Hi everyone - A lady mislaid her 'goody bag' while she was having a massage after the run today - we found it at the end when we were clearing up (I'm assuming it is hers - everyone else was holding onto theirs for dear life!) and it would be a shame for her to miss out on the memento (v.nice) if she didn't manage to get another bag.
Anyway, if anyone knows who she is - and if she wants her bag back - can she call us at sport-med on 0161 474 7469 or email email@example.com
Forgot to ask before, Newty - did you ever try acupuncture? Myofascial pain syndromes from trigger points can reproduce this pain in the anterior tibials, and acupuncture can be really effective in reducing muscular tension. Just a thought?
You need to control overpronation -not just with orthotics and motion control shoes, but by switching on the gluteal muscles (which stops the thigh rolling in and overpronation of the foot during the gait cycle)I'm assuming your physio gave you some postural control exercises as well as the knee bends etc.... You also need to control the speed of pronation (cause some pronation is normal, it's when you go too far and overpronate that you irritate the tendon and the periostium - the surface of the bone)You need some eccentric control exercises for the anterior and posterior ankle muscles to make this movement smoother and more controlled and to strengthen the tendon. I would have thought that your physio would have given you these exercises, but if you want any more info, email me on firstname.lastname@example.org and I'll try and explain more.
Totally agree - methods don't always work for everyone. Just sounded like a slightly OTT approach to have surgery if none of the conservative methods have been tried. If conservative methods don't work THEN have surgery.
Like I said, try the biomechanical assessment, find out why it's happened and deal with the causes.
Sorry if I didn't make myself totally clear. Hope you get it sorted.
I'm assuming you're talking about compartment syndrome in the anterior tibials - the muscle becomes overdeveloped and too large for the sheath surrounding it causing a deadening pain in the muscle. If you have the op (a fasciotomy, where they split the sheath to reduce the pressure) you can just end up with more problems - scar tissue where they've done the cut can contract, causing it to get even tighter, or the muscle continues to overdevelop and gets to big for the split sheath causing the same problem again. As well as all the obvious risks of infection etc...
Ways to get rid of it
1) Heat - apply warmth so the muscle becomes soft and more pliable. Hot water bottle for twenty minutes should do.
2)Massage the muscles - start with a professional massage to get the ball rolling then maintain the muscle relaxation at home with some self treatment either using your hands or a massaging aid - knobbler, roller etc.. for about ten minutes a day. This reduces tension in the muscle and reduces pressure which eases the pain.
3) gentle stretching - gently sit back onto the ankles. If this doesn't give a stretch, roll a towel up under the toes in the same position.
All this is well and good for treating the symptoms, but you've got to deal with the cause to stop it coming back.
4) Biomechanical assessment - the muscle often overdevelops due to overpronation (the thigh rolls inwards, the foot goes flat and muscles have to work harder to dorsiflex (pull the toes up) the foot from a flat position, to swing through for the next step. This overdevelops the muscle. So stop overpronating - either using a core stability approach with/or orthotics with/or motion control shoes.
5) Cut the training by about half, until it settles, then gradually increase the training over 2 - 3 weeks to get back to full training.
I had a patieny who was listed to have surgery a week later and came to us as a last resort. He didn't need the surgery and he's fine now. Give it a try?