A few friends have asked when I would be posting another blog. Well, quite frankly, I haven’t cared to. Injury does more to you mentally than it will ever do physically, especially when that injury comes without warning, at least without noticeable warning, 4 weeks before a marathon.
I identified the problem as peroneal tendonitis and, without my influence, 5 professionals verified my results. (Freakin’ scientist.) Below you will find their diagnosis and plan(s) of action in the order in which I visited them. I am not using names and respect all of the people with whom I sought guidance whether their proposed solutions worked or not. The human body is a tricky instrument and I do not fault anyone, including myself, for not being able to figure it out all the time. The thoughtful, educated advice is what is appreciated and is the general method by which we continue to learn.
The Physical Therapist
Credentials: Physical Therapist, Certified Strength and Conditioning Specialist
A major bonus with this PT is not only that PT is an athlete, but also spends a lot of time working with dancers and runners. As an ex-dancer (12 years of that craziness prior to running), it is very helpful to have someone who recognizes some of the weaknesses that can be a result of those years in dance.
Diagnosis: Peroneal tendonitis as a result of tight calves
Solution: Initially, the PT taped me for peroneal tendonitis. History has taught us, however, that tape+Cat=no bueno. I pull that stuff off within an hour. PT also gave me some great strengthening exercises using the band and advised rest, ice and cross training. I eventually met back up with the PT a few times for deep tissue massage of the area and finally ART. Husband has been performing ART on my leg the past few days and it definitely alleviates some of the tension on that blasted tendon.
The Sports Massage Therapist
Credentials: Certified in orthopedic and athletic massage from the Center for Pain management, Massage Therapist for 10+ years, Interned at the US Olympic Training Center
There are more credentials than those listed above, but I think you get the point. Additionally, this SMT works with dancers, runners and triathletes. I met SMT at a race and have been to this professional multiple times at the beginning of an injury. The result has been positive and the injuries have not matured following treatment.
Diagnosis: Peroneal tendonitis
(At this point I should make a note because doctors reading this might be freaking out. These folks don’t “technically” diagnose me, but I’ve had some pretty poor luck with doctors. In fact, I don’t really go to them anymore. So, I trust the opinions of the people I’m listing here. They’ve also gotten me through injuries or kept me from developing them more than once in my 5 years in Norman, OK. Additionally, just like any good science experiment, it should be repeated and viewed from multiple angles.)
Solution: KT tape. Have you heard of this stuff? If not…here. But, I’m sure, as someone interested in athletics you have noticed professional athletes looking as if they fell into a vat of 3 year-olds with permanent rainbow colored markers. The KT tape felt good at first, but eventually it started pulling on the injury like other tape jobs tend too. This is cool because it shows how this incredible tape works without limiting range of motion. But it sucked for me at that moment in time.
Credentials: Doctor of Chiropractic Medicine, Naturopath, Acupuncturist
Another benefit of going to this person in particular is that I searched for a knowledgeable DC for a while and have been seeing this person for almost 5 years now. The DC knows me well.
Diagnosis: Peroneal tendonitis, the DC did not rule out a stress fracture in the 5th metatarsal either, but thought it highly unlikely based on analysis
Solution: The DC was able to adjust the ankle, but it fell back into the same painful position almost immediately. Rather than readjust, readjust, readjust, like a lot of DC’s will do, he used acupuncture. Post-acupuncture was the first treatment that allowed the foot to have a freer range of motion for over 24 hours. (This was prior to learning ART.) Acupuncture and ART seem to be the best combo, along with rolling the foot out using a golf ball, rolling the calf out with a foam roller and stretching my lower back/ham strings. I noticed that my right foot flares out a bit, which seems to be more a problem of the hip girdle being out of alignment. This combined with a tight peroneal would present as a foot flare, but, what do I know? I’m not a doctor.
The Shoe Guy
Credentials: 18 years of running shoe sales experience, ‘nuf said
I’ve been going to this running store since I began running cross country. I’ve primarily had success with a few failed shoes here and there. However, shoes are built with molds, foot construction is not so methodic. I went to the shoe store because, if I was going to run the marathon, I was COMPLETELY confused at this point on what shoes to wear. The Mizuno Legend circa 2005-2007ish was a magical shoe. Then they changed the mold. I’ve since struggled to find that perfect shoe, as I’ve touched on in a previous post. For the most part, the more broken down and the wider the toe box the better. My previous foot problem started in a motion control shoe (new model of Mizuno Legend) and this recent one in a stability shoe (Nike Structure).
Diagnosis: No diagnosis, but probably a form of tendonitis in that peroneal and, still, the potential of a stress fracture
Solution: Make a cut out with an old insert that raised my inner arch and heel. About 8 days post injury my foot felt better. 10 days post injury I went for a run in the Nike Structures with the inserts. Painful! Walking even hurt. I ripped those shoes off in a hot second. Walking slowly barefoot helped, but the injury was back. I’m not blaming the shoes or the inserts…just know that this didn’t work for me. I came home and cried…and took more time off.
In the mean time, I was attempting to heal the foot myself. Note: Drawing on the area didn’t work (see photo). I was also cycling, swimming and performing any muscle endurance and resistance exercises that did not aggravate the injury. (For example: aquatic bootcamp drills and some of the exercises Shane from Gym210 had given me.) I found encouragement from friends who had been injured (FYI: most runners have been injured) and found themselves stronger after healing. In particular, an elite athlete and friend was struggling with some of the same issues. Although, no one’s issues are really the same because no two bodies are the same. Check out Camille’s blog on the most recent addition to her education on foot mechanics.
Today, for my own sanity, I visited a Sports Orthopedist. I mentioned above I’ve had bad experiences with doctors. I KNOW you aren’t all uncaring, money hungry, and fueled-by-the-pharmaceutical-industry, but, let’s be honest, sometimes it sure does feel that way when patients pay upwards of $100 for 5 minutes of your time and a prescription for a drug that, if they’re me, they are not going to take. To my relief…
The Sports Orthopedist
More important to me…distance runner, triathlete, out-of-the-box thinker
Diagnosis: This comes complete with X-rays (if I had a stress fracture, it should show on a typical X-ray at this point), peroneal tendonitis
Solution: Keep the lower body as loose as possible (this is also advice I received from a really great runner in our state, Jenny Graef) and, unfortantely, it will be an experiment to find those next magical shoes. Doc also, in general, made me feel better about going to the marathon and baling if necessary. Doc said to run in whatever shoes feel better. There’s a chance, running in less supportive shoes, with pronation, that I would have some knee issues, but with all the strength training I do it is highly unlikely. My feet need to move. Inhibiting their range of motion is apparently detrimental to my running.
Now, I guess I go to the marathon and run what I can. If I was strictly a runner, which I always considered myself until this thought crossed my mind, I would run with no thought of taking myself out for the next 8+ weeks–recovering all summer. I suppose sometime last year, I became a full fledged triathlon junkie. The thought of missing triathlon season for my first marathon even after training to run a sub-3:30 just doesn’t appeal to me. I am, however, hopeful for a quick recovery and have prayed for healing more than I usually pray for myself. But, it is what it is. There are so many more miles yet to be logged and the best ones won’t be in races.