Strained Tendon in Foot

16 messages
13/06/2011 at 13:43

I just checked the forums and am aware there's already a thread on someone with a sore foot, but having read the description of the injury mine is different so I hope no one minds some repetition.

 As a bit of background, I've been training for my first half marathon and increasing distance week on week. Average week would be:

Mon: Intervals @ 5k total & Strength
Tues: Easy Pace 9K
Wed: Cross-train (Bike) & Strength
Thurs: Easy Pace 12k
Fri: Intervals @ 4k & Strength
Sat: Rest
Sun: Long run, easy pace 15k (increasing 1.5k per week

I've been clocking up longer and longer distances but doing it slowly (after recoering from an ITB injury in my right knee) and have been injury free.

Last Thursday I woke up with a sore right foot. I think it was due to wearing thin, thin shoes on a cold stone floor outside (at a BBQ) for 3 hours. It felt like it'd cramped up. Nothing major.

I went for a run on Thursday and it was sore. It didn't get much worse but the repetitive pounding was definitely not helping. I cut the run short and headed home.

Since then it's just not getting better. It felt swollen on Friday, I've not run on it at all since and have instead being doing the bike in the gym. 

Yesterday I used ice, then some heat, then some ice. It seemed to help a little but today it's still not any better.

I have signed up for the Race for Life 10k this coming Sunday and would really, really like to run it but won't if my foot isn't better. Before I spend some pretty pennies at the physio, does anyone know what this could be from experience or have general advice for helping a sore foot heal?

It's on the back end of my right foot, not ON the heel but from the heel up the outside of the food about 2/3 of the way up. The front balls of my feet are absolutely fine and it feels fine walking in high heels / on the ball of my foot. It's the back-end that really hurts to walk on. It's not gotten worse but it's not getting better.... Should I perhaps try not walking on it at all?

Thanks in advance!

13/06/2011 at 14:15

Hi Jen,

How long have you been training for this half marathon?  How often did you use the ice and heat? When does it now hurt? What does the pain feel like? Is the pain on the top (dorsum) or on the bottom (plantar) surface of the foot?

The pain sounds like it's situated midway along your 5th metatarsal. If you follow the outside of your foot (the lateral side), you should come to a small bump approx half way along.  This is your styloid process. Is the pain in front (nearer the toes) or behind (towards the heel) this?

That'll do to start with.

Kind regards,

Ablefeet

www.ablefeet.com

13/06/2011 at 15:08

Hi Ablefeet,

Thanks so much for your very detailed response! Yes I noticed that small bump on the lateral side, and it's from there down towards the heel. It hurts to put pressure on it.

I've been running again since April (I had a very bad ITB injury in January which left me unable to walk until February and then I very, very slowly began running again). I started up'ing my distances from 8 - 10k as a maximum, to beyond 10k about a month ago.

I put it on ice for 5 - 7 minutes, then heat for 10 minutes then just left it. And then did the same about 5 hours later.

It doesn't hurt when I've not been putting pressure on it for a while although if I've been walking, and then sit for a while I am 'aware' of it as if were a wee bit warmer or just 'angry'. The pain is just like an intense pressure that is sore to stand on. Not sharp, it doesn't shoot up my leg, and it's not overly intesnse...I was able to run over it but just cut it short as I knew I should. It's like a dull ache after walking, a strong enough pain when walking that it's all I can think about, but not crippling or overwhelming. If I walk for longer than 10 minutes I start to limp.

The pains only on the bottom of the foot, not on the top at all. And today in the gym, I noticed my calf muscle in the same leg felt tighter...I don't know if it's because it's over-compensating or just being used in a slightly different way.

I've only been doing the bike since the injury (apart from my first run) and that doesn't put pressure on it at all as I use the front-balls of my foot to pedal.

13/06/2011 at 15:32

Alright, I've got a few more questions.

What type of trainers do you use?

What happened with your ITB injury?

Kind regards,

Ablefeet

13/06/2011 at 15:36

I have trainers fitted to my in-step. They were bought at Run 4 It, and I was filmed running in several shoes. They do correct my instep.

 My ITB was brought on by over-training after a period off over winter. I just went too fast, too far, too quickly. It was my right knee (same leg as the foot) and due to my very bad natural bio-mechanics took a very long time to heal. I went to a physio, had a foam roller, rested for a month (ie didn't walk at all) then did lots of strength training. The pain was very severe, on the outside of my right knee. It hasn't come back since I rested it, although I did have a few 'false starts' in February / April where it got better, and even after walking a short while it got sore again.

 I have 'knock knee's so my knees go in. I also strike the ground on my heel and roll quite prominently on the outside of my foot. This is all according to the physio when I was filmed walking for my ITB. The ITB injury was so bad I literally couldn't walk for a month, the pain was unbearable.

13/06/2011 at 15:38
And thank you for asking questions and taking the time to think and respond I really appreciate it!
13/06/2011 at 15:55

Right Jen,

If I've got your description of your anatomy correct it sounds as though the pain is situated where your peroneus longus tendom goes under your foot, just behind the styloid process.  The action of this muscle is to plantarflex and evert the foot, aswell as stabilise the forefoot.  If, whilst being at the BBQ, you were in a poor pair of shoes, it could be that you've given yourself a very low grade localised tendonitis as he peroneus longus would have to be working harder. 

RICE is the key starting point, increasing what you're doing already, as you said you'd had a mild benefit from this.  With regard to your training, you're going to be able to maintian your cardio by doing the bike (or swimming so your non weight bearing).  Also, combine this with some good gastroc and soleus calf stretches as you can already feel the tightening where your body is trying to compensate.  

Also, due to the site there is always the possibility that it could be a stress fracture to the styloid process, which is very common in runners.  This would be diagnosed via an X-ray, but generally doesn't show up for at least 2 weeks.  If you place a tuning fork on the sight whilst vibrating, if this has you scraping yourself off the ceiling, good chance it's a stress fracture. 

Kind regards,

Ablefeet

Edited: 13/06/2011 at 16:00
13/06/2011 at 15:59

Hi Ablefeet,

 Thank you so much for taking the time to read my posts and give advice. I will do all you suggested, and if it's not improved in a few more days at all go to see a doctor or physio.

Do you know how long this sort of injury typically takes to improve? I know every single injury is different, but is it known to be a long, steady recovey (out for a few weeks) or can it improve in a matter of days?

Thanks again!

Jen

13/06/2011 at 16:06

I've just editied my post with more info.

I'm a musculoskeletal podiatrist, who specialises in gait analysis and sports injuries, and that's the sort of person I would recommend you go and see (this is with no disrespect to the physio's and GP's).

If it is a true tendonitis, then it needs rest - the more you do stuff, the more it'll be irritated.  But then you might find if you rest all week, you may still be able to do the run on Sunday.  Having never seen you, it's always difficult giving a truly accurate answer over the internet.

Kind regards,

Ablefeet

13/06/2011 at 17:07
Hi, I've been suffering with a similar injury!

Also training for a half marathon and 2 miles into a 5 mile run last Tuesday I noticed an ache on the outside of my left foot, slightly in front but under the ankle bone, and by 4 miles I was in agony and had to limp home and have not been able to walk on it properly since or even wear a closed shoe.

My gp sent me for an xray on Friday, but will take 10 days to get the results, though the technician did say she could see no obvious fractures so it could possibly be a tendon injury, but there is no swelling or anything. In the mean time I'm panicking that I'm doing more damage by walking on it!

13/06/2011 at 22:19

Don't panic Aydee! I've been walking on mine and just taking light steps, and avoiding walking where possible. Buses, drive a car, taxi a taxi. That's great you've already been to the doc's and had an xray. Having read around it more I think I probably should go to the physio / doctor's rather than "wait it out" as my calf is now starting to feel tight and this evening my old ITB knee injury twinged a little

Ablefeet, again thank you for the advice! It definitely helped in my understanding and research.

14/06/2011 at 11:30

Hi Aydee,

Your problem actually sounds different from Jen's problem.

Where exactly do you get your pain? Is it underneath your outer ankle bone (lateral malleolus) or is it infront of it? Was there any specific injury (eg twisting your ankle) or did it just "start hurting"? What does the pain fell like, and can you now recreate it when not running? what terrain were you running on and was it any different to what you would normally run on?

Kind regards,

Ablefeet

14/06/2011 at 13:10

Hi Ablefeet

The pain is just in front of the bottom part of the ankle bone on my left foot (if that makes sense).

It came out of nowhere during a run last tuesday. I felt a niggle along the outside of my foot at about 2 miles and by 4 miles I had to stop running completely. I was running on pavement and road, like I always do.

My foot feels okay when I rest it, just a slight dull ache where the heel meets the arch on the outside, but as soon as I try to  walk normally I feel a kind of pinching, crunching quite bad pain deep inside the painful area. It hurts if I press on the outside, but not severely and there is no bruising or significant swelling either. It also hurts a lot if I wear a tight shoe, so I have been in flip flops since it happened!

I have to say that It does actually feel quite a bit better today, but I that could just be because I have not done as much walking as usual!

Thank you for your response

21/06/2011 at 10:27

Hi Jen,

So how did the run go?

Kind regards,

Ablefeet

21/06/2011 at 10:29

Hi Aydee,

Are you still suffering?

Kind regards,

Ablefeet

21/06/2011 at 13:15

Hi Ablefeet

Well, my foot is much improved....as long as I don't wear a closed shoe or walk on it for too long haha!

After being pain free walking for a few days I wore trainers on Saturday for a shopping trip, however after an hour on my feet I was in absolute agony again and could not put any pressure on my left foot at all. Although this time the recovery has been much quicker and I was walking with very little pain again by Sunday morning.

 I did see my physio last Thursday and she said she did not think it is a stress fracture but rather a ligament injury. At the moment I can walk pain free in flip flops again, but the area is quite painful to the touch on the outside since saturday's episode.

I was hoping to be able to ease back in to running this week....wishful thinking??

This is all very frustrating, especially as I was supposed to run a half marathon on Sunday which I had spent the past 5 months training for!

Regards, Aydee


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