Peroneal Tendonitis?

tsbjax said:

Has anyone had experience with this type of tendon issue/pain? If so,
would you share what you did to help it? Has anyone used ART therapy
and if so, what are your thoughts? Should I not run in the 5k Sunday
night? Do you think I'm still ok for the 1/2 on January 15th?

Tara,

I don't have that much experience with injuries, but I am still going to
offer my point of view: Take care of your injury now, instead of later.
Missing a race or a week or so of your training is much better than the
injury becoming more serious.

Don't know anything about ART (or art for that matter!).

Quoted message said:

Sorry for all the questions--I'm just feeling pretty down and
frustrated at the moment. Things were going so well!!

Hey, there are always setbacks. Take some time to *heal* and when you
are better get back to your training for the 1/2 Marathon.

When I sprained my ankle some while back, the doctor prescribed RICE
(Rest, Ice, Compression and Elevation) and Ibuprofen. The stress was on
the *rest*.

Good luck,

--
Ylan

"The universe is not required to be in
perfect harmony with human ambition"
- Attributed to Carl Sagan

Ylan Segal said:

Take care of your injury now, instead of later. Missing a
race or a week or so of your training is much better than the
injury becoming more serious.

I second this, and I do speak from recent experience. In 2003 & 04 I
was sidelined for a week or longer at least a half dozen times; in 05 I
twice took a few days off/easy, iced & did some targetted stretching,
and was back to my regularly scheduled programming almost immediately.

Some folklore says injuries get exponentially worse with each day you
run on them. It also seems to me that experienced runners who have
already dealt with a given pain / sensation / injury sometimes know
they can get away with reducing the distance and/or intensity rather
than stopping altogether; but this depends on the runner, the body
part, and its dysfunction. Better safe than sorry, stitch in time
saves nine, an ounce of prevention et cetera ad nauseum in my book.

FWIW, just this last Sunday evening I started to experience about the
same sort of discomfort described by the OP. I became aware of it
during a 15 minute walk in the neighborhood and couldn't identify
anything I had done in the preceding seconds, minutes, hours, or days
to stress my outer ankle, unless it somehow had to do with wearing my
hiking boots for one of the first times this fall.

Anyhow I iced a few times that night and maybe 5-6 times the next day.
I've been able to run on it - I am going short and slow lately anyway
due to other factors - without discomfort and have felt no discomfort
at all today.

Quoted message said:

When I sprained my ankle some while back, the doctor prescribed
RICE (Rest, Ice, Compression and Elevation) and Ibuprofen. The stress
was on the *rest*.

I don't know about sprained ankles or yours specifically, but ibuprofen
is in general at best somewhat controversial - probably best to read
up, and not reflexively take it for every ache and pain.

And I certainly wouldn't deemphasize rest, but I also think ice may
deserve at least a secondary stress compared to the CE - though maybe
their relative merits vary from one malady to the next, I dunno. Dan
Stumpus seems to be a real ice devotee, and my experiences with it this
year lend support to its miraculous properties.

Charlie Pendejo said:

I don't know about sprained ankles or yours specifically, but ibuprofen
is in general at best somewhat controversial - probably best to read
up, and not reflexively take it for every ache and pain.

Good point.

Note to OP: I am not a Doctor, nor play one on Usenet.

Quoted message said:

And I certainly wouldn't deemphasize rest, but I also think ice may
deserve at least a secondary stress compared to the CE - though maybe
their relative merits vary from one malady to the next, I dunno. Dan
Stumpus seems to be a real ice devotee, and my experiences with it this
year lend support to its miraculous properties.

Actually, I think all the RICE components have their merits.

In my case, I thought the compression and elevation were most useful in
the first few hours of treatment, when the swelling was at its worse (my
ankle looked like a grapefruit). After the swelling came down, I stopped
the elevation, but kept the other 3. I feel that most of the subsequent
benefits came from the ice and rest (and your experience seems to
suggest this too), but who knows? Doctor said to keep the compression
bandage, and that is what I did.

Once I started running again (about 6 days later) I did it with the
bandage, for about a week, since I still felt my ankle was a little
weak. It seemed to help, but it could just have been a placebo effect. I
dropped it about a week later and ran carefully for about a month, since
I could still "feel" the injury. I haven't had a problem with that ankle
since.

--
Ylan, who can't come up with witty endings to each post like Pendejo
does, but is making a crude attempt.

"The universe is not required to be in
perfect harmony with human ambition"
- Attributed to Carl Sagan

In article <[email hidden]>,

tsbjax said:

Hello,

I am new to this group, but am hoping for some insight and advice on a
very frustrating issue.

I am training for a half-marathon in January (my first one), and have
been doing great up until about a week ago. I started noticing some
pain on the outside of my right foot, sort of below and around the
ankle bone. It was very mild, and would go away pretty quickly. I did
a trail race this past Saturday, which took me through some pretty
rough terrain, and lots of beach-type deep sand. I felt fine that
night, but into the next day I started feeling my foot/ankle pretty
badly. I ran yesterday (Monday) and it felt "ok" although I was aware
of it. By yesterday afternoon, it was really painful, even just
walking. It almost feels like an ankle sprain.

I ended up going to a therapist yesterday afternoon who does ART
(Active Release Technique) therapy. It felt better afterward, but I
ran this morning (stupid) and it has hurt pretty badly since. I have
another appt. with the ART therapist tomorrow, and I'm hoping he can
help. I want to do a 5k race Sunday night, and a long run on Saturday,
and I'm wondering if I will be able to. The therapist says my peroneal
tendons are out of whack--they probably got worse by running in the
deep sand.

Has anyone had experience with this type of tendon issue/pain? If so,
would you share what you did to help it? Has anyone used ART therapy
and if so, what are your thoughts? Should I not run in the 5k Sunday
night? Do you think I'm still ok for the 1/2 on January 15th?

Sorry for all the questions--I'm just feeling pretty down and
frustrated at the moment. Things were going so well!!

Any advice would be greatly appreciated!!

Thanks.
Tara

Tara,

Have your therapist also work on your posterior tibialis. That and the
peroneus are called the stirrup muscles and effect each other.

A reply to someone with a Peroneal strain from back in 1999:

In article <[email hidden]>, Katherine Verleger

Quoted message said:

I fell victim to a -nasty- patch of ice (and I -was- looking where I
was going, drat it!) while walking to class last week. Got off the
crutches relatively efficiently, and am doing the flexibility
exercises they gave me at the University Health Center. They've
told me to stay away from running until April, and recommending
swimming and biking to keep the cardio benefits up. No problem
there.

Here's the question -- how do I come back from this? The last time
I got told this, it was "wait until fall of '98 before running
again." That was 2 years ago (obviously -that- sprain was
substantially nastier than this one, they were worried about major
ligament & tendon damage which they don't think I'm at risk for this
time), and I started from scratch.

I'm a recreational runner, 6-9 miles a week, and a grad student,
which means I tend towards a relatively sendentary lifestyle aside
from the running. Should I just start form scratch (again)? Any
thoughts on what I can do to keep the flexibility and endurance I'd
-finally- built up again? Commiserations? Anecdotal evidence on
what works, doesn't work, etc.?

Katherine,

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.

Way to loosen it with someone else helping.

Have your partner start about 3 inches above the ankle bone. Hold as if
you are going to strangle - 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 your partner use light pressure by pushing in with theirthumbs as
you make a small (emphasis on small), smooth (emphasis on smooth)
circle. As you makes small smooth circles with the foot your partner
strangling your leg, slowly slides 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.

Usually after 3 or 4 times of small circles and your partner holding,
walk. 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.

To do the same thing, face a railing with a middle railing (see picture
from web site)http://www.mindfulness.com/of1 . Turn your body 45 degrees
and place the peroneus side of the leg on the bar, usually the lower is
better unless you're very tall. Do the same foot movement as mentioned
above to loosen the peroneus and the fascia which may be constricting
the ankle for its full range of motion.

In health and on the run,

Ozzie Gontang
[email hidden]
Maintainer - rec.running FAQ
http://www.faqs.org/faqs/by-newsgroup/rec/rec.running.html
Director, San Diego Marathon Clinic, est. 1975

Mindful Running http://www.mindfulness.com/mr.asp

Thanks Ozzie and everyone for your replies. I will take everything
into consideration. My ankle feels better today--I rested (so hard for
me), and have iced about 3 times since last night. I will see the ART
therapist this afternoon.

In my desperation to get this thing whipped, I called a chiropractor to
schedule an appointment. He says I should see a podiatrist to rule out
a stress fracture first. That, of course, freaked me out. Could that
be my problem? I certainly hope not. It definitely feels better when
I walk on it today, but the pain I do feel feels like a "pulling" in
that area, like something (tendons?) are pulling around that ankle
area.

I went ahead and made the appt. with the podiatrist for Monday...we'll
see what he says. Does anyone know what I would be feeling if it were
a stress fracture?

Thanks so much!!

Tara