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Tibialis Anterior Tendon problems
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 2014-02-14 10:46 AM |
 413 |  Subject: Tibialis Anterior Tendon problemsFoot and Ankle Ortho specialist I saw this morning saw me for bump (not swelling)/soreness on left tibialis anterior tendon. Took a ton of x-rays of both ankles/feet. Big sports medicine practice, so there's some credibility there. Hx: I've got flat feet but have been running with custom orthotics and max pronation control shoes since last summer. Under podiatrist's care for years. Not overweight. Ran 2 times a week for a couple months with no problem (20 miles/month). Upped it to 4 times a week, but kept the durations and intensity low (40 miles/month). It's only once I hit the off season and upped my running to 5-6 times a week with increasing mileage (80 miles/month) for a couple months to make some speed gains that I developed this problem. Concerned my shoes were too tight so re-laced and tie them looser. Took a break to try and improve it, and it did (even though the bump remained). Went back at it with increased intensity (speed work, etc.) and frequency. Crashed and burned after 2 weeks with increasing discomfort and some ankle/knee PAIN while running. Have only run 5 times in the last month and the discomfort/tightness persists. Diagnosis: At this point, his differential is tendonosis vs. tendon tear with ongoing healing. Said an MRI could help with the differential. I know I overdid it, and probably had some micro-trauma that did not heal and was just re-injured through overuse. Does not feel acute. Could be chronic, which is very concerning. Prognosis: He said the best case scenario is that I am able to heal it up, but then I should set my sights low -- maybe running 2-3 times a week max and that he'd never see me doing half-marathon distance or higher. Does this sound real? Treatment: He said if it does not resolve with more icing and resting, he might recommend a boot to immobilize Questions: What else can I do? Am I destined to not run? Will cycling aggravate this? Will PT help? Any help appreciated. |
| 2014-02-14 11:18 AM in reply to: PsyTri |
Regular 847   Akron | Subject: RE: Tibialis Anterior Tendon problems get a new doctor! U might need to put it in a boot for a bit, but maybe some ART and graston will help. |
| 2014-02-14 12:23 PM in reply to: SEADOCHA |
| 413 | Subject: RE: Tibialis Anterior Tendon problems ART? Graston? |
| 2014-02-16 8:05 AM in reply to: PsyTri |
Regular 847 Akron | Subject: RE: Tibialis Anterior Tendon problems you can google Active Release Therapy and Graston treatment helps break up the scar tissue that has build up over the time. A lot of people use the techniques. You can find a provider in your area at their websites. good luck! |
| 2014-02-16 7:58 PM in reply to: SEADOCHA |
| 413 | Subject: RE: Tibialis Anterior Tendon problems Thanks |
| 2014-02-16 9:54 PM in reply to: PsyTri |
 Bronze member | Subject: RE: Tibialis Anterior Tendon problems Originally posted by PsyTri Foot and Ankle Ortho specialist I saw this morning saw me for bump (not swelling)/soreness on left tibialis anterior tendon. Took a ton of x-rays of both ankles/feet. Big sports medicine practice, so there's some credibility there. Hx: I've got flat feet but have been running with custom orthotics and max pronation control shoes since last summer. Under podiatrist's care for years. Not overweight. Ran 2 times a week for a couple months with no problem (20 miles/month). Upped it to 4 times a week, but kept the durations and intensity low (40 miles/month). It's only once I hit the off season and upped my running to 5-6 times a week with increasing mileage (80 miles/month) for a couple months to make some speed gains that I developed this problem. Concerned my shoes were too tight so re-laced and tie them looser. Took a break to try and improve it, and it did (even though the bump remained). Went back at it with increased intensity (speed work, etc.) and frequency. Crashed and burned after 2 weeks with increasing discomfort and some ankle/knee PAIN while running. Have only run 5 times in the last month and the discomfort/tightness persists. Diagnosis: At this point, his differential is tendonosis vs. tendon tear with ongoing healing. Said an MRI could help with the differential. I know I overdid it, and probably had some micro-trauma that did not heal and was just re-injured through overuse. Does not feel acute. Could be chronic, which is very concerning. Prognosis: He said the best case scenario is that I am able to heal it up, but then I should set my sights low -- maybe running 2-3 times a week max and that he'd never see me doing half-marathon distance or higher. Does this sound real? Treatment: He said if it does not resolve with more icing and resting, he might recommend a boot to immobilize Questions: What else can I do? Am I destined to not run? Will cycling aggravate this? Will PT help? Any help appreciated.
I have some experience with these types of issues and am actually struggling with something similar right now. Ok - first off, like you, I have flat feet, not overweight been to podiatrists lots, wear orthotics etc. I also had the bump - I went to the regular doc because I had to go for some other issues and she thought the bump was a cyst and nothing to worry about so I kept running. I had the bump for a year and a half. Mine did swell though so that might now be entirely the same as you. Funny thing, when it was really swollen it didn't hurt! Anyway, let me fast forward, now the bump is gone but I have pain all the time even just trying to walk around. Forget about running. I have had tendonitis like this on the other foot (minus the deal with the bump) so I have not bothered to go to the doc because I already know what he is going to tell me. First off I quit running a couple of months ago and have tried variations of the following - ice, ankle compression wrap, NASIDS, ankle brace, ART, different shoes with more drop and more support, ankle strengthening exercises, stability boot around the house and now the stability boot all day long because: A. I already own the boot B. I'm getting desperate and I just want it to go away!!!!!!!!!!!!!! I have had a torn tendon in the same area several years ago but it was a whole different feeling. There was a popping feeling and sudden almost shocking and unexpected pain. Also when my tendon was torn I had zero ankle stability. I rolled my ankle just going for a walk around my yard. With tendonitis I have a nagging sort of burning like pain that is pretty constant when I am on my feet. Does that sound similar? I still ride my bike. I was ok'd to ride when I had a torn tendon so I figure it is fine with this and it does not seem to make my symptoms any worse. But again, i will warn you, I have not been to the doc this time around. I wear my ankle brace when I'm on the bike and try to ice immediately after. FOR ME - ART was not the answer for this issue. ART is good when you have an area with a tight muscle but for me this tendonitis is caused by my tendon being stretched and weak from my flat feet so stretching it more actually makes it worse. You have to evaluate your own situation but that is an ART caution from someone who has been there. As far as your running situation - here is what I can tell you.... I've been a flat footed runner for 20 years. I have tried every kind of miracle shoe that is supposed to fix all the issues - they don't. I have tried to run slower but more frequently as is often discussed on the boards here. It does not matter what I try, I still wind up with some kind of foot issue. But I also never give up. I have run very few longer distance events including one HIM. I was so proud of myself for that but I didn't run for 6 months after because I had exactly what we are talking about right now Right now I am treating myself with NASIDS, wearing the stability boot all the time, doing my foot exercises every morning before I get out of bed and plunging my foot in the ice bucket as many times a day as I have time for. Just started all that on Friday. I was wearing the boot only at home and not great about ice because - well - it's been freaking zero degrees and I'm sick of being cold! 2 full days with this regiment and I'm feeling better than I have in a month so I will continue with this for a while and see how it goes. Maybe I'll even call the doctor......... I just always try to remember with tendonitis issues that I have to focus on calming that inflammation. Make that your first priority, be aware of what aggravates the pain, avoid those activities. BEST WISHES and let me know if you want more info about ankle braces or exercises!. |
. I have never been able to build distance without some kind of chronic foot issue.
| 2014-02-17 1:48 PM in reply to: trigal38 |
| 413 | Subject: RE: Tibialis Anterior Tendon problems Wow. Great work on the HIM. It sounds like you have really taken your rehab seriously. I really respect that. It sounds like you've been through the ringer. Good for you for continuing to work on it. Best of luck with that. More rest migth be warranted, though, to avoid turning it into a more serious problem that can't (easily) be reversed. My issues sounds similar in some ways but different in others. First, the bump. I had my orthotics made about 5 years ago by one podiatrist. Only started tri's last summer. Before starting, I went back and that podiatrist had left. I got in with the main podiatrist, who, after I started complaining of the bump after a few months, said the "post" on the right orthotic (the side with the bump) was made too high. Blamed it on the lab that made them - a difference of opinion about how the orthotics got made. We shaved it down a bit, and coupled with a change in running form (more mid-foot rather than ball of foot strike), it stopped getting aggravated at all after running. He also gave me a prescription topical anasthetic, which soothed it a bit after runs, as needed. It's pretty much resolved, even though the bump remains. Still, I can't speak highly enough about the Brooks Beasts. They are great. Now, the tendon. I did not have a discrete injury to it. One thing that may have contributed was how tightly I was tying my running shoes. I used to crank down on the laces because I'm between sizes and hated sliding around. That put too much pressure on the top of my foot, right where that tendon crosses over to from the anterior tibial muscle to the arch. Also, I ramped up running too quickly and just ran too much without enough rest in between, and I had stopped working on my achilles flexibility. I did end up revising my shoe lace tying pattern. I use the heel lock eyelets, but skip the pair right after that, heading toward the toe. It takes some pressure off the foot. I have this fleshy bump on the tendon on the left, but it's not painful, per se. There is a constant tension/stifness to that side, but it does not respond to ice or NSAIDs. Doc felt it could be tendinosis, which is when there is abnormal tendon regrowth due to repeated microtraumas without sufficient rest afterward. It's not typical of inflamation, per se. I'll wear the boot and stop all stress on it for a month and then go back and probably get an MRI. I'm not going to risk doing more damage than I've already done. Going to be conservative. I'll be rooting for you. |
| 2014-02-18 10:38 AM in reply to: PsyTri |
Regular 847 Akron | Subject: RE: Tibialis Anterior Tendon problems The reason I suggested Graston and ART was they break up the scar tissue and promote blood flow to the injured area. |
| 2014-02-18 12:11 PM in reply to: SEADOCHA |
| 413 | Subject: RE: Tibialis Anterior Tendon problems Did a web search and found what seems to be a fair and credible site called www.tendinosis.org. Reviews the available information about the condition. |
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