I just did a follow up post on my tendonitis, but I am going to do another since I decided to get a second opinion because I wasn’t having a much relief as I would have liked and I didn’t like the approach to getting out of the boot.
I had my first appointment on Wednesday with a chiropractor who practice focuses on treating athletes through use of Active Release Therapy. I wouldn’t classify myself as an athlete but my running/triathlon coach disagrees with me and suggested I give it a try. I realized I had noting to lose so it was worth a try.
After getting a history and giving me a once over, he agreed with the original diagnosis of posterior tibial tendonitis. He stressed the fact that it is a hard injury to heal since the tendons have no blood vessels to aid in the healing. He used is Active Release Techniques and OMG, it wasn’t pleasant! But I have to say in the days since, I have had less pain then I did prior!!!
He, however, did disagreed with the approach of getting out of the boot. He has had me to start easing back in to all activities. My homework for my appointment with him today was to start riding my real bike and water running in the shallow end of the pool. He suggested with the bike rides that I stick close to home for the first few rides in case pain did arise. He had me move to the shallow end of the pool so my foot could strike the bottom of the pool. By doing that it could help us better determine if I would have pain when I ran on dry land. Based on how those things went, he would re-evaluate if and when I could start running again.
One thing he did mention was that if I got any swelling in my foot then I needed to go back to my boot. Also, if at anytime during my activity I had any pain I had to quit was I was doing and rest my foot. He stressed that the tendon it is easy to damage and slow to heal since there is no blood flow to it. So a little discomfort is fine but it should be very minimal.
I did my homework and I can say it all went very well!!! Today I met with him again and we discussed what the possible causes of the tendonitis could be. He believes it is one of two things, or possibly the combination of both. During the Garry Bjorklund Half Marathon, at about mile 10, I had pain in my calves like I have never had before. He questions if my calf muscle failed and the three smaller muscles kicked in to help, one being connected to the tibial tendon. Or the other issue is my shoes. He looked at them and noticed that there is a band that goes down the side that is constricting and possibly (see picture) slightly rubs the tendon area causing the issue. Of course, there is no way to be sure which one it is.
With that he suggested I get new shoes. He wanted me in a neutral shoe with good inserts for the time being. Then once this issue is gone he wants me to invest in another pair of shoes, so that I have three total (I can still use the ones I have unless we find they are the cause for the tendonitis) and cycle through them. He feels that by changing the shoes out during my runs it will create different muscle memory making my feet and legs stronger.
After committing to getting new shoes and insert he cleared me to start running!!! (I couldn’t be more excited!) He suggested starting with 1/2 – 3/4 miles the first day, then the same the second day, and slowly up it a quarter mile after that. He also wants me running more often but shorter distances. He feels that it will get the tendon stronger and help build more healthy tissue around that area as well as rid the scar tissue.
Tomorrow I will run for the first time in almost four weeks! It will only be a short distance but it is still running!!! I will see this doctor one more time on Monday but then he feels I am good to go! I am very happy I decided that getting a second opinion was a worth considering, because had I not I would still hanging out on the sidelines.