Ankle pain (OMG not again)

[Sky King]

I have a custom orthotic somewhere... The inserts I stumbled upon and really like are actually birkenstock insoles! As my knee gets worse though I can see my left hip dropping so should probably find the orthotic to before my back starts to get wonkie

[ny biker]

So, Celebrex is helping though I did have a few days last week where my ankle hurt. Side effects are pretty much minor.

First PT appointment was yesterday. It went well. The PT seemed impressed that I had my own Theraband -- I brought it to show her what I had and find out if I should get a different color (different resistance). She also seemed to like that I knew the names of the various tendons and muscles and that I'd noticed a difference in muscle mass and shape between my left and right lower legs after the surgery. There are a few exercises I need to do every day, some twice a day and one thing (ankle circles) five times a day. I'm able to do them all at work as well as at the gym, which is good.

One weird thing -- in most of the tests she did, my right (injured) foot and leg were stronger than my left (healthy) foot and leg.

One very interesting thing that she said, and that I wanted to mention to Pax and anyone else with ankle problems -- apparently strong hip abductor muscles are important for keeping your ankles healthy. I don't remember all the details of what she told me but I think it has to do with ankle stability. If your hip abductors are weak, your knees end up working more, which is not ideal. The abductors are the muscles on the outside of your hips (I always get adductors confused with abductors so I had her clarify for me). One of the exercises I'm doing specifically works the abductors, and I can really feel them working so I guess they do need to be strengthened.

[Catrin]

Glad to hear the Celebrex is helping! It sounds like you're working with a good'un, keep her. May things continue to go well!

[ny biker]

A plot twist.

I went to PT for 4 weeks, have been doing the exercises, the therapist noted improvements in various measures of strength and range of motion. But my ankle is not better. I am still very limited in the amount of walking I can do, and some of the exercises I was doing for PT made it hurt. The doctor had said that if it didn't improve I should go for an MRI and come back to see him. So I had the MRI last week and saw the doctor today. He looked at the MRI and said, it looks like a different tendon is damaged. Um what?

In my crude understanding of the anatomy -- there are three tendons close together in a normal foot and ankle -- the posterior tibial tendon, the flexor digitorum longus, and the flexor hallucis longus. Back in the day I had a torn PTT. The surgery I had was a "tendon transfer," in which part of the PTT was removed and the FDL took its place. The location of the pain I've been having since January indicated that the current problem was where the FDL and PTT were attached. But on the MRI, that area looks okay -- and the FHL looks damaged.

As a next step, I will go next week to have a long-acting anesthetic injected into the FHL. If this relieves the pain, it confirms the new diagnosis. Based on what I've read about the function of the FHL, and one particular PT exercise that caused pain, I suspect this will be the case.

One good thing is that I'm still able to ride my bike. I have noticed some minor pain when I ride up steep hills. Based on today's developments, I think I need to be more conscious of my foot position when I pedal, to make sure I don't point my toes at all.

[Crankin]

Sorry to hear this, but glad you most likely have pinpointed the cause.

[Catrin]

NY Biker, how is this going? All better now, I hope?