steroid injections

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julysbaby
julysbaby Posts: 97 Member
I have been off the plan for some time, but am wanting to restart. This past spring, I began experiencing pain in my foot. I was diagnosed with a contracture related to high arches and a tight Achilles tendon and given a steroid injection. It worked wonders and gave me my mobility back. I was going through quite a lot at the time and was unable to work out on a regular basis. So that and second injection in August led me to gaining 20 lbs in a few short months. My life has settled some, the pain has returned and I'm now ready to resume activity. I would like to know if anyone has had a similar condition and how it was treated and also if it seems to make sense to get yet another injection but plan to kill it in the gym to avoid the additional weight gain. Also, wondering if anyone has ideas on how to heal the adrenals since most likely this is a factor as well. Thank you in advance!

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  • heybales
    heybales Posts: 18,842 Member
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    You need to clearly separate in your mind weight loss and exercise - killing it in the gym is not the way to avoid additional weight gain.

    Eating less or same as you burn is the way to do that.

    Diet is for weight loss - done right is only fat, done wrong includes muscle mass.

    Exercise is for heart health and body transform - done right supports fat loss, done wrong encourages muscle loss.

    Only thing exercise has to do with weight loss is allowing you to burn more daily, thus allowing you to eat more compared to no exercise.
    That fact may help you adhere to the diet better for the actual fat/weight loss.

    But "killing it in the gym" would actually have as side effect water weight gain - no weight loss at all.

    And am I reading right you say the pain has returned and ready to resume activity?
    That's not logical.

    If the injections are allowing healing but merely masking pain - then what benefit are you actually getting in the end.
    I went years with plantar fasciitis issue because I foolishly thought I could figure out way to get over it with exercise.
    I eventually did, but it took 1 year of doing things calm regarding weight bearing workouts - with custom orthotics in all shoes, and addressing a short-leg issue - to eventually get over it.

    Had achilles issue mid-spring 2014 that I helped along just enough to do some races and not get worse with big blocks of time off - but it didn't get better and required a lot of work. Winter finally healed with no stress on it.

    So have you been daily stretching your 2 calf muscles to loosen up achilles tendon (since tendons barely stretch)?

    Since Achilles doesn't wrap under the foot to the arch but stops at heel, 2 different issues. Though achilles could have you walking funny making arch worse.
    So did you get custom orthotics to allow arch/fracture to heal?
    And do you have very flexible shoes for natural foot movement, or very rigid shoes that forces unnatural movements?

    Adrenal - unstress body. Depending on severity and genetics - maybe for decent amount of time. And may never be able to take the level of stress that body could otherwise, without negative effects. Like elevated-cortisol water retained.
  • julysbaby
    julysbaby Posts: 97 Member
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    I forgot to add that pain has returned at the Time I'm ready to resume activity. I plan to get an injection, get fitted for orthotic and resume exercise. Does this sound better? Have been doing stretches as well.
    Thank you. I appreciate your answer.
  • heybales
    heybales Posts: 18,842 Member
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    Good to hear - because foot injuries are the worse I think - as just daily life walking is usually enough of a stress to prevent healing - but just holding steady in the injury state.
    But you think it feels better so you want to do more, which is the killer.

    It takes extra effort and lots of time merely with daily activity walking usually, just to actually improve and heal.

    Years after the Plantar fasciitis healed and I'd been barefoot running (which made everything stronger), I overdid some treadmill running with sprints, and sprained the plantar. Just like sprained ankle, couldn't use it all, since no lever ability with foot for pushoff, no use of calf muscle either. Took 6 weeks in boot in heal, and then come back slowly.

    But, there's nothing to stop pushing against the heel which doesn't engage the plantar, for leg workouts, nor the whole upper body.
    So the calf suffers a bit, but rest can be worked.

    Since weight loss is about the diet not the exercise - it's the time to do strength training workouts.

    So on the quads and hams with leg extension and curl machines, and some careful heel drops that while working the achilles can help the plantar for the same reason.
    Ask your Dr about eccentric heel drops for achilles issues, and same reason they work there, they can be helpful on plantar also. Plus benefit of using the muscle at least. And stretching the achilles. double duty.

    Upper body of course can be totally worked out.

    You'll want maintenance or barely any deficit to allow the body to aid healing.
    Just as it's really hard and/or slow to build muscle eating in deficit - same applies to body repairing tendon tissue - except even harder since worse blood supply.
  • julysbaby
    julysbaby Posts: 97 Member
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    Last paragraph sums it up. I have to set myself up for success. Thank you so much for your input. I was feeling defeated, but you've really helped me with your guidance.
  • bnowell724
    bnowell724 Posts: 31 Member
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    Since you guys are talking about feet, I have a question @Heybales -Do you know anything about flat feet? I have little to no arches and my ankles actually roll inward. I have always worn flat, loose fitting shoes because that is what feels best. As far as strength training /crossfit, anything I should know or be careful about?

    I am told I have great mobility and feel as if I can do the different movements/running just fine but sometimes I get knee pain and my knees feel sort of fragile. It's hard to explain I guess, because I haven't been injured. However when I first started crossfit I attempted to run on my days off. It was too much and it caused so much knee pain I had to cut out running altogether for a few weeks, and squatting was difficult. Could the knee issues be connected to my feet? They've gotten stronger(or some other part of my body that supports them has) as I've progressed with weightlifting - they don't feel as fragile now and I can run more, but I feel hyper aware of them when I'm squatting... I'm sorry if I hijacked this thread, it just seemed appropriate to post here.
  • heybales
    heybales Posts: 18,842 Member
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    Just being aware that the arch allows for some shock absorption, so your feet may feel warn out faster than if you had arches.

    Then again, when you run mid-foot strike, you absorb so much more in quads then foot could get anywhere near.

    Rolling foot is normal. The no arch shoes, that are truly flexible, are great for allowing food to get as strong as they can no matter what the arch.
    In fact you probably can't roll as much as body would like, which means it moves up to knee for movement. I could actually see walking being worse, where foot can only land under your body by so much, but jogging it could land more under body not needing to roll as much. Walking can have bigger range of motion under tension for the muscles used.

    The foot slightly spreading out while under weight is what can actually cause imbalance problems for folks not used to it. But usually the build up in weight makes you used to it before it matters, so no issues.
    You get no such spread, feet already spread out.

    I've been believer for awhile in the barefoot and near-barefoot ability for better form. The place where it fails is in non-flexible shoes causing unnatural movements and gaits. Or super padded heel causing change in motion.

    Only place I've seen in reports it can be more difficult is for folks with really high arches and too much weight carried. Since tendons/ligaments don't stretch much, that potential range of flattening can be really tough on feet where the weight is going to make something move, or start tearing.

    ugh, shivers thinking about that.

    Oh, you could have non-flexible lose shoes, that's no good either as it'll usually have you rolling forward funny, so change to gait.
  • bnowell724
    bnowell724 Posts: 31 Member
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    Yeah I've looked into the mid foot strike thing and I don't really understand how to do it. I've read about it and watched videos but I don't get it. When I've actually tried it I feel like I'm doing it wrong. It's the type of running where you sort of fall into your strides, right?

    Interesting note about not rolling as much as my body would like therefore the movement transfers to knees... How can that be fixed?
  • bnowell724
    bnowell724 Posts: 31 Member
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    FYI my shoes are all mostly pretty flexible.
  • heybales
    heybales Posts: 18,842 Member
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    The pronating or lack of it really can't be. That's where the arch helps when walking.
    Land on heel.
    As weight transfers forward foot rolls inward as arch collapses somewhat and foot spreads out.
    Push off on inside of forefoot.

    Flat foot just prevents the roll since nothing to flatten out, it's like as soon as weight moves forward above midfoot, it's already on ground totally, so straight to the forefoot.
    And depending on body compensation, perhaps not the inside of forefoot.

    Do shoes show a forefoot wear pattern with more concentration on inside around big toe area, or pretty even across whole front of foot.

    That difference could be transferring to knees, and it may be a different walking style could minimize it.

    You can actually walk midfoot strike method too.
    With long stretch to walk, test with normal padded shoes, and then barefoot.
    Most people won't take as long a stride to impact the heel as much when barefoot, so faster shorter steps if pace was the same, or slow down. It's like you barely hit the heel before the whole foot is fully on ground, as such it's not as far out in front of you when you stride forward, more directly underneath you when the weight transfer to it.

    The running is same way, attempting to land almost whole foot at once. In reality if you have minimum padding, the forefoot lands just barely first, your calf/quad muscle absorb some shock and those joints bend as heel touches ground an instant later. That allows the spring recoil back to forefoot for takeoff again.

    You may see some missing the heel touch - totally on forefoot - that's not good either. Takes some doing to get it down right, and usually nice even ground, or shock absorbing treadmill, to get nervous system pattern down.
    Then it can be taken to uneven surfaces and done correctly.
    A turnover of around 180 per min, or 90, depending on how you count.

    The falling forward part is kinda right, but running should always be a slight lean forward from ankle up, you could attempt straight up, but no matter what style that should feel funny.

    The amount of lean determines the speed, so don't need much.

    Just found this good video with same descriptions I'm talking about.
    Now, this guy must have been self-trained with no coach, because what he came to discover has been around for years already, sad if he couldn't have learned it earlier without self-discovery. And despite his comments of running tall, he means not hunched over, you gotta lean as even his video running shows. But good synopsis.
    http://triathlon.competitor.com/2015/01/training/video-pete-jacobs-talks-running-technique_71713

    This video looks at 2 examples, of running styles in triathlon. This is much more detailed as to why and how and differences.
    https://youtu.be/tJWPwVF30yo

    probably more interested in glider for slower speeds.
  • bnowell724
    bnowell724 Posts: 31 Member
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    Thanks a lot, your description really helps me understand the barefoot forum better. I will check out that video.

    All of my shoes are misshapen and have a "rolled inward" look just like my feet. They look like they've been smashed to lean inward, if that makes sense?

    I just went for a jog last night, my third 20 min jog this week, and my knees were hurting. I may just have to cut out the extra running. It sucks because I like the cardio and with all the sprints we do in crossfit my endurance has greatly improved. Maybe with this info I can figure out a better running form to use that doesn't transfer so much of the impact to my knees, if that is even what's going on...

    I heard or read somewhere that strengthening my hamstrings is helpful for easing the strain on my knees... Maybe it's a balance thing...

  • heybales
    heybales Posts: 18,842 Member
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    For sure have seen shoes like that while people walk - and that doesn't help if there is much padding, because then your feet are forced to pronate even more because foam is broken down more on inside.
    Low padding shoes would be better so there is little to break down in the first place. For walking that is.

    Practice that flat foot landing while running with current shoes, and the next shoes you can perhaps find some low-rise or barefoot style - still padding, but flat from toe to heel, or only 4 mm rise perhaps. Assists in the flat landing style. Saucony has several like that.

    You do actually want your knees and ankle to flex so the quads and calf can absorb the impact.
    Knee only takes impact if landing right on heel with straight or almost leg slightly out in front - which is common with well padded shoes.
    Go barefoot on grass though and you won't do that for very many steps. Even less on soft track.

    I really think the knees are getting the brunt of that non-roll of foot while walking or jogging slow, and foot can't be directly under mid-point of body then. Look at couple of my pics in my profile page while running, there is one going slower and foot landing is like walking, not mid-point of body.

    http://www.myfitnesspal.com/photos/view/12714576

    Hard to correct that slow jogging or walking - just knocking ankles and knees together then attempting to be too close - that hurts. Orthotics (not foam) may be needed to help slow/stop the roll or extreme nature of it.

    And it could indeed be strength balance issue like you mention.
    http://sportsmedicine.about.com/cs/knee_injuries/a/aa101000d.htm
    http://breakingmuscle.com/running/the-hamstring-to-quadriceps-strength-ratio-in-female-runners

    So perhaps there is more to cross-fit to help the hamstrings.
  • bnowell724
    bnowell724 Posts: 31 Member
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    I've been trying that barefoot style while jogging and walking lately - it feels like I'm shuffling my feet. I'm not sure I'm doing it right. I looked at your pictures and I'll keep trying to work on my form.

    I really appreciate all of your input, Heybale's!