Exercise can be an awesome thing that pushes our limits, molds us into better individuals, and improves our confidence by testing our abilities. But exercise can be a double-edged sword: you can reap amazing benefits and get injured. No bueno…
Earlier this year I decided to run a trail marathon at the end of August with some family members, so I ramped up my running miles. I hadn’t run too much before and I tried to be smart about my training, but the inevitable happened: I got bad peroneal tendonitis in my left leg which sidelined me for an entire month until my leg was back to normal.
I pushed myself one day over a weekend and I ran 6 miles – longer than I had ever run before. This was a milestone for me, but I started getting horrible pain in my left ankle. The pain escalated in 1-2 days until I was limping around and thought for sure that I had fractured my foot.
I pinpointed the source of my pain and then I did some research and figured out that I had peroneal tendonitis in my left foot. Ouch…ouch…ouchy
I tried working through the pain on my own with ice and massage, but the pain persisted so I went to a physical therapist. This was the best thing I did! For the entire month of May, I did only low impact activity, no running, jumping, or Zumba. It was rough, but I wanted to make sure that this was going to be resolved permanently and not continue to plague me forever.
What A Physical Therapist Can Do:
Besides the low impact activity, here’s what we did:
- Ultrasound: my physical therapist started every session with ultrasound
- Targeted massage: after the ultrasound came the hard part: having someone aggressively massage my inflamed tendons brought tears to my eyes…it was quite painful, but necessary and it made a big difference
- Mobility and strength assessments: I had some assessments done and found that my left hip was not as strong as my right hip. My achilles, calf, and plantar tendons were also quite tight, resulting in less than ideal foot movements during running. Once we knew what was imbalanced, we did strength and flexibility work to address my muscular imbalances.
- Running assessment: once I was doing better, we had a running coach join our physical therapy session to do a running assessment. They took videos of me running on a treadmill and we pinpointed some postural issues that needed improved.
- Change shoes: often people who get peroneal tendonitis under-pronate (they supinate), meaning they have higher arches and tend to land on the outside edge of their foot as they run, irritating the tendons in outside of the foot and leg. I got a better pair of shoes that helped correct the problem and my physical therapist suggested arch supports.
My Pro Compression Calf Sleeves – I love these things!
What You Can Do to Treat Peroneal Tendinitis:
- See a doc or physical therapist: Always see a doctor if the pain is severe and/or persistent. You should get a doctor to rule out stress fractures, sprains/strains, and muscle tears.
- Rest: when my pain got pretty severe (it only took 1 day for the pain to get to where I was almost crying), I cut out high-impact anything and did low impact exercises like rowing, bicycling, and appropriate weight lifting. As frustrating as sitting on the sidelines can be, it is very important for proper healing.
- Ice: when the pain starts, don’t wait: ice the area. Ice is your first line of defense to reduce inflammation.
- Compression: compression socks or ankle supports are a great thing to add to provide support and reduce swelling in painful areas
- Foam rolling/myofascial release/massage: I rolled my lower leg on all sides and found a very tender area of adhesion on my outside of my ankle in my peroneal tendon. I am a huge foam roller addict and I roll on a nearly daily basis. But the one place I was neglecting to roll was my peroneal tendon. When you are very active, take time to roll every muscle and tendon group imaginable, especially the areas that are very tender.
- KT Tape: I used the video below to tape my foot and add extra support, improve blood flow to the area, and provide a little compression. You can also get a physical therapist or sports doctor to tape your feet or knees when needed.
- Make corrective measures to your gait and posture. Many times foot and knee injuries are actually a result of imbalances so it is worth going to a physical therapist to check for muscle imbalances that might be causing recurring injuries.
- Mileage: Make sure you are increasing your mileage safely and not too aggressively.
- Run on level surfaces: Keep your tendons happy: running on sloped surfaces, tracks, and uneven trails can cause constant foot shifting that can irritate tendinitis. Mix up your running surfaces so you can prevent over-use tendinitis.
- Myofascial release/foam rolling: I might sound like a broken record, but I cannot overstate how important recovery and foam rolling is! Make myofascial release a regular part of your workout routine to keep your body and it’s elements (muscles/tendons/fascia) elastic and mobile.
- Compression is also a good way to prevent tendinitis before it starts.
- Cross training and strength training: You can prevent future injury by making strength training a regular part of your routine and keeping your body in balance with a good flexibility and recovery routine as well. Running is fun, but it is important to make sure you do other activities to keep your body fit in many ways and to prevent over-use. Fitness encompasses many aspects, including cardio, power, strength, muscular endurance, and flexiblity, so make sure you are incorporating plenty of variety in your routines.
Now that my tendonitis is resolved, I slowed my progression a bit and decided to train for a half-marathon in October. I have plenty of time to increase my mileage safely and do my strength training and weight lifting to keep my body strong through the upcoming miles.