pedaling motion that is somehow putting pressure on the inside of my ankle. I recently had some changes made to my seat and handlebar height and if that doesn't help I'll probably look into new orthotics for my bike shoes and maybe have my cleat position adjusted.

All of which is a long story to say - take care of the tendonitis and do everything they tell you to do, to give it a chance to heal. Unfortunately ti's the type of thing that heals slowly and requires patience. And do make sure you ice it - it really helps! Good luck.