It’s all coming back to me…little comments made over the years that indicate that my current condition–posterior tibial tedinitis–has been a long time coming: A shoe salesman said that I was flat-footed. A doctor commented that I was knock-kneed. A chiropractor told me that I overpronate. These characteristics were noted in the same manner in which one might observe my left handedness or my green eyes. The critical difference, however, is that the former are things that can be changed, although you wouldn’t have thought so they way they were presented. They are the result of muscle tension imbalances that could lead to potentially debilitating problems, and are to some extent reversible if the root cause is known and addressed. Sad that none of the people above knew about, or thought to mention, that these “characteristics” could and should be reversed.
Collapsed ankle, dropped arch.
The long and the short of it: weak hip muscles, through the kinetic chain, have caused tendinits in my ankle. How? My weak hips allow my femur to rotate inward, which causes my knees to collapse (knock-kneed), which puts strain on my inner ankle, causing it to roll inward (over-pronate), which leads to a flattening of the arch (flat-footed) and a slightly outward rotation of my right foot. All of this puts incredible strain on the posterior tibial muscle and tendon, whose job is to lift my arch.
Years of this kind of strain, exacerbated by running, has caused the tendinitis, which manifests as pain on both sides of my ankle, the back of my heel up into the achilles area, the inside of my lower leg, and my upper calf muscles.
The good news is that I can strengthen the muscles responsible for proper alignment and relieve the stress on my posterior tibial muscle/tendon. I’ve been prescribed side leg lifts, side plank, forward lunges, and squats with a strap around my legs just above the knee (the goal being to keep the strap in place through outward pressure–because I’m knock-kneed the strap falls as soon as I bend my knee). I’ll also need an orthotic to support my arch while I’m working to strengthen the hip abductors and vastus medialis (one of the quads).
I’m pretty excited to have finally pinpointed my issue, and to have found the right team of medical professionals to guide me through fixing it. If you’re in the Denver-Boulder area and need a sports medicine doctor or a physical therapist, I highly recommend both Dr. John Hill (CU Sports Medicine, Denver) and Bob Cranny (Altitude Physical Therapy, Boulder & Longmont).
Oh, the photo of the collapsed ankle above is from this New Zealand-based health website called Easy Vigour, which really helped me understand my condition. Ironically, the doctor who put this site together is a veterinarian!
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