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Jan 10th, 2014

Susie asked The Guru for the following Physiotherapy Advice:

Hi lovely Six Physio people.

I have an annoying pain that seems to be moving from my ankle bone area to the bottom leg/calf area.

I ran (13 miles) on a tight calf, and had slight ankle pain – put it down to usual running aches. Then ran hard for 8 miles couple of days later – and was left with very tender ankle next day. I have been doing low impact at gym, and now the ankle & top of foot keeps swelling. (posterior tibial tendonitis?)

Icing, TENS machine, Ibroprufen and compression seems to be helping day by day. My trainers are fine and reasonably new (I am very good with this, as I pronate badly!) I have just started wearing orthotics in shoes which seem to really help with the pain. I have stopped gym & runninbg. It seems to be slowly getting better – also have a sports massage booked.

My questions are: can I do any more to speed recovery, and can I run if I have slight pain still? The pain is coming and going, but the swelling has gone down.

I have a big half marathon on Sunday – which I really, really want to run – but don’t want to end up after laid up for a couple more weeks resting, or even worse, – aggravate it to a nastier injury.

I guess I would rather miss the race and be ok in the long term – Help me!

PS Followed your IT band advice to the letter and I am cured! I am definitely coming in for running analysis from you experts soon. You guys ROCK.

The Guru Responded:

…..hummm! Great that the ITB has settled.

Here’s the tricky bit. You’ve either got 2 totally unrelated issues (ITB & ankle) or they are both connected. I reckon it possible to win the lottery once (getting 1 injury sorted), but to win the lottery twice? I’m not sure….

Lets suppose you have 2 injuries. ITB, fine. Ankle – not sure it’s tib post as that swells on the inside of your achilles and attaches under the arch of your foot, but may be tib anterior…and I think you’re doing the right stuff. Do have a check of your knee-to-wall distance, left versus right foot to see if you’ve got a stiff ankle joint, rather than tight tissues.

When did you start to use the orthotics? Do you have any other apparently non related symptoms.

Id have a good, long hard look at the control around your pelvis and see if there’s any connection between ITB and ankle, even if there are on different legs.

Stay on the safe side and don’t do the half this weekend, but maybe do a 9m-ish run, without the pressure of time and pace – then see what gives at the end or at least the ability to bail out if needs be.

Hope this helps

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