This is very very helpful and I will definitely let you know how it goes! Standard practice is immobilization followed by physical therapy. I would highly recommend that you find someone that can evaluate your lower body looking for imbalances in strength and mobility. So typically a person will need a shoe or orthotic that provides a better arch support. It is also possible she sustained a ligament tear of one of the smaller ligaments that hold the carple bones. Lighten the load and focus on technique then slowly progress the resistance. She also told me to continue running, which I did…got back up to 12 miles before I decided Honolulu wasn’t going to happen and just stopped running. So……..I am sorry I can’t be more specific but looks at mobility of the foot and hip as well as strength of the foot and hip and compare side to side. I think the best advice I can offer at this time is to be more patient with yourself. Whilst running is obviously a no go or a while, is swimming ok? Chronic Pain; Cold, Flu, and Sinus ... and success aren’t the same as the warm and fuzzy feelings of happiness—and mixing them up may actually bum you out. Also any orthotic you use OTC or prescribed will change the drop of the shoe so again its alignment and comfort that matter most. I agree with you that people with diabetes can have a more difficult time healing. You may find a running lab either in or near an Olympic training center, a very niche high level physio clinic or tied to a university. Look at your entire lower body address any issues in range of motion, strength and balance. Do you have any advice for me? Exercise will not be a quick fix but a long term maintenance. By day 9 I was in extreme pain and couldn’t do a single heel raise and had to resort to crutches to get around. This was March 2018. If you choose to self mobilize you would not want to do it for very long. I followed it and as such have started to slowly increase running to a point I have done a 5k. One would be a surgery to explore/repair any potential issue the other would be a trial of Stem cell injections followed by immobilization and then PT. Thanks for all the advice!! I can do single foot calf raises without any pain, and I can run short distances without feeling anything. I look forward to hearing the rest of this story after you have healed. At the end of this two day period I felt big improvements when just walking around, and decided to try running again this morning. She said I will acclimate over time. Thanks for your article. You do not need to wait until you are 100% pain free before you start rehabbing. What is an Inspirational Team Names With Meaning? I should have planned more rest and recovery days here. In my opinion you will not be able to rest yourself out of all the aches and pains you have. When attempting to jump on one foot do you get pain? I go back soon for a MRI. Thanks for the question. Lee….sounds like you have already delved into deep introspection. Your body is telling you that it needs more time to adjust. The human body is amazing. Not sure where you live but I would suggest getting a good pair of over the counter orthotics. I will have a go at the 5 set of 5 reps, and continue with the exercises. This way you get the benefit of the magnesium absorption as well. Good Luck! heel raises. There are many people with genetically flat feet that have never suffered any pain from them. Otherwise I have people start back on an extremely slow progression. Hi Ben! Thank you so much for such an informational site! Both the cubiod issue and the PTTD are likely symptoms not the root cause. They just do not hurt as much. So though 4 months is a long time when looking at severe injury it is not. Should I be strapping it to limit mobility? I don’t think you need to give up on the dream to run a marathon, you will just have to progress more slowly and be sure to eliminate as many risk factors for PTT as possible. Thank you for the input on my post. This will cause additional scarring and hopefully more stability in the area which will help the pain and help to avoid surgery. I was training for a marathon and in mid Feb i got a pretty bad Soleus strain. Hi Kishor, It sounds like there is something going on with your running that is putting too much stress on your foot and lower leg. Hope that helps. When finished, I had a lot of soreness on the inner ankle area which I iced immediately. They are responsible for achieving the upright posture when the body is bent at the waist; maintaining the body in the upright posture by keeping the hip joints extended; and propelling the body forward via further leg (hip) extension when walking or running. [3] A modern-day example can be seen in some Southeast Asian countries, such as Singapore. You will want to work on slowly and progressively strengthening the muscle and addressing any other biomechanical issues that may have lead to this. Just make sure you haven’t missed anything that is out of balance up the kinetic chain. I do weights upper body and so far squats and deadlifts – no lunges. And yes this will bring more blood flow to the area which should bring in more nutrients and theoretically help it heal faster. Was sent to PT for 18 weeks (I’m the one that suggested PT to the doctor.) I ran the London marathon and it was such a bittersweet experience. My GP suggested steroids injections. I think you are doing the right thing to try and rest it prior to the race and just work on keeping a decent base with cross training. Hi Becky, good question. I do not possess a long history of continuous running and during 2017 I have been running only since May, so I believe I’m pushing myself “too hard too soon”. Happy rehabbing! Congrats on the NYC marathon, Marsha! This happened after I had been working out by running, walking and going to zumba classes 5 days a week for almost 2 years. I was grateful he believed I wouldn’t need surgery though. Then, I think from all the stress, exhaustion and lack of sleep, I came down with the flu! Don’t progress your training volume and/or intensity levels too quickly. Of course you have to slowly progress to that don’t jump right in. I have had it before and where I was advised to do some resistance band exercises and heel raises. Thank you for any input you have the time to furnish. I can manage wearing these insoles for a bit more time, but without the Duexis the pain hit a level 10 in a few hours. Start back with the easier ones then progress as you tolerate. I have no pain when doing them but I am bearing my own weight. My foam roller is coming out of the shed tomorrow where it’s been for quite a while! Refunds  •  Privacy Policy  •  Terms of Service, Online headquarters of the Marathon Training Academy Podcast and running coach, Empowering You to Run a Marathon and Change Your Life, Posterior Tibialis Tendon Dysfunction Exercises.pdf, Lower Extremity Mobilizations using a Foam Roll.pdf, The American Physical Therapy Association, https://www.silvesterfootclinic.com/library/amniofix-injections-for-plantar-fasciitis.cfm, https://www.youtube.com/watch?v=Vmh5sOF1-MQ, https://www.youtube.com/watch?v=NkfZ3EqUgYc, https://www.youtube.com/watch?v=k2-Wq7WCS0I, https://www.thephysicaltherapyadvisor.com/2014/06/11/7-reasons-why-the-squat-is-fundamental-to-life/. I believe the human body functions best when it is able to move and remain strong. In early 2018 I followed a 16 weeks program for the London marathon and at the very end of one the last long runs (27kms, which I had never ran at the time) I had BILATERAL pains to my posterior tibial tendons, just over the navicular areas, worse when I stopped running and walked and so bad that walking was extremely painful for days. The calcaneus (heel bone) usually shifts outward at this point. I really hope this helps. More recently, the cleavage of the buttocks is sometimes exposed by some women, deliberately or accidentally, as fashion dictated trousers be worn lower, as with hip-hugger pants. And do you think that I will have a full recovery? In cases as you described often we find forefoot and great toe lack of mobility significantly contributing to the issues found elsewhere in the foot. No twisting of ankle, no fall. What would you advise? With regular icing and icing the pain is minimal which is encouraging, but I would like to eventually get back to marathon training and it’s about time for me to replace my long run shoes. I would advise a short test run (warm up first) the day before. The brace helps sooo much and I consistently wear it. With not much progress after total rest, I finally see a podiatrist who immediately recommends orthotics (and I have to explain that orthotics cause problems and solve none for me) and 2400 mg of ibuprofen a day for two weeks. I’ve seen my PT this week. Good Luck! Good Luck! I am glad you are working on your balance and strength exercises. A week after Chicago I saw my PCP and he diagnosed me with PTT but also said running shouldn’t be a problem. HI Kieran, Sounds like you are on the right track for the exercises. Good luck home your running pain free again soon. There will likely be several problem areas than need to be addressed, but the good news is that it is completely treatable and she should get full resolution. 2. Again go back to the most typical reasons for this to develop including issues with foot strike and footwear and of course hip strength as weakness in the rotators of the hip will cause foot strike issues and ultimately pain. As PRP injections progress you may look into that as an option. Again, even if it supports the tarsal tunnel and PTT, at what cost to the rest of my body? I have researched different massage techniques for PTT and that seems to help her. Massage and acupuncture can both be helpful in promoting healing and reducing inflammation. It can temporarily help with the pain, but again those tendons take a long time to heal. Ben, Elizabeth. They need to be at least a semi rigid design. You need to start with the hips and work your way down. If the pain does not subside you may need to be in a walking boot to immobilize the area for a while. It can help provide a diagnosis which can help guide treatment and recovery. Also you need to start working through the exercises noted in this article. Well I don’t know what it is/was but I was able to train through and have pain maybe 5% of the time now. Chris….sounds fantastic. All together it is working. I have been suffering from this condition for couple of months now, and it occurred right after my recovery from pes anserine bursitis injury (probably I began too much too soon right after the recovery from PAB). I do not want to stop running for as long as last time. I have high blood pressure and pre-diabetic… both treated with meds. I met with a “master surgeon” who is recognized as a leader in the HypoCure procedure here in Northern CA and was told I am a viable candidate for the procedure (I still have the flexible arches / can form an arch and can do one legged calf raises etc.) Something a little outside the box is to work on hip external rotator strength and glut medius strength. He put me in a walking boot for 6 weeks and then on crutches for 3 weeks. Good Luck! We recently went to an orthopedic doctor who is attempting to get her a referral for a MRI, but at this point she is quite frustrated.

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