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Achilles Tendonitis or Posterior tibial tendon dysfunction?

Discussion in 'Ask your questions here' started by Eric A, Jul 1, 2010.

  1. Eric A

    Eric A Guest

    This started about 3 weeks ago after a long, challenging hike. I didn't really notice it in the first week, because I have been treating a Peroneas Longus strain and Plantar Fasciitis in my left foot. I have been training very intensly (Crossfit training) since last August as a means for preparation for joining the army (shipping this September, even more the reason why I need to head this off with a quickness). When I started, I was severely overweight (6'3" - 305lb ex collegiate defensive end who let himself go ). I have since lost 85 lbs through the early adoption of a pretty strict 90/10 paleo diet, and a slow build on my training (went from 1 on 1-2 off to now 3 on 1 off with some long runs and speed work sprinkled in at least once a week). Only reason I mention any of this is because it is probably important to understand that my body has gone through some massive composition changes in the last 9 months, so these sorts of injuries are not surprising to me.

    Anyways, here are my symptoms. General soreness in my right foot (attached a picture to show exactly where the pain is concentrated). Pain is onset when I run/jump or perform any explosive movement, and then seems to fade as I go through my warm-up, and is generally gone by the time that I cool down after the workout. But, there is dull pain to the touch, and sharp pain to deep pressure (say, from when I massage the area with a golf ball).

    here is a picture of the area where pain is showing up -

    Pain - as described above. There was redness for a while around the area circled in the picture, and I do not believe I ever had swelling occur

    Severity - 3-10 when warming up. 8-10 when I initially massage with golf ball lowering to a 1 after 15-20 min

    Position - pain seems to move up and down the circled area. pain does not ever seem to be actually on the back of foot where Achilles is

    Provokes - from running/jumping or explosive movements. no pain from walking unless already aggravated. I am a slight heel striker, but have gotten better at striking in the mid foot/front foot.

    When pain presents - at the beginning of a run, when ever I have been resting it and then start to do any heel drop excercises etc.

    Running history - I run 1-2 times a week outside of WOD's as Rx. Generally, if I am not doing speed work, I will run distances of between 3-5 miles. NOTE - I bought my running shoes when I was a moderate-severe over pronator. They are very much broken down, and have been for probably the last couple months. I replaced them 2 days ago at my local running store, and also picked up some green superfeet to help with my PF and for better arch support.

    Shoes - Running shoes were Men's Nike Zoom Structure Triax+12. now are Brooks Adrenalines w/green superfeet insoles. I WOD in Adidas Scorch Sport TR's (going to put my superfeet in those when I am not in my running shoes)

    Age? 26

    Medical history -

    Medication? Ibuprofen, Multi-vitamin and fish oil.
    Arthritis? no.
    Knee problems/pain? no.
    Back problems/pain? sometimes after a taxing workout, but nothing lingering.

    Functional tests -

    One leg balance time? stopped at 2' on each leg.
    Elevating onto both sets of toes with minimal support? fine, no support needed.
    Elevating onto affected foot's toes with minimal support? fine, no support needed.

    Current Treatment - resting for 2 weeks. Such as (since I started resting last Friday) PNF stretching calves/quads/hams, Foot drills (toe/side of foot and heel walks), heel drop drills, ankle drills, general flexibility improvements in lower extremities, foam rolling, four corner balance drill. I am massaging with a golf ball (that's where that blister came from ), using ice cubes to massage.

    I apologize for the massive post, but I leave for training in September, and it is of the utmost importance that I go into training at 100%. Plus, my insurance sucks. To make it worse, I have Keiser Perm; who are notorious for being generally ****ty at anything sports related. Self treatment is my only real resort, as long as I can just narrow it down to one of the two ailments in the title, I can go from there. I really, really appreciate any input I can get. Hopefully someone smarter than me can tell me what it is I have exactly, so I can treat it appropriately so I don't cause any more damage, or misutilize my rest time.

    NOTE - I forgot to mention that when I massage near where the arrows are pointed, I hear/feel crackling. very odd. also, most pain is concentrated in the red circled area
     
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