Posterior Tibialis Tendonitis

[TahoeDirtGirl]

Yesterday they told me at PT that I am not allowed to ride a bike for a week. Because apparently dummy me was too lazy to change out my orthotics to the *correct* ones and the bad ones I wore to the gym and did balance exercises. I think I just aggrevated it. However, the PT wasn't buying it. I almost cried when he told me no riding. I just started losing weight again after the stupid flu!!!

But this is how it is with this injury from last October, up and down. Up and down. Now I'm down. They are saying if it doesn't go away, they are going to cast my leg for 4 to 6 wks.

I am wondering, anyone else have this problem? I have to admit I'm bad at the icing part. But this is taking soooo loonnnnggg...

this is more of a vent...just hoping someone else out there has had this and can give me some feedback??

[pardes]

Posterior Tibialis Tendonitis?

Okay, but can I get that with fries?

Tendons for being such strong things are really tender little things under all their bravado.

They are like some people who, once hurt, NEVER let you forget it. Even Dr. Phil cannot talk them out of their plots of revenge.

You have to be the bigger person here and make the first move of making friends again with your tendons.

I understand they have a weakness for long hot baths in epsom salts and quiet walks on the beach at sunset. I've also heard that many go weak-kneed and get misty-eyed when someone reads Walt Whitman to them.

But most of all, you must curb your anger at them and reassure them that you love them just the way they are. It's amazing how much harder they will try to curb their fiery anger after that and soon you both will be biking again.

[ny biker]

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.

[RolliePollie]

But this is how it is with this injury from last October, up and down. Up and down. Now I'm down. They are saying if it doesn't go away, they are going to cast my leg for 4 to 6 wks.

I am wondering, anyone else have this problem? I have to admit I'm bad at the icing part. But this is taking soooo loonnnnggg...

this is more of a vent...just hoping someone else out there has had this and can give me some feedback??

TahoeDirtGirl...is tendonitis contagious in our part of the world? I'm less than an hour from SLT and I'm having similar long ongoing ankle tendonitis issues. I feel your pain (literally!). And I share your frustration.

I've been dealing with this since last November. My ankle and foot still swell, hurt, ache etc. I tape and wrap my ankle every time I ride and pray that I don't make it worse. I did a metric last Sunday up in the mountains and I haven't been on the bike since because my stupid ankle and foot are complaining big time. I'm thinking this is just going to be an ongoing injury that I have to live with. Especially since I can't afford PT or further medical testing like an MRI. Sounds like you're still getting treatment, and I hope that continues to help you heal.

I'll be thinking about you from over here on the west side of the mountain!!!

[TahoeDirtGirl]

Hey Rollie! May be! I'm in Massachusetts (I hope I spelled it right) so it must of gotten me through my mail that has been sent to me

The only thing I have found that is helping is doing IT band stretches, ice and meditation on it. Yeah I said meditation. I've been thinking of doing water therapy with it, I did go to several workshops on it but just haven't been doing it out here. Myabe this is a sign I should get back out there and start working with it?

They told me to stay off the bike, and it did get worse this week. Oh did it ever. That's when the meditation came in because short of sawing it off, I had no other options.

I'm trying to break in new Superfeet but they don't seem to be real favorable right now. Just sitting on my butt. That's about it. This is depressing.

I'm still doing strength training which should be one of the things you should do. Can you get up on your toes? This is one of the hallmarks of this injury, that you can't-but getting up on your toes is one of the ways you get it to respond and get stronger. Also, if you can get to the gym, calf raises, leg presses and single leg presses are key to getting stronger. I also do ball squats and balance exercises.

That stinks you can't get to PT. I'm not sure if PT is helping me. You could maybe get to a massage therapist for it? I'm thinking accupuncture next.

[ridermelanie]

Hi there! I was diagnosed with posterior tibial tendinitis mid-March after FINALLY getting a referral to a podiatrist at Kaiser. My left foot has been swollen and painful around the inner ankle bone and foot bone. I was cycling a lot last summer and completed my first 100-mile ride in June. A few weeks later, the pain got worse. I pretty much ignored it and kept riding, although shorter distances. I broke my wrist in October while hiking and had to quit riding for months. I thought that would help my foot settle down, but it continued to hurt and swell. I asked my doc a couple different times for a referral and once I got in, I got slapped with "the boot." I am now hobbling around in this gigantic Frankenstein-like boot that is supposed to rest my foot (podiatrist threatened to put me in a hard cast, but I wouldn't have been able to ice or move my ankle). I am not even allowed to walk my dogs. I can't do lower body weight training at the gym because it will engage my calf (which is where the tendon inserts). I am doing physical therapy, but it is very slow going as I am waiting to get in to a sports medicine doc who makes custom orthotics (out-of-pocket expense). I don't see him until April 13. I am terrified of what he is going to say. I am missing all the spring bike rides I signed up for. I am depressed. I have done a lot of research online, and it all says the same thing: It is very common in women over 50 (happens 4 times more often to women), especially if you have extra weight on your frame (and I did. In Weight Watchers now). It usually only happens to one foot. They are not sure why. If you look up exercises for this lovely ailment, calf stretches are a very common one. Tight calves aggravate the tendon. Of course, I never did the right amount of stretching after these rides. I am very good about icing now. I actually enjoy that "frozen" feeling. It certainly helps with the swelling! I see the PT again on April 5. Has your arch fallen on the foot with the problem? This is very common. My foot is somewhat misshapen now, and I've looked at pictures online of what happens when you don't take care of it. Absolutely horrifying! I am with you on this journey, and it has been especially cruel as I was just cleared a few weeks ago for my wrist. Got back on my bike once and then got referral to podiatrist who shut me right down.

[ny biker]

I completely forgot about this thread, and never bothered to search the forum before I posted recently about the flare-up with the tendon that I had surgery on all those years ago. I just spent four weeks with the ankle boot. I was allowed to take it off to drive and at night, otherwise I wore it all day. The deets are in this thread.

http://forums.teamestrogen.com/showthread.php?t=55911

Today was day one without the boot. I guess it was okay. Just walking around the office, slowly and mindfully. Haven't decided yet if I will pay for custom orthotics or just wear Superfeet. Taking it one day at a time.

[Catrin]

If it helps your deliberations on the custom orthotics. I've lots of issues with my feet and ankles, though different from yours. Have had ankle surgery (ligament repair + a heel osteotomy), micro-tears in my achilles (antibiotic related), very high arches, arthritis, etc. I've used across the counter supports, including Superfeet, and have had custom orthotics twice. The first attempt (a few years back) were not true orthotics, they were just very expensive arch supports and did no good rather than to support the podiatrist.

My second attempt, just last fall, has been nothing short of a miracle. These are orthotics in the true sense of the word - in they help to actually realign my feet so that my feet hit the ground properly. There is no arch support in the usual sense of the term, though that is also addressed in correcting my stride. It took a few months to adjust to them, I won't lie about that. Once I adjusted to them? It has been fantastic. ALL of my pain from various sources is just...gone. My major metatarsal arthritis, plantar fascitis, ankle pain, everything - gone (outside of occasional twinges from the arthritis). Even my calluses from almost 60 years of walking with such high arches are gone - and they were significant.

If it's in your budget, I would seriously consider it. That being said. WHO makes them is just as important as anything. Unlike many I've heard of, my podiatrist doesn't agree with just making one - he prescribes a pair and this pair actually cost me just a little less than the expensive arch support (one only) from 2006 or so that lasted an entire 6 months. Frankly I would have never believed that having this level of success from this pair of floppy things that go in my shoes was possible, and I was skeptical when I first saw them. They confuse shoe sales staff as they don't look like the arch supports they are used to seeing - they do all of their adjustment in the hind-foot - at least for me they do.

[Pax]

This is my new fun issue due to gait changes from my knee replacement. Having wicked valgus on the right leg for a long time made me walk a certain way, now that it's gone everything is realigning and changing. Wouldn't be much of an issue if I was young and bendy, but since I'm not it feels like something new/different crops up every month.

Doc says very little point to custom orthotics at this point as the changes will continue for a while. Thankfully, wearing my OluKai Ohana flip flops makes my feet feel just about perfect, and it's getting warm enough to wear them more often. Best things EVER!

[Catrin]

This is my new fun issue due to gait changes from my knee replacement. Having wicked valgus on the right leg for a long time made me walk a certain way, now that it's gone everything is realigning and changing. Wouldn't be much of an issue if I was young and bendy, but since I'm not it feels like something new/different crops up every month.

Doc says very little point to custom orthotics at this point as the changes will continue for a while. Thankfully, wearing my OluKai Ohana flip flops makes my feet feel just about perfect, and it's getting warm enough to wear them more often. Best things EVER!

That makes sense, better to wait until things calm down. I do think that my bad shin splints from the 10 mile hike last October was, in part, because it came just after I started using the new orthotics and I hadn't yet realized that my body would take some time to adjust to them. I can't say I wasn't warned that it might take some time, I just didn't believe him, not really

[shootingstar]

If it helps your deliberations on the custom orthotics. I've lots of issues with my feet and ankles, though different from yours. Have had ankle surgery (ligament repair + a heel osteotomy), micro-tears in my achilles (antibiotic related), very high arches, arthritis, etc. I've used across the counter supports, including Superfeet, and have had custom orthotics twice. The first attempt (a few years back) were not true orthotics, they were just very expensive arch supports and did no good rather than to support the podiatrist.

My second attempt, just last fall, has been nothing short of a miracle. These are orthotics in the true sense of the word - in they help to actually realign my feet so that my feet hit the ground properly. There is no arch support in the usual sense of the term, though that is also addressed in correcting my stride. It took a few months to adjust to them, I won't lie about that. Once I adjusted to them? It has been fantastic. ALL of my pain from various sources is just...gone. My major metatarsal arthritis, plantar fascitis, ankle pain, everything - gone (outside of occasional twinges from the arthritis). Even my calluses from almost 60 years of walking with such high arches are gone - and they were significant.

If it's in your budget, I would seriously consider it. That being said. WHO makes them is just as important as anything. Unlike many I've heard of, my podiatrist doesn't agree with just making one - he prescribes a pair and this pair actually cost me just a little less than the expensive arch support (one only) from 2006 or so that lasted an entire 6 months. Frankly I would have never believed that having this level of success from this pair of floppy things that go in my shoes was possible, and I was skeptical when I first saw them. They confuse shoe sales staff as they don't look like the arch supports they are used to seeing - they do all of their adjustment in the hind-foot - at least for me they do.

Could you take a photo of this set, Catrin? Am curious..

[Pax]

That makes sense, better to wait until things calm down. I do think that my bad shin splints from the 10 mile hike last October was, in part, because it came just after I started using the new orthotics and I hadn't yet realized that my body would take some time to adjust to them. I can't say I wasn't warned that it might take some time, I just didn't believe him, not really

Totally get that, whenever my doc tells me "this will probably happen", I assume he means to someone else.

[Catrin]

I do have the photos Shootingstar, just having a problem getting them uploaded. Hopefully will solve by Monday night!