Ankle pain (OMG not again)

[ny biker]

I am somewhat freaking out. Back in the early 1990s (when I lived in cities and walked a lot) I had a problem with the posterior tibial tendon in my right ankle. Basically pain on the inside of the ankle, for years, and eventually having surgery in 1993. There was no acute injury; the problem with many microtears caused by repetitive strain from overpronating. The surgery and rehab experience was not fun and it took years for the pain and stiffness to go away. But for quite a while now, I don't know how many years, there have been no problems with it.

Until Saturday night. I was walking from one room to the other when all of a sudden there was a sharp pain in the same inside part of my right ankle. I have no idea why. It didn't seem like I stepped wrong or twisted anything. It hurt for a while every time I took a step. I iced it, it felt better. The next day it was mostly okay. It felt a bit inflamed but only hurt a small amount once or twice. I iced it again that night. When I got up on Monday it seemed fine for several hours, then started to hurt again with every step, for about a half hour, then was okay, later that day more pain for a while and then okay again, iced it at night. Same thing again today with some periods of sharp pain with every step and other times it's okay.

I am thinking that compression might help. Any thoughts on that, or other ideas on how to deal with this? I simply cannot have this develop into the long-term problem that I had before.

I went out and bought a compression thing for ankles at lunch today, but will have to return it. Following the directions on the box, I measured around my heel and instep. The box said size small would fit 10-12.5" and size medium would fit 12.5-15". Of course I measured 12.5, on the cusp. I bought the small but within 30 seconds it was digging into my foot so I took it off. Being on the low end of the range for medium, I wonder if there would be enough compression to matter with that size. Maybe I should just get an Ace bandage and wrap it tightly?

BTW from the wear patterns on the heels of all of my shoes, I know that I am now an over-supinator, not an over-pronator. For years during and after the injury I only wore shoes with really good arch supports, and I guess that helped. These days I don't really worry about arch support one way or the other, except for my sneakers and bike shoes. Thinking as I type this, I should go out and get some Superfeet insoles. Will do that tonight.

I really don't want this to become a big problem. Really.

[Pax]

That sucks, NY, not much to offer but sympathy... but I agree on the Superfeet. I stopped wearing mine after my knee replacement, for some reason my plantar fasciitis stopped after the surgery, but every once in a while it still flairs up and it's Superfeet to the rescue.

[north woods gal]

Sorry to hear about the ankle issues, NY. Old injuries like that seem like they come back to haunt us, now and then.

One suggestion for when you get back to biking is to try flat pedals instead of clipless on your road bike. I know ditching clipless is almost heresy for the road bike crowd, but I switched to flats, this year, precisely because I was plagued by foot cramps on long road rides when using clipless. Would have to stop and massage the foot and sometimes it was a long and painful process. Going to flats allows me to move my feet around more on the pedals rather than having them locked in permanently in one position. Has greatly reduced the foot cramps and, maybe it's just a coincidence, but haven't had as much back pain or pinched nerves in my legs that also plagued my in the past from too many miles on the bike. I'm no doctor, but I do think locking your feet into clipless pedals might further aggravate the repetitive stress injuries to your ankle.

Remarkably, have kept track of my average speed over the same routes with clipless versus flats and have not found a significant difference. Anyway, just a thought to keep in mind as an option.

[ny biker]

Thanks ladies. I went out and bought some insoles last night and I think they started to help immediately.

I actually was looking into flat pedals with pins yesterday. My bike is in the shop right now for the annual clean-and-tune, but this weekend looks like we'll have good riding weather and I'd like to take advantage of it. I suspect I will be able to pedal without problem, but turning my foot to clip out could be an issue. But, if I get flat pedals I will need shoes too, because I think the soles of my sneakers are not stiff enough. So this could get expensive quickly. Another option would be to put flat pedals on my mountain bike and ride that for a while -- I think I could use my mtb shoes without cleats. My main concern there was Catrin's comments in another thread about the pins scraping up your legs if the pedals hit them, since I do recall cuts on my legs back when I had flat pedals with toe cages on my mountain bike.

But, one thing at a time. I'm wearing compression socks today with Superfeet insoles in my sneakers. Tonight I will look for a better-fitting compression sleeve.

I know you can relate to how hard it so to suddenly not be active. It's bad enough not being able to go out and walk with the nice weather we're having. But around here we have several large outdoor shopping centers -- mega strip malls and "town center" clusters of stores. I always park my car and then walk from store to store when I'm running errands, but now I need to think about driving from one to the other if they're not close together.

[Pax]

One thing that might help is your superfeet in your sneakers, they will stiffen them up a little. At least enough so you could ride some now and figure what you want longer term.

[Catrin]

NY Biker - While I DID get a few scars from pedal slap from my SunRingle ZuZus - that passed pretty quickly as I learned how to both start and stop and avoiding pedal slapping at the same time. I can't even see those scars any longer, so they weren't very deep. Tall socks would help as well - and guards for mountain biking.

[Crankin]

I hope you figure this out, NY.

[north woods gal]

NY, you really DON'T need special shoes for flats. You don't want too floppy, of course, but going too stiff may aggravate your ankle injury. A good walking shoe or light hiking boot is fine. I use my light New Balance hikers most of the time for backcountry work. Heck, in the summer, I've even used my Birks for quick rides, but my lug sole Columbia hiking sandals also work. In the winter, some folks up here even use Sorel pack boots.

There are special shoes for flat pedals if you want to spend the money, of course, but one of the big advantages of going with flats is that it gets you away from needing bicycle specific shoes. The only real advantage of flat specific shoes is the sole material that allows good grip with pins, but all kinds of regular shoes can do the same. Even my lugged hiking boots and lugged sandals have plenty of grab. Just a matter of trial and error with a given flat pedal to see what works.

[ny biker]

So, an update. I bought two different ankle-compression things and lost count of how many others I tried on, and I hated them all. They either are too tight on my foot, or have a heel opening surrounded by too-tight stitching, or bunch up in front of my ankle when I try to walk. I already returned one of the ones I bought and will be returning the other one tomorrow.

Ultimately the best thing has been an old-fashioned Ace bandage, because I can decide how tight to make it. And they cost less than all the other things I've looked at. I've bought two of them so I can wash one and still have one to wear. With the Ace bandage and the Superfeet, I have been mostly pain-free for several days now. After a week off from all exercise, I'm going to the gym tonight for weight training.

While I was at the bike shop the other day I mentioned that I might need to put flat pedals on my road bike for a while while the ankle recovers. I stressed "might" since I hadn't tried to ride or clip in and out yet. But they insisted on lending me a pair of inexpensive plastic pedals and showed me how to take off the Speedplays and put on the flat ones if needed. I had to buy a pedal wrench but can return it along with the pedals if I don't need it. As it turned out, the nice weather we were expecting for the weekend didn't happen and I ended up spending a lot of time working on the furniture painting project, and the place in my living room where I normally set up the indoor trainer is currently full of newly-painted dresser drawers. So I still haven't tried to ride the bike yet.

[north woods gal]

That's a good bike shop to let you try a set of flats like that. As long as those pedals have at least some teeth for the sake of grip, they'll give you a good test. Best of luck. Ride when you can.

[emily_in_nc]

Yes NY, I hope the pedals will enable you to ride. Sorry the ankle braces didn't work out, but sounds like wrapping in an Ace bandage is the best solution -- and nice when it is also the least expensive, no?

[ny biker]

It's 71 and sunny right now but I can't go outside to ride or even take a walk. GRRRRRRRRRRR.

It's been two weeks. The ankle is much improved but not totally healed. It is so hard to resist thinking that I can take a chance and go out and do something. But I so do not want to make things worse.

I rode my bike on the trainer for 25 minutes last night. The ankle felt fine. I could clip in and out without pain. But then I realized -- I always clip out first with the right foot and put that foot down when I stop. If I'm on a downhill or have to stop suddenly, the foot hits the ground with a fair amount of force. It could injure the tendon more. So I think I need to stay off the road bike for another week or two. This is so hard! We will have great weather for an evening ride later this week, too.

I think there is less risk riding the mountain bike if I take it out on flat trails. Not today, because it still needs some repairs to the left shifter. And with this weather the trails will be mobbed anyway. So I will put the flat pedals on it and take it to the shop for repairs. Maybe next weekend (after another week of rest) the weather will be decent and I can go for an easy trail ride. My thinking is that I go slower on the mountain bike and with the wider tires, I am better able to balance so it would be less urgent to put a foot down if I have to stop suddenly.

Ok, typing all this out and just having a plan makes me feel better.

[emily_in_nc]

So sorry, NY. I can only imagine how frustrating that would be with the early nice weather.

I hope your ankle will be 100% soon. And just remember, spring is coming. It's only February, despite all appearances to the contrary in so many parts of the country!

[north woods gal]

I'm one to talk with all the crazy riding I do in extreme weather, but, really, I'm with Emily. Take your time. Maybe a short ride to see how things pan out. Best of luck.

[ny biker]

Thanks ladies. I got lucky with the mtb when I took it to the LBS to get the shifter repaired -- it just needed a few drops of lubricant, no need to replace any parts. Also I was not able to get the old pedals off that bike, couldn't loosen the bolts at all, so I had them put the flat pedals on for me. As an added bonus they put on new grips and moved the shifters in a bit so my wrists don't hurt anymore.

Since I was able to get everything done while I waited, I had a chance to go for a short test ride on Monday. Overall it went well and the ankle felt good. The only problem was that I have forgotten how to ride with flat pedals!! I just couldn't get started, especially on an incline. This caused some problems at intersections with stop signs where drivers were waiting for me to get going and clear the intersection. We've had plenty of people over the years who posted a thread looking for advice on how to clip in, but I may be the first who had trouble transitioning from clipless to flat pedals.