Heel Pain

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In article said:

Hi all,
I know I know not another pain question. But....
After my longest run ever, 7 miles on Saturday I seem to have some
pain in my foot. It's not PF my wife has that. The pain is on the outside
of my right foot between the bottom my my foot and the ankle bone just
forward of the ankle bone. It doesn't cause me to limp or anything but
I know it's there. I ran 3 on Monday without any problem but decided
to take a couple of days off. My next run is scheduled for Thurs, should
I consider taking off until Saturday. Would some cushion inserts for my
running shoes (Asics 1070 w/~300 miles on them) make a difference?
Being 36 and this being my first problem after running for over a year.
I'm not real grand on the idea of taking too much time off.
Any help would be appreciated.
HM

From a post and article on what might be your problem. Sounds like you need to work on the peroneus:

Some Magic On Rehabilitating Sprained Ankles: Free The Peroneus

I continue to maintain that the problem of the continual re-spraining of
one's ankle is more a function of the peroneus remaining shortened by the
original sprain and the fascia holding the muscle in that shortened state.
Here's some magic you can work on your own ankle or you can get someone to
help you: Free the peroneus

Some Magic On Rehabilitating Sprained Ankles: Free The Peroneus
by Austin Gontang,
September 27, 2000

Some Magic On Rehabilitating Sprained Ankles: Free The Peroneus
c. 2000 Austin "Ozzie" Gontang, Ph.D.

Quoted message said:

Hi, I sprained my ankle a good four months ago and have been doing daily
exercises to rebuild the strength, flexibility, balance etc. They've
worked really well and now I have progressed to very gentle running. I can
hop, skip and jump on the ankle now with no problems. However, when I've
been sitting, or occasionally when I get out of bed, the ankle siezes up
and is very stiff. I then have to hobble about on it gently to ease it
back into life. I don't understand why it stiffens up when it would appear
to be almost fully healed and rehabilitated. Any ideas/ advice ?
Thanks, Minnie Mouse

Minnie,

One thing I've found over the years is that the peroneus, the muscle which
runs down the outside of the leg - it lifts the outside of the foot - often
gets pulled and to protect itself it tightens- i.e. shortens. After the
healing of the ligaments around the ankle, that peroneus (longus and medius
portion) can remain in its semi-contracted state. which means it doesn't
fully relax when the posterior tibialis - its counterpart - lifts the inside
of the foot up.

So often the sprain is gone but those muscles and fascia which splinted to
protect the pulled muscles and strained ligaments don't let go. Those
muscles that hold on are unknown by most people. They keep thinking ankle
and forget the ankle residue of tightness and/or clicking may be a symptom.
Those muscles and their fascia (the thin transparent film you see between
the skin and the meat on a chicken breast) must be worked on through
transverse friction, deep tissue massage or fascia release. Once that muscle
group on the outside of the leg is freed up the ankle joint is freed up and
it's ease of movement almost feels like a miracle has happened. There's no
clicking and the person feels immediately a fuller range of ankle motion.

I continue to maintain that the problem of the continual re-spraining of
one's ankle is more a function of the peroneus remaining shortened by the
original sprain and the fascia holding the muscle in that shortened state.

Back to my soapbox about my reason for having people train on unpaved roads,
grassy or uncompacted dirt is to train their stirrup muscles which are
postural muscles (peroneus and posterior Tibialis) that evert and invert the
ankles.

If people keep running on flat, level surfaces that are concrete or asphalt
the level, flat surfaces create an overuse syndrome which never let the
ankle act as the semi swivel (not anatomically correct) it is. My reason for
having people run on grass and unpaved surfaces is to allow the ankle to do
what it was make to do...adjust to the terrain.

Paved roads create an overuse syndrome because those muscles never get taken
through a wider range of motion and therefore shorten and the fascia then
locks them in that position.

I think that the solution is counter intuitive. It's not the unpaved and
uneven surfaces which are the problem. It's the paved even surfaces which
never allow for the variability which the ankle needs to experience to
maintain its range of motion and muscle flexibility.

What To Do About The Tight Or Clicking Ankle

Using A Partner

Start about 3 inches above the ankle bone on the outside. Hold as if they
are going to strangle the outside of your lower leg- fingers wrap around the
lower leg thumbs pointing toward each other or one thumb rests on the other
thumb (if more pressure is desired).

Have them use light pressure by pushing in with thumbs as you make a small
(emphasis on small), smooth (emphasis on smooth) circle. As you make small
smooth circles with the foot they slowly to slide the thumbs up the peroneus
muscle.

The idea is that you can loosen the muscle from any adhesions and also you
can loosen up the fascia which may be holding the peroneus from relaxing and
going through it full range of motion.

Stop after 3 or 4 times of small circles and they holding. Walk a few steps.
More often than not, you'll feel less pressure around the ankle as it can
move more freely due to the freeing of the peroneus higher up the leg.which
takes the tightness off the ankle area.

The peroneus and posterior tibialis are often called stirrup muscles as they
invert and evert the foot. They are also postural muscles and therefore slow
twitch, in that they help maintain correct posture when functioning
properly.

Doing The Loosening On Your Own

To loosen the peroneus on your own, face a railing with a middle railing
(http://www.mindfulness.com/of1.asp). Turn your body 45 degrees and place
the peroneus side of the leg on the bar, usually the middle bar is better
unless you're very tall. Do the same foot movement as mentioned above to
loosen the peroneus and the fascia that may be constricting the ankle for
its full range of motion. As you make the small circular movements slide the
outside of the leg slowly down the railing. Start about 3 inches above the
ankle bone and go to about the middle of the lower leg.

If the circle made by the ankle is to big, it will be a jerky circle and
you'll just be straining tendon since the muscles won't be letting go. So
small circles, start penny size. The circle is not made with just the front
of the foot. The bottom of the heel is scribing a circle also. Imagine your
foot is the bottom of an unside down pie plate and you get the idea how both
the front of the foot and bottom of the heel are circling. As the foot makes
the small circles at first imagine you're screwing out the foot so there's
more space in the ankle. When the peroneus loosens up there is a better
range of motion in the ankle.

Remember to do this lovingly. If you make big circles, or do it too hard or
too fast, your body will remember the feeling when it was originally hurt,
and tighten up even more to protect itself.