Injury couch chronicles: The Physio visit

[nowster]

I've just spent an hour being prodded and squeezed by a physiotherapist.

I was the first person she'd ever seen wearing toe shoes.

After a bit of quizzing, she got down to checking movement and pressing on various areas. Ouch!

She identified two areas of tendons around the front of the ankle that are injured. Also by chance identified a touch of shin splints on the inside back of the leg.

She's currently suffering from some shin splints herself. She had been working up to a 10km run in Tatton Park and got injured at the 6km mark.

And then she massaged the areas to break up any potential scarring. Ouch! Ouch!

My homework:

- Elevate the ankle above waist height from time to time

- Alternate cold and hot compresses on the ankle a few times each evening (approx 10-15 mins each)

- Plenty of Ibuprofen for the inflammation

- Ankle exercises: circles clockwise and anticlockwise, step edge lifts/drops

- Balance exercise: balance on one foot on a cushion or pillow for a minute or so

- Ankle stretches: kneel on bed with toes pointing horizontally and push on heel (essentially a "foot pull")

- Calf stretches: eg. foot-pain-explored.com/calf...

Come back next week for more prodding and poking. No running for at least another two weeks and, when you do start running again, run short intervals.

And... you've been expecting this, haven't you... maybe wear some more supportive shoes when I restart running.

[IannodaTruffe Mentor]

I hope that sorts you.

The whole "barefoot" running movement is highly contentious..........as is cushioned and supportive shoes........but most running shops will not recommend barefoot until you have developed your running musculature fully and even then transition is safer if done gradually.

I love the Idea of barefoot running and studies in India have shown that children who wear shoes have more foot issues than those who don't, but as someone who has spent most of my working life in rigid steel soled and toe capped boots, my feet definitely need some support and cushioning and removing that would most likely lead to injury.

Take care.

[Biscuitbaker]

Really positive that you’ve now got a plan of action, you’ll be back running before you know it. (That’s what I keep telling myself anyway as I languish on the injury couch 🙄)

[nowster Graduate in reply to Biscuitbaker]

Part of writing it up here is so I could remember all the things she'd told me to do. 😀

[Tinytears60 Graduate]

Well least your getting sorted with some professional advice!

👍 That’s good... even better that’s she’s a runner... she will know her stuff!

Least you have a plan of action 👌

Soon be sorted once that kicks in 😀

[Lookslikejames Graduate]

Sorry to hear you’re still having problems, but at least there’s a plan to get back to fitness. Good luck with it all.

[Blondefox Graduate]

This does make me wonder if exercise really is good for us.......😂

[nowster Graduate in reply to Blondefox]

Not exercising at all is worse for you.

[Blondefox Graduate in reply to nowster]

Yes I know - but in the short term it doesn't hurt as much! Long term however.....

[moshpitmolly in reply to Blondefox]

Hahaha that's what I'm thinking with my black eye 🙄🤕

[Blondefox Graduate in reply to moshpitmolly]

How did you get a black eye?

[moshpitmolly in reply to Blondefox]

Tripped over a stone or a branch on Tuesday night about a minute into my cool down walk 🙄 and headbutted the pavement. That's the last time I run in the dark!

[Instructor57 Graduate]

Good to hear you know the problems and the solutions !

Stick with it ! You will be better for it ! 👍

[nowster Graduate in reply to Instructor57]

Strangely, after the manipulation, a single ibuprofen and a few hours' rest the ankle is already feeling a lot better.

No, that doesn't mean I'm going out for a run any time soon. I normally walk to the chippy on a Friday evening (about 1 km round trip). I'm driving there today.

I'll be doing the exercises etc. religiously. I want to be able to get out there again.

[Instructor57 Graduate in reply to nowster]

It will be all the sweeter when you restart 👍

[Birdlady64 Graduate]

Well, at least you know what the problem is now, and that it can be fixed.

Great that you managed to find someone who knows a bit about running too. That will make all the difference.🙂

My experience with physiotherapy after a car accident some years ago was rather less than positive.

Keep up with the exercises and you'll be back out there before you know it 👍

Enjoy your fish and chips! 😋

[Dexy5 Graduate]

So glad you got expert advice nowster - physios are worth their weight in gold. I’m now running again after suffering Achilles tendinitis and those exercises really made a difference. Good luck to you on your recovery and have fun later choosing a new pair of shoes after gait analysis.

[Tasha99 Graduate in reply to Dexy5]

I’m on tenterhooks...

[Tasha99 Graduate]

A higher drop must surely help ankle issues. Good luck. Higher than zero is easy to find 🤣

[nowster Graduate in reply to Tasha99]

Actually higher drop shoes are extremely uncomfortable for me to wear nowadays. My calf muscles and tendons have had eight years to adapt.

Support could mean a less flexible sole and something to control ankle rotation and pronation.

[nowster Graduate in reply to Tasha99]

Thinking about the geometry of it a little, the area of the injury being at the front of the ankle would arguably go against a higher drop shoe being the solution.

The shin splint on the other hand...

What I do suspect is it's a case of "too much, too soon" and being overconfident. The balance between the muscle groups hadn't yet developed and matured.

The other thing that might have made it worse was driving round the lanes of North Yorkshire for many hours on Bank Holiday Monday. Lots of clutch pedal use on the back roads.

I'm doing ankle and calf exercises now and will be adding walks/gentle runs on uneven surfaces to my regime when I resume.

Actually feeling good (when I'm not stretching the ankle) this morning. Still a bit stiff.

[Tasha99 Graduate in reply to nowster]

It’s to do with where the stress is distributed to when you land. Having a higher drop puts the stress more through the higher part of the leg than the lower.

zappos.com/c/what-is-heel-t...

I only go on about drop as changing it fixed me completely overnight. Only 3mm change rid me of crippling knee pain.

Where are you in North Yorkshire? I’m in Middlesbrough. At the foot of the moors 😊

[nowster Graduate in reply to Tasha99]

It was a trip out on a sunny day: Skipton and onwards north to Aysgarth Falls. (The steep hill from/to the car park there didn't help either.)

I'm in North Manchester, aka. CV19 central.

The literature out there is hugely contradictory. The link you gave says:

"Most experts agree that runners with chronic knee issues could benefit from a lower-drop shoe, which will move some impact forces off the knee to the lower leg. But, remember, those impact forces have to go somewhere."

...which is contrary to your own experience. 🤔

[Tasha99 Graduate in reply to nowster]

No I’ve gone to a lower drop - the opposite issue to you - knee pain.

Pretty much Covid central here too 🤣

[GoGo_JoJo Graduate]

Good luck with the exercises. I'm looking to potentially transition to 5 toed barefoot shoes, I've got some Vibram evos that I'm wearing as slippers and for walking. Because I spend a lot of time in work boots I feel like my feet need to stretch and breathe!

I agree a more rigid sole may help, perhaps a trail version with a thicker sole.

If not, Saucony trail shoes are only 3mm rise, or maybe a vivobarefoot sporty shoe.... either way, good luck 🤞🏻👍🏻

[nowster Graduate in reply to GoGo_JoJo]

There are several models under the "Evo" banner. Usually it indicates refreshes of earlier models.

I was running in KSO Evos, which are as floppy as they come. I'll probably start again in Bikila Evos (aka V.Run) which have a bit more of a rigid sole.

The other thing about them is the toe splay. My toes really like to splay nowadays. Finding the right size is fiddly when most outlets are mail-order or a long distance away. Also my Vibram shoe size has gone down since switching: from M47 (12) to M46 (11½).

I suspect I'm 47 in VivoBarefoots as that's the size of my hiking boots from them.

~~~

Anyway, today my ankle is feeling lots better. I can feel it's not right yet. But I can go up and down the stairs at speed again. I've just been in the shower (Sunday lie-in plus late brunch). Bonnie Tyler's "Holding Out for a Hero" came on and I started doing ankle exercises whilst showering. 😀

[GoGo_JoJo Graduate]

Ah yes, KSO evo is what I have. They were fantastic for kayaking too 🤣

For wide toe box, if you end up having to look at more support I'd recommend hoka or altura as they have the best width toe box. Hoka is technically zero drop just with a thicker sole and is my primary trail shoe currently.

🤞🏻 for speedy solutions all round!