May 17, 2008
I've been running the track at school for almost four months, now. Over final exams and the very short semester break, I did not run at all (10 days). My first day back after the break, I ran my furthest distance, yet, just over 5 miles. The next day I had a little tenderness in my left ankle and knee. Then the following morning I awoke with a little stiffness, some mild puffiness in my ankle, a tender bump on my medial knee. I decided to run again (it's my habit to run M-W-F) because often it resolves the stiffness and works out my soreness.
Following the run, everything felt better, though a little hot. The following day, the bump on my knee was still there, even more sore, and the arch of my foot was a bit painful, and the swelling in my ankle was even more pronounced. I expected my symptoms would resolve over the weekend. On Monday, the swelling had gone down some, I still had the tender bump on the medial knee, some tenderness just below my medial maleolus, and a place in the arch of my foot that was tender and felt a little inflamed when I massage it. I decided to skip my Monday run and ask the advice of my colleagues who are also athletic trainers.
They suggested staying off the foot; treat with ice to reduce swelling; take OTC anti-inflammatory to alleviate discomfort and help reduce swelling; change up exercises to a stationary bike or swimming until the problem resolves. One asked about my shoes (I just got new shoes and this injury has happened since I got them).
That evening I decided to check how much my swelling had gone down because I'm really a wimp when it comes to ice and I'll do just about anything to avoid it. When I compared ankles, I noticed some slight discoloration over the arch of the affected foot that I hadn't seen before. Rats! Swelling was reduced further the following morning, so I decided that low-impact walking would probably be a safe form of exercise. Walking did not create pain during the activity and it serves to get the blood moving, reduce stiffness and still burns calories. That option worked out fine, except that bump on the inside of my knee continued to complain. One of my colleagues expressed concern about a possible stress fracture.
Personally, I think I have an inflamed bursa under the medial collateral ligament. With age, I believe that the arch in the affected foot has begun to fall ever so slightly. So when I run, it pronates my foot and stresses not only the arch, but the medial side of my ankle, and my medial knee. Rather than a stress fracture, I probably have a strain in my "spring" or plantar calcaneonavicular ligament with aggravation to the tibialis posterior tendon--I feel only slight tension in tibialis posterior when I strongly dorsiflex my foot. So, there's my anatomy education helping me pinpoint where my problem is, but fat lot of good that is doing since I don't know enough about how to solve the problem.
I decided to go to a doctor. I had to get my annual TB skin test updated anyway to be in compliance with clinical requirements. So, while I was at it, why not get all my niggling aches and pains checked out? After all, there's this nagging history of back pain that I have (which has improved some since I've been running). And, of course, there's my knee/ankle/arch dysfunction which I've suspected for a while (and may be the actual source of that back pain all these years.) They basically told me the same thing as my athletic trainer friends. The only difference was to elevate the foot in the evening while I was icing it. Also, they did x-rays to rule out a stress fracture--they'll call with the results next week.
Until then, I'm off to work on the elliptical trainer, a stationary bicycle, or the pool.
Posted by linda at May 17, 2008 3:33 PM
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