Posterior tibialis tendonitis

Discussion in 'Common Training Injuries' started by A350-800, Oct 23, 2016.

  1. A350-800

    A350-800 Member

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    Hello everyone, I have been suffering from this on and off since I had Itbs in February, I have been resting but I recently got new orthotics and it got seriously painful, I can't run and I am extremely concerned. The pain radiates from the medial calf down into my arch and particularly behind my malleolus on both feet; I was wondering if anyone else had suffered from this and if they could provide advice, thanks :)
     
  2. old-lynx-mech

    old-lynx-mech Active Member

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    Sounds like a couple of issues which may be related. @NikNak32 might still be on here to help out.
    Are the orthotics professionally prescribed or just off the shelf items, beware if they are prescription, bar to entry etc?
    Would be best to seek some advice from a sports physio or similar.
     
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  3. A350-800

    A350-800 Member

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    The orthotics were professionally perscribed , but I didn't go on the NHS. I am currently going to see a sports physio and I will request an MRI scan, I would just like to say this forum has been a lifeline to me because I am heavily depressed at the moment with all these injuries and daily pain, it has been a bit of a challenge to avoid what will go on records and things along with lots of people criticising me for wanting to join the corps, which I would be able to ignore if I wasn't injured :( thanks for your time
     
  4. A350-800

    A350-800 Member

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    There's also a bit of confusion online, my post tib injury isn't shin splints, it's the tendonitis kind :(
     
  5. old-lynx-mech

    old-lynx-mech Active Member

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    also quite confusing as your initial post says Itbs which i read as Iliotibial Band Syndrome (ITBS) which normally manifests as pain on the outside of the knee
     
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  6. A350-800

    A350-800 Member

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    Unfortunately I have both knee pain and ankle pain
     
  7. A350-800

    A350-800 Member

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    (PTT at the ankle and ITBS at the knee) sorry I confused everyone
     
  8. C30

    C30 Member

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    Have recently overcome the signs of posterior shin splints / tendonitis so I could probably help with this. In terms of rest, how long have you been resting? Do you have pain when you walk? Does it go away after a few days rest? Did you run through the pain? What are you doing to manage it (R.I.C.E) ?

    Here is what worked for me...
    The first step is to address the underlying factor which is causing the condition - most likely flat feet / poor biomechanics + overuse. Then you need to stay away from impact exercise and use Rest Ice Compression Elevation a few times a day until you feel no pain in the leg at all (frustrating I know!). Then you need to do resistance exercises to strengthen the posterior muscle. Finally you need to ease back into running, with plenty of rest days in between runs initially.

    Stick at it, you will get over it eventually!
     
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  9. A350-800

    A350-800 Member

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    Thanks for your reply, I am icing, I am not running, I am swimming and gently strengthening the posterior muscle though I think the latter exacerbated it dramatically :(
     
  10. C30

    C30 Member

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    Yeah most likely, I wouldn't attempt to strengthen it until the inflammation and pain is completely gone. Although it is frustrating having to rest up, if you put it into perspective, a few months or even a year is nothing in the long run.

    This exercise was most effective for me using a resistance band, and is now the only exercise I do to maintain strength in the posterior.
     
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  11. A350-800

    A350-800 Member

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    Thankyou :)
     
  12. A350-800

    A350-800 Member

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    I have also come to the conclusion that this injury and my Itbs originate from the same cause :/
     
  13. "Crikey mate"

    "Crikey mate" Member

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    Not a physio but I do work in the fitness industry lads, just my 5 cents.

    Suggest anyone having issues with ITB pain near the knee cap and low leg tendon pain, look into what is actually causing it 'biomechanically' instead of just resting up until it goes away, likely it'll come back after intense phys if you just do that (such as during RT!)

    Firstly check your knee traction when walking/running/squatting. Does your knee cap run steadily over your second to big toe or are they all over the place? You'll likely find they're all over the place.

    Secondly check if you have an APT - Anterior pelvic tilt - This means you'll likely have weak glutes(butt muscles)/hamstrings(back of legs), tight lower back, weak lower abs and tight hip flexors.

    Both of these are seriously common and basically because these days we all sit down so much.
    If either of these are the case and you're experiencing ITB pain near the knee cap its likely ITB Fricton Syndrome.

    Happening because your glutes are weak and a little hip muscle called the TFL (tensia fascia lata) is basically taking over the job of the glutes.
    The job of the glutes is the stabilise the knee and make it run on the correct path (as well as many other important jobs)

    So the knee pain?
    The TFL is connected to the ITB. This added work of the TFL overtime will make it tighten and inturn tighten the ITB and cause swelling. Point of pain usually near the knee cap where the tendon goes through a joint and will 'rub' which is the pain you feel.

    The lower leg pain?
    Most likely due to poor traction of the knee. This poor traction is happening because the TFL is no where near as strong as the glute and can't stabilise the knee half as well. The poor traction results in the tendons of the lower leg needing to help stabilise and this added work will also cause them to swell, once again, the pain will likely be felt by the ankle joint and this is where the swollen tendons will 'rub' and cause the pain.

    The solution?
    Get them glutes to do their damn job and relieve the TFL! Will take anywhere from 4-10 weeks depending how hard and often you do your rehabilitation training. You need to create a mind-muscle connection, learn to feel your glutes working.

    -Roll out your TFL on a foam roller twice daily for 60-90secs at a time (will reduce the pain a lot) (also roll out your glutes, theyre probably overly tight too)
    -Look up an exercise for glute activation called clams (do daily)
    -Do bridges with a 10 second hold at the top (do daily)
    -and the 'magic exercise' is Deadlifts, making sure you really get a hip thrust forward at the top. Deadlifts strengthen your entire posterior chain and will correct the APT if you have one and will get them glutes to work. Just really ensure you are using correct form, I suggest you tubing a demonstration by Scott Herman on regular deadlifts and on romanian deadlifts.

    Avoid running/walking/cycling. Keep up the swimming to maintain cardio. Any questions let me know, quite hard to put this into writing! Good luck! :)
     
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  14. Ryko

    Ryko Member

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    As far as PT tendinitis goes I've had it myself. It's a nightmare if you mess up your recovery. You absolutely have to strengthen your tendon, calf raises etc, I'm sure your physio gave you exercises like that. I took six weeks out no running, did my calf exercises daily, I got deep tissue massages weekly, I invested in proper running shoes and wore them permanently while I recovered and I foam rolled my entire leg, foot and PTT area once a day. It's an okay injury if you handle it right, but if you mess it up you can be seriously injured. But yeah I know the feeling of it never improving but it does.
     
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  15. Ryko

    Ryko Member

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    As far as PT tendinitis goes I've had it myself. It's a nightmare if you mess up your recovery. You absolutely have to strengthen your tendon, calf raises etc, I'm sure your physio gave you exercises like that. I took six weeks out no running, did my calf exercises daily, I got deep tissue massages weekly, I invested in proper running shoes and wore them permanently while I recovered and I foam rolled my entire leg, foot and PTT area once a day. It's an okay injury if you handle it right, but if you mess it up you can be seriously injured. But yeah I know the feeling of it never improving but it does.
     
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  16. Ryko

    Ryko Member

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    Sorry for double posting, I'm in a foreign country with the worst internet connections imaginable.
     
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  17. A350-800

    A350-800 Member

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    Thankyou for your replies :)


    I am currently doing single leg squats, deadlifts, hip hitches, side planks and weighted lunges, hopefully this should strengthen my gluteus muscles :)

    Thankyou Ryko, I am sorry to ask but was your post tib swollen at all or just hurting to walk on, could you x train, thanks :)
     
  18. Ryko

    Ryko Member

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    I had minor swelling at the beginning and after two weeks no activity other than my calf workouts once a day it went down and then I started x training, I used bike, elliptical and swimming, kept my fitness and was fine when I started running again. But if you haven't already invest in good running shoes, will save your life
     
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  19. A350-800

    A350-800 Member

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    Thanks, I too have some minor swelling but I am weight bearing, a bit or popping and sharp pain but no arch collapse. I am icing, have orthotics , foam rolling calves and I am seeing a specialist tomorrow to advise me. Thankyou for all your help and advice, its great to see you are up and running again and a real encouragement for me and others with this injury :) I went to the gym today, I did lunges, monster walks, squats and swimming with a pull bouy :) thanks for all your help :)
     
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  20. A350-800

    A350-800 Member

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    I also got an X ray ; no accessory navicular :)
     

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