Runners: Posterior Tibial Tendonitis- fix me!

bprague

Hey fellow runners. I'm pretty sure I have posterior tibial tendonitis since all the symptoms match up nicely. I have proper running shoes, a flat foot, had shin splints but they seem much better this week (only painful when applying slight pressure to shin), and I'm upping the intensity (distance wise) every time I run (three times a week). I really don't want to stop my running since I'm getting back on track with it.

How do I get rid of this nonsense?! Advice please!

jeffrodgers1

For starters... can you clarify "Upper your intensity each time you run"?

A general rule of thumb is to never increase your distance\time by more than 10% per week and to make one week out of every three or four weeks a fall back week (meaning you back off distance and allow some recovery to occur)

Sounds to me like you are over doing it. Most running injuries can be traced back to doing too much, too soon.

I would back off and allow for some healing to occur. You have to keep in mind Pain is the warning bell that tells us something is wrong. You really need to listen to the warning bells. A serious injury will keep you from running period.

PeachyKeene

Rest looks like the best way to fix your problem. I know you don't want to stop running, but you could cause a lot more damage if you don't let it heal properly. Stay off of your feet for a week, walking even henders healing. See how you feel after that.

Copied from website: http://orthopedics.about.com/cs/footproblems/a/posteriortibial.htm

Treatment of Posterior Tibial Tendonitis
The initial treatment of posterior tibial tendonitis if focused on resting the tendon to allow for healing. Unfortunately, even normal walking may not adequately allow for the tendon to rest sufficiently. In these cases, the ankle must be immobilized to allow for sufficient rest. Options for early treatment include:
•Shoe inserts and arch supports
•Walking boots
•Casts
By providing a stiff platform for the foot, shoe inserts and walking boots prevent motion between the midfoot and hindfoot. Preventing this motion should decrease the inflammation associated with posterior tibial tendonitis. Casts are more cumbersome, but are probably the safest method to ensure the posterior tibial tendon is adequately rested.
Other common treatments for early stage posterior tibial tendonitis include anti-inflammatory medications and activity modification. Both of these treatments can help to control the inflammation around the posterior tibial tendon.

Surgical treatment of posterior tibial tendinitis is controversial and varies depending on the extent of the condition. In early stages of posterior tibial tendonitis, some surgeons may recommend a procedure to clean up the inflammation called a debridement. During a debridement, the inflamed tissue and abnormal tendon are removed to help allow for healing of the damaged tendon.

In more advanced stages of posterior tibial tendonitis, the arch of the foot has collapsed, and a simple tendon debridement may be insufficient to correct the problem. Reconstruction of the posterior tibial tendon is occasionally performed. In a reconstructive procedures, a neighboring tendon, called the flexor digitorum longus, is moved to replace the damaged posterior tibial tendon. This procedure is often combined with a bone reconstruction as well. Finally, in the most advanced cases of posterior tibial tendonitis, when the arch of the foot has become rigid, a fusion procedure is the preferred treatment.

bprague

For starters... can you clarify "Upper your intensity each time you run"?

A general rule of thumb is to never increase your distance\time by more than 10% per week and to make one week out of every three or four weeks a fall back week (meaning you back off distance and allow some recovery to occur)

Sounds to me like you are over doing it. Most running injuries can be traced back to doing too much, too soon.

I would back off and allow for some healing to occur. You have to keep in mind Pain is the warning bell that tells us something is wrong. You really need to listen to the warning bells. A serious injury will keep you from running period.

If you are familiar with the Podrunners interval series: that is what I'm doing. They gradually build you up to running a full 5k This week it went from two sets of 8 minute runs with a five minute walk straight into 20 minutes of running with a five minute warm up and cool down.

jeffrodgers1

Still exceeds the recognized norm. To go from 16 minutes to 20 minutes is a 25% jump in distance or time. I would cut back the distance until you can run pain free.

You can address the pain now, or your body will ensure you address it later.