It's Time to Come Clean...

[hmduey]

Hello everyone! I've not been posting for awhile, mostly because I'm one of those "quiet types" (well, sometimes). I've been lurking though! I decided to finally post about something I've been avoiding because I want to know how many others have had to deal with this...

I tore my posterior tibial tendon, pretty good apparently. I thought it was a stress fracture (it happened when I ramped up my mileage and increased my speed - not on the same runs, but at the same time, alternating days if you will), so I treated it like one. I'd rest for two weeks (still walking around barefoot), then try to run. I'd feel OK until the second run, then it felt like the fracture was still there, so after two months of this I finally went to have it looked at.

X-rays revealed no fracture, so I went for an MRI, which revealed a nice tear in the PTT. Fortunately my doc thinks we can heal it without surgery, but it's been slow going (this all started around Thanksgiving, and I've not run a step since December 27). I've been in a boot since the end of January, first on crutches, then one crutch, now walking.

Anyway, I am finally able to walk in the boot, but I seem to have hit a plateau. I still can't do a one-leg raise, which is "the test" to see if I can walk (I check about once a week or so). I go back to the doctor on the 30th for him to check it, and I was really hoping to be out of the boot by then. I'm bummed because I've been forced to wear big clunky shoes for the last two months.

Has anyone else had to go through this? If so, any input on how long it took to get back to 100% would be most appreciated. Right now I could care less about running, but I'd pay a whole lot to be able to walk around barefoot (I have to wear a shoe because the boot is so high off the floor - and what's funnier is that I only have ONE pair of shoes that meets that criteria because I threw out most of my shoes last year!).

BTW, it doesn't hurt much anymore and it's not the worst injury in the world, and I know this. I'm just feeling sorry for myself because I'm sick of the SHOES! Especially now that it's warm and the grass is soft again.

 

[Jimmy Hart]

I've never had the injury so

I've never had the injury so I'm not much help in terms of experience. From a knowledge standpoint I gotta say it's kind of an impressive injury that is not so common. Your recovery time may be longer than what is common based on how long you let it go without treatment. I'm sure you've found out how important the PSTT is for support of the foot and I would be shocked if your arch is still there at all after a tear.

I would typically expect someone to be booted for 6-8 weeks if they caught it early but you have a full blown tear that you're trying to let heal itself. That's a process that can take a lot of time and sadly I cannot offer any sort of time table for it. Keep wearing the boot and trying to test your leg raise. It's an interesting thing when tissue is healing in the body. One day it wont work and the next it will. For some reason it doens't always follow the steady improvement scale that we expect.

Have they told you they will want you in orthotics when the boot comes off? That's usually the next step is to support it after you get out of the boot.

 

[hmduey]

Thanks Jimmy for the input. 

Thanks Jimmy for the input. I've found the variance in the way my foot feels to be interesting, as you said one day it seems like it's really on the mend, and the next it's virtually useless. I think my tear is up higher on my leg, as the arch no longer hurts, but around my heel really gives me some issues when I do the leg raises. Funny, as the referred pain I was getting when I initially figured I was injured was on the front of my ankle!

You mention the fallen arch; mine was actually sliding out; it looked like I had a second ankle (I wish I had taken pictures because it was really funky looking) on the inside of my foot, and that's what drove me to go in. That protrusion has now nearly gone away and is barely noticeable. I can feel the tightness in the tendon, so I know it's "shrinking up" and I think it's managing to heal itself. It was not a complete tear, but obviously bad enough to warrant lots of R&R.

Amazingly, my doctor is a marthon runner and I asked him point-blank whether he thought I'd be able to continue runnign barefoot. He said absolutely I should be able to. He hasn't mentioned orthotics or anything of the sort yet, but there is an arch support in my boot (that I think is too low, and I wonder if it does any good at all). At this point I would do orthotics for a time just to get out of the boot and have somewhat normal movement though!

 

[SaraLord]

Wow hmduey - I really hope

Wow hmduey - I really hope you are back on the roads soon. This makes me examine my oh so potent drive to do TMTS.

 

[hmduey]

Thanks Sara!  The thing I

Thanks Sara! The thing I hate the most was that it took me about 9 or 10 months to get up to 3.5 miles, and then I went to 4 and had no problems. It wasn't until I really started trying to do long runs on the weekends and then put in some speed(ish) work during the week that I had problems. And, I started "looking into" parkour as well, which is probably what tipped the tendon over the edge. In any case, it's definitely an overuse injury, despite the fact that I was pretty careful. That may be what bums me out the most.

 

[SaraLord]

I feel for you, truly.  This

I feel for you, truly. This is a big worry for me, that I'll think I'm doing it right and bam, it's the couch for a looooong time. Can you cross train to keep your conditioning?

 

[hmduey]

I can do non-weightbearing

I can do non-weightbearing stuff like weights and floor exercises, but no bike (yet - I'm hoping for soon). I asked about that and begged and pleaded but no dice. :-(

 

[Paleo]

Similar story for me about 3

Similar story for me about 3 years ago with a stress fracture to the lower fibia. I was training for a marathon and already at about 70km a week. The injury came as I both increased the distance and started doing some intervals at the same time.

It took a long time to be able to run again. I have made my motto now "no setbacks". Which means I am ultra conservative about increases. An accepted rule of thumb is as follows:

1. increase frequency of runs

2. increase distance

3. increase speed

And strictly in that order, and never more than one at a time.

I have also stopped recording my times, and I only record distance. I do have a feel for my speed, which is probably generally faster than many would recommend, but I am very consistent. I have forbidden myself from doing any intervals until I have at least 15 months of injury free running behind me (4 months to go). These things keep me from going bananas and getting hurt again.

I wish you all the best with the recovery. As you start again, remember "no setbacks". Always increase less than you think would be safe. Hopefully, that way it will remain so.

Best

Paleo

 

[Barefoot TJ]

I have no experience with

I have no experience with this, thank God, only sympathy. I wish you a full, speedy recovery, Heather.

 

[hmduey]

Paleo:that's great advice, I

Paleo:

that's great advice, I will try that. I thought I was doing well, and really I was. I just thought I could take on more than I did at the time (after I had a pretty good base going). Unfortunately I don't heal as fast as I did 20 years ago, if you know what I mean. ;-) Thanks for the recovery wishes!



TJ:

Thanks for the well-wishes. It's nothing like what you've had to go through, and I'm still hoping to avoid surgery. I'm really going to be pissed though if, after 12 weeks of being in the boot, I end up having surgery anyway.

 

[paraganek]

hmduey wrote:Right now I

Right now I could care less about running, but I'd pay a whole lot to be able to walk around barefoot

I feel for you, I was in a similar situation 7 weeks ago when getting micro-fracture on my fibula right above my ankle stopped me even from walking and I remember I'd pay a whole lot just to be able to walk without limping again.

I wish you a full recovery and hope you will be back on the roads soon.

 

[hmduey]

Hello everyone!  I just

Hello everyone! I just wanted to give an update and say that, after three months of "the boot" I am finally free! I can't run yet, but I'm free to walk around with or without shoes. I'm so happy I could just...well, go for a walk (except that it's pouring down rain and thundering right now).

The most amazing thing is that the doc said I don't need orthotics or arch supports. He said, "You have a natural arch; you should not wear arch supports in your shoes unless you have flat feet and foot pain." I thought this was very interesting, given that the shoe companies all want those of us with high arches to have lots of support in our shoes.

He also said he thinks I'll be able to run by the time I go back (a month), and I can do it barefoot whenever I'm ready (letting pain be my guide).

Just thought I'd share, because given what I've read here and elsewhere, orthotics seem to be recommended after an injury like this, but my doc recommends that I not use them at all (he is a marathon runner, but not barefoot). They are out there, just hard to find I guess.

 

[Barefoot TJ]

That's great news, Heather! 

That's great news, Heather! Do you think your podiatrist should be added to our Map of Barefoot-Friendly Docs?

 

[khyricat]

woohoo.. and wow.. I was

woohoo.. and wow.. I was always told flat feet- I needed arches.. I was actually told by 2 different physical therapists over the years that not wearing my orthotics (which always hurt to wear) was why I had so much back pain.. umm.. my core was never strong enough back then.. and I have a very large bust.. combine the 2 and I was guaranteed a painful back. They also used to push me for a breast reduction.. now I know I might do one for other reasons eventually but I don't need to in order to be healthy.. core strength and running BF has made all the difference...

 

[hmduey]

TJ, yeah, might be worth it. 

TJ, yeah, might be worth it. He's actually an orthopedic surgeon, who took the conservative approach and didn't do surgery (in fact he was very against it) and for that alone I would recommend him to anyone. He's not a barefoot runner, but he does run and he did not even try to tell me not to run barefoot, or that it was wrong, or anything else. I would recommend him to anyone so yeah, I guess he belongs there if his specialty doesn't interfere with what's supposed to be there. I'll add him if I'm able to and if not I'll shoot you an email.

 

[jschwab]

Congrats on getting through

Congrats on getting through this one without surgery. I was curious if you were just in the boot or if you had other therapies, too, like ultrasound, or PT?

 

[hmduey]

thanks jschwab! No other

thanks jschwab!



No other therapies, although I will go back at the beginning of May for a check (to see if I'm able to run yet). I tried a few steps the other day and I'm still not there, but no pain walking. I haven't had any PT, ultrasound, or anything else, but that may change if I'm not able to run in about three more weeks. There's also the possibility that I'll have to go back into the boot if I start having troubles again. But, so far, so good!