[Josh Gray]

Dr. Andy, first let me say thank you for your recommendation for my Achilles tendinitis. I was able to calm it down to where is is practically a non issue for me, I only feel it slightly the day after a big effort.
I guess turning 40 is really starting to show because now I’m dealing with what I believe is tendinitis in the opposite ankle, inside between my ankle and arch. I first noticed it after a big 8k’ day in the mountains. It has been manageable pain wise, maybe a 2-3 out of ten but it has been pretty persistent and annoying for the last 4 weeks, only subsiding slightly after total rest. I have another upcoming backcountry hunt in 5 weeks that more likely will require substantial miles and vertical. I’ve heard total rest is the only real cure. I guess my biggest fear is it getting worse, tearing or collapsing my arch. What are your recommendations on treating this. Thanks I’m advanced.

[Andy Reed]

Hi Josh

If I am reading this correctly it does sound like the tibialis posterior or possibly flexor digitorum or FHL. As with most tendon injuries, anything more than a couple of days rest is rarely helpful, as tendons respond best to loading.

Some of my go to exercises are linked below. Isometrics (standing on tip toes) can be helpful at first to decrease pain. Quickly move on to more active loading exercises as pain improves. I like 2 legged calf raises with a ball squeeze (see below):

Play

I also like heel raises on a slant board – so that the foot is everted (example in the video below).

Play

Simple band work to add resistance to ankle inversion is beneficial, as well as intrinsic foot muscle strengthening exercises – look up ‘foot core exercises’.

Lastly, this is an injury where a simple arch support can give good relief for day to day weight bearing activities, and during hikes/runs.

The risk of rupture is low, and typically is only seen in the extremely obese, or if there is a major tear in the tendon (not likely unless a big slip/fall/twist).

Flatter hikes will be better tolerated at first, so avoid steep hiking until you see improvement.

Do the exercises every second day and add more load as they start to feel easier.

Hope that helps. Fire me an email at andy@evokeendurance if additional advice is needed.

[Andy Reed]

I think that second link was corrupted! Try these: https://youtube.com/shorts/Y9zrw85gUL0?si=l5WGI1PDD5bUgeDF

Also https://youtu.be/MIRYOo1YLUs?si=9Gk8enxZJZqg4Ipd

 

[Josh Gray]

Thank you Dr. Andy! I’ll start on these immediately and just picked up some arch support insoles

[Author]

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