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.

[Catrin]

Yikes NY Biker, do keep us posted, not fun at all!

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[Pax]

I wonder when orthotics became such a racket? They have tried several times to get me to go that route, but I watched my sister in law sink a couple of thousand into "custom" orthotics that were so custom they had athletic tape attaching new pieces as needed. She went through the mill with that office, so I decided unless I got completely desperate I'd stick with superfeet and good shoes.

[Catrin]

My first attempt at orthotics over 10 years ago felt the same way. My new ones from last year has been little less than a miracle...and after insurance I only paid 80. (They were 500 before - for the pair, not for each). So they are not all a racket and mine have prevented foot surgery 😎

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[Crankin]

i remember when my insurance (from where I taught in AZ) paid for my custom orthotics in full, in 1987. Although they cured the plantar fasciitis, little did I know I was setting the stage for my back being a wreck now, from teaching high impact aerobics on concrete floors, covered by thin carpet.
I have used Superfeet in my cycling shoes since 2011. I could not tolerate the fancy custom molded things that came with my shoes. Too thick.

[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!