James is an experienced runner with worsening ankle pain

Jul 10th, 2017

Hi – Experienced half/full marathon runner have been experiencing worsening ankle pain when running over a period of months. I have seen Sports specialists on the NHS and have had x-ray, MRI and ultrasound scans but they have been unable to pinpoint the problem.

I have been doing strengthening and balance exercises for a number of weeks now and have had an anti-inflammatory injection however i do not seem to be making any progress. At a standstill now with my running and desperate to find a diagnosis/solution..


Jul 10th, 2017

The Guru Responded:

Hi James

You sound like you’re doing all the right stuff.

Time, with appropriate rest after a jab is often a great recipe for success. Just continually (over) loading for the right thing is sometimes the wrong thing to do!

It’s a little concerning that your docs can’t pinpoint what, or why. It may be entirely appropriate to ask for a second opinion via a foot and ankle surgeon or a more specialist SEM doc.

Impingement is often diagnosed via US or MRI – it can be soft tissue related, which responds to a jab. Or, it can be due to bone, which may need something a little more invasive….

There can also be a little scuff on your talar dome called an osteochondral defect which can sometimes tricky to see but can give similar symptoms.

If the jab hasn’t helped then it’s telling you and the docs what it’s not rather than what it is, and you need to be reassessed from a differing stand point.

Hang in there, make the system work for you and get your diagnosis nailed.

The Guru


James thanked the Guru for his advice:

Thank you for the detailed reply, really appreciated. I have a follow up appointment next week so will see how I go from there.

I have used Six Physio in the past for a knee problem and the treatment/rehab was fantastic, totally transformed my running for the better – should I need a second opinion or further treatment is this an issue Six could look at or do I need something more specialist?


Guru replied….

Morning James – I actually think that it maybe more prudent to get a decent interpretation of the imaging and/or a decent overview on “what” is going on.

I think we’d probably say go see a decent SEM/OS that we could recommend – so please let me know what’s been said after next week and I’ll make sure I point you in the right direction, either into or out of SIX.

Thanks for the kind words!!

The Guru


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