Diagnose Me

>> Wednesday, January 20, 2010

.... No, not my “head” problems. And not my undiagnosed hypertrichosis with a hint of triathlon-induced narcissistic personality disorder - I’m at a good spot with that.

As many of you “regulars” know, I have some constant achilles issues. I tend to get overuse injuries. But for the last 2 weeks, it’s been changing a little, and I don’t know if it’s STILL an achilles issues.

Normally, the pain is at the lower part of my calf / upper part of my heel, right in the middle. Usually, the pain is here:

But over the last 10 days or so, it SEEMS to have been slowly moving around to the inside of my leg. Now, the pain is here:

It’s a dull, deep ache. Could this be the same achilles issues as before and it’s just moving to a new part of the same tendon? Or could it be something different? Any thoughts? Time for an appointment with my ART Doc?

I’ll post this to a BeginnerTriathlete Forum as well, and we’ll see who can diagnose me better... ;)

Thanks everyone!


mattGT 7:02 AM, January 20, 2010  

Might be overuse/tendinopathy of your tibialis posterior muscle (shin slpints in the back).

GoBigGreen 7:22 AM, January 20, 2010  

Yes. Posterior Tib. Wade can help the symptoms but perhaps it's time to see a good PT so you can diagnose the why? Do you overpronate? A shoe change would be the first non medical move:)

Wingnut 7:43 AM, January 20, 2010  

I was thinking posterior Tib. I agree with the PT recommendation as well. ART won't fix the problem, it's only addressing the 'what' and not the 'why'. You need a good biomechanical eval. Perhaps the issue is really stemming from a weak gluteus medius. If the glute med is weak, it will throw off the whole chain down to the foot. Skip ART and get a PT eval.

Coach Liz 8:17 AM, January 20, 2010  

Steve, have you looked at my Tuesday Training Tips? It sounds like you have ankle mobility issues. Basically, you need more flexibility because the tightness is causing lower leg pain and could lead to injury. I have just a few tips on my blog, but you can contact me for more info. Before you go the route of PT, try the mobility exercises and see if it helps and if not, THEN go and see the PT.

Think simple before thinking complex.

Maggs 9:25 AM, January 20, 2010  

If you can see an ART person, go for it. It might only take one visit and they can give good insight on what's happening.

Velma 9:30 AM, January 20, 2010  

I agree with some of the previous posts. I went to an ART doctor for a while, and he helped with the symptoms. Now I am working with a sports med MD and PT, and we are getting to the root of the problem. Good Luck!

Greenking17 "TRI-harder" 9:35 AM, January 20, 2010  

What they said. Simple is the truth here. i read, the other day, a running injury is always curable (fixable) if it came from running...so find out what the cause is and then what the fix may be.

Jeff 9:39 AM, January 20, 2010  

Two words: Physical Therapist. (Two more: go now)

Anonymous,  10:07 AM, January 20, 2010  

I agree with mattGT. It could be steming from your foot/arch area. Good luck and let us know how you make out.

Amy - the gazelle 10:16 AM, January 20, 2010  

I have the same thing, on my right side, because my ankles suck. My ankles do not bend as much as they should when I run, so it puts extra adjustment strain on that area (and then my knees, my ITB, my hip, my adductors, etc). Considering all the running on odd surfaces you've done lately, it's not surprising you're having more pain there, as your body is having to do more adjusting for balance than usual. My sports massage guy has been invaluable in helping with this injury.

SteveQ 10:33 AM, January 20, 2010  

Soleus muscle strain due to overcompensating for lack of flexibility in achilles tendon.

D 10:42 AM, January 20, 2010  

Don't bother with PT.
ART is what you need. And I hate to say it, but stretching REALLY helps this problem too (I'm the anti-stretcher, but for this one situation it helps sooooo much that I give in).

After years and years of different injuries and issues, this is the only one that's been a problem for me in the past few years. ART & stretching, both gastrocs & soleus!! (and actually, removing ART and *just* stretching after some time) are just what you need.

Mary,  12:21 PM, January 20, 2010  

Any chance you have a stress fracture?

trimybest 12:46 PM, January 20, 2010  

Go see a PT! I agree with the posterior tib muscle.

Anonymous,  1:17 PM, January 20, 2010  

+1 rule out sfx

Kristen 1:38 PM, January 20, 2010  

Do you have a high arch by any chance? I incurred the same injury recently and was told because I had a high arch, that I supinated and this was throwing my stride off causing my foot to roll in.

Carolina John 2:17 PM, January 20, 2010  

That actually is usually more of a knee thing. i dont' know how to fix it, but i believe it's related to a knee flexibility issue.

LHE 2:21 PM, January 20, 2010  

FWIW: I get the pain after running as well as the dull ache in the exact area on image 2. I also have a high arches. I'll be no help to you, but this post and the comments has been help to me! Thanks!!!

Charlatan Mountebank,  2:25 PM, January 20, 2010  

You present well, with some genuine insight into the SERIOUSNESS of your CONDITION, but you're obviously DYING....

You might yet live to be 80, but if that's what I think it is, don't count on it....

All that POUNDING has loosened an ENORMOUS CLOT which is painfully advancing through the arteries in your calves, to its rendez-vous with DESTINY....

Your BRAIN....

Anyway, that's the best I can do, without a lot more data, ie., GROSS FOOT photos, CAT-LICKS, PITZ shots, etc....

Meanwhile, I suggest you enjoy what could be your LAST DAYS with Pharmacie, indeed, your last TIME....

Dr. Charlatan Mountebank

P.S. Hardened as I am by years of (mal)practice, it yet saddens me to the point of tears. This! For one so young. So beautiful! So GOOD!!!


Unknown 2:40 PM, January 20, 2010  

compartment syndrome. :) Who knows. Agreed. See a doc! :)

Lani 3:35 PM, January 20, 2010  

Do you have any swelling in your lower leg? Does it ever hurt when you are not running? I have had 2 blood clots and they presented pain in the same area. If it's not swollen or only hurts when you work out I wouldn't worry as much, but I would get it checked out.

Ana 7:59 PM, January 20, 2010  

Judging by your pictures, you're a hard heel-striker. Change your running form (read about Chi-Running and/or POSE technique, read Born to Run) and your running injuries will disappear.

Silvergirl 10:34 PM, January 20, 2010  

You are definitely pointing to the posterior tibialis muscle-but again, just from a post, it is impossible for ANY of us to diagnose you properly and more importantly, to give you an accurate reason behind the WHY-which is definitely the #1 question you must answer. Find a good PT, who can do a thorough biomechanical assessment and hopefully give you the answers you are looking for! As a PT myself, I believe in ART for reducing symptoms, but PT for diagnosing, treating and preventing reoccurrence! Good luck!

Melissa 10:52 PM, January 20, 2010  

Hi Steve. OK, I'm pretty sure it's not this based on what you described, but since you mentioned the pain moving up to a new location, I feel like I have to say: if it moves up further towards your knee, consider the slight chance it's a blood clot. I hate saying that, but I had a friend who complained of heel pain, then his calf felt tight, then he ended up in the hospital with a large blood clot. Just be aware if it keeps moving, please :-)

I just had to comment. I hope you figure it out and get back 'at it!

Anonymous,  2:53 AM, January 21, 2010  

Soleus. There are specific stretches that will help.

Anonymous,  12:39 PM, January 21, 2010  

I love all the faith that is placed in the PTs. Only one problem, the majority of them are not trained well enough to diagnose. A good biomechanical evaluation is appropriate here. Find a good sports orthopedist or sports chiropractor that can diagnose you, perform ART for you and give you some sound advice to alter your running form. You really have answered the question all by yourself by stating that you have a chronic Achilles tendon problem. You are a hard heel striker. Check the form.

Unknown 1:13 PM, January 21, 2010  

Before I would go spend any money at all, I would go to the shoe store and try on the exact same pair you have now, and see the difference.....

TriathleteRocker 3:34 PM, January 22, 2010  

Hey, I've had soreness deep in the same area that you're talking about. I was doing too many miles a week for my fitness level at the time, and I know this because the rest of my body was going to hell at the same time. :) Overtraining? Maybe too much impact stress? Hope this helps.

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