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December 01, 2008

POSTERIOR TIBIAL TENDONITIS

That's the verdict.

Which if you read about, you will realize (probably faster than I did) that it's not really a KNEE problem after all.

It's a foot problem.

Weird how those things have a way of telling you right?

I started to draw you a picture of how foot problems can cause knee pain, but well, when I drew the foot, and then added the knee...it sortof looked perverted, and since my dad reads my blog sometimes, I figured it was best to go with no picture.

So, here is what happens, according to the good doctor:

When I run my left arch gets tired quickly. I wear store bought inserts but because my left arch is higher than my right arch it's really hard to get them to fit both feet properly. So, my left one just tires out quicker than the right. When it gets tired, it starts to cause the posterior tibial tendon to become inflamed. That tendon runs along the inside of your foot, and up the back of your leg. On the inside. I've never had pain on the inside of my left leg, but that's what the doc told me happens. So, the tendon gets inflamed and tired, and I (unconsciously) try and overcompensate for the inflammation by applying more of my striking on the outside of my foot, or pronating. But just on the left side. After 8 or 9 miles of that, my knee starts to kick me in the part of my butt that really hurts and yells at me and tells me I'm stupid for continuing on this run. It causes me pain that mimics ITBS problems because it's trying to tell me that my foot already tried to tell me that all of this was a bad idea, but I refused to listen so now the knee will really make me remember what a bad idea it was.

And that's when I have knee pain, that seems to be worse than the foot pain ever was. And that's also the reason that I never have the foot and the knee pain at the same time. And that's why I always have the foot pain first. And just so you know, it's not ITBS but just mimicking the pain...they called it a "pain duet".

Weird how our bodies try and try and try to tell us stuff but we just won't listen.

So, what do they hope will solve the problem (other than not running at all, because that is NOT an option)?

Custom fit orthotics.

Which should be ready in 2 to 3 weeks. Let's hope it's more like 2 weeks, okay?

And 3 weeks of physical therapy. Man, how I've missed those guys at ATARI...

Now for the bad news. Or the "news I really didn't want to hear":

While I can still run between now and the time I get my orthotics, I can't run more than 10 or 11 miles as a long run.

So, you do the math...

Okay, I'll do it for you:

Let's be optimistic and say the orthotics are ready in 2 weeks, which would be on or about December 15. Then they told me that it would take at least a week for me to get used to them, and "not to go try and run 12 miles the first week I get them". So, that puts me at the week of December 22 to get some really good long runs in, or long runs longer than 10 or 11 miles. The longest run I've had since the Snickers Marathon last March is 13 miles. So, that gives me 3 weeks to get in enough long runs to complete the Disney Marathon on January 11.

Now, I know some of you crazy yahoos can go from 13 to 26 in a week (TIM) but as I have had to learn the hard way: I'm not any of you. While I'm really really really good at most things I do (like being so organized or sticking to a schedule), jumping my mileage up 200% over the course of 3 weeks is not something I'm good at, or my body is good at handling. It's just a fact of my life. And I'm learning to be okay with that.

So, with that...just like that...I'm gracefully bowing out of the Disney Marathon. And I'm okay with that.

Now, just because I'm bowing out does NOT mean that you (and I mean Stefanie, Tim, Troy, Andrew, and the other crazies running) won't see me at the marathon holding up one of these signs!









Okay, so that last one will strictly be reserved for Troy....and I'll let Mandie even hold it for Tim when he runs by...

Have a great evening!

Pictures borrowed from Elitefeet.com

9 comments:

b2hokie said...

Amy,

If your experience with orthotics is anything like mine, you will be sooooooooooo happy with the results. And oh yes - you really ought to do the PT (or that 2 to 3 weeks will be much longer).

At least the light at the end of the tunnel isn't a freight train.

Ask Disney is you can trade down to the 1/2 - what's the worse they can say - no?

I'm glad to hear that you've got your problem addressed - it should make you a better runner.

TTFN

Walter

Stefanie said...

I am super bummed that you wont be running Disney. But on the bright side you have the coolest sidekicks to hang out with. (Mandie and Kenny.)Kenny is very skilled at pushing to the front and getting awesome pictures and you can help push Mandie around in a wheelchair!

I had a very similar issue last thanksgiving. Luckily I was only running the half and could recover. http://partystefanie.livejournal.com/2007/11/22/

I have every faith in the world that you will recover beautifully and be out running with the crazies in no time at all.

Rest Up!

Anne said...

I had a similar situation after running my first marathon and the custom orthodics made a world of difference -- as did following the doc's advice and giving my tendon a long time to heal. Unfortunately, tendonitis is very stubborn and has a long memory. Disney will always be there. (I did it several years ago and didn't think it was that great, but that's me.)

TriExpert said...

Wait! Deep water running can salvage your buildup. Seriously!

timc said...

Amy, have you thought any more about maybe doing the full at Aviation? If so, I would love to have some company going around in circles around the airport :)

jeff said...

you know which sign i like the best. how could i pass up an opportunity to comment about poop?

Jazzy said...

Hi Amy! I am just now reading this post (and your blog) after doing a search for posterior tibial tendonitis, which I fear I may have. How did the orthotics and PT work out for you? Are there other posts that discuss your experience that you could point me towards?

Thank you!
Jen

Joe said...

Amy, I found your post by chance when searching for info about PTT, as I was just diagnosed with it. I can run about 12 miles but then the foot was getting really inflammed, the arch hurt, & the knee kicked in too. Now I am in a soft cast for a week.

Can you share your results with me? Did u do the PT? How long before you were able to run long? Did the custom orthotics work? Were OTC inserts an options? Anything else you can add would really be appreciated. I have a big event in 6 wks and I really want to go run it.

Jazzy said...

Joe, I also asked for more info and updates on the PTT. I found myself in a similar situation as I started increasing mileage for a half marathon. On my long runs I had similar problems that you are experiencing. I did some research and talked to some folks (online and in person) and decided to try OTC inserts. I tried three and found ones that I love. It did take a couple weeks and several short runs to break them in (which was a bit painful to be honest), but they have been great ever since. I was able to run my half without much discomfort and have been running since. I went with the Spenco Total Support. If I have any troubles in the future I'm going to seek out professional/medical help and go with custom orthotics. Just my 2 cents. ;) Good luck!