Doc, just can't take it anymore...

[bertrevert]

6 months of pain - ach! - not going away.

I have a persistent tight pain down the outside of my ankle - the tendon or muscles (?) running through underside of the protruding ankle knuckle and attaching to the outside base of my foot halfway along - gad I just wish it would go away.

Physio massage about halfway up the outside of my calf provides temporary relief.

I've been exploring shoes to lessen the stress.

Runnning helps - it's not lateral and just strengthens up the ankle generally.

I believe it really flares up from lateral movement, stopping and starting sideways.

I know I know, self diagnosis using the internet is a curse :twisted: but hopefully a saviour too

Any ideas?

 

[Chauvalito]

Possibly rest, ice, heat, and seeing the doctor?

 

[bertrevert]

Well the physio was as close as I got to medical advice.

I have to admit I've been managing it not v successfully - ie. I haven't stopped play and probably should - and I guess I don't want to be told to stop either.

Anyway I was hoping Doc Internet would put forward the magic cure...

 

[Cyclone]

well luckily for you, Dr. Internet is here. You probably have some form of ligament strain or sprain. My advice is to see a doctor, first of all. Until then, buy an ASO brace. That will provide a solid amount of support for your ankle while it heals, and even afterward.

Always ice after you play, not before. Icing afterwards helps calm the inflammation. Ice for only 20 minutes, making sure that there is some sort of thin medium between the ice and your skin (i.e. something more than just a plastic bag). Give around one hour's rest between icing, you don't want to overdo it. Also ask your doctor about taking anti-inflammatories like ibuprofen, short courses of high doses work wonders to lessen pain and inflammation permanently. ask your doc tho, as always when you're going to start/stop taking some drug.

Work on your ankle stability. This is achieved in several steps. Firstly, type in "ankle exercises" on google and you'll get a bunch of sites with exercises that will increase your ankle strength. Running is alright for forward motion, but it does very little to improve your ankles' ability to cope with the extreme lateral stresses inherent in hard court tennis (damn these hard courts, switch to clay!). You should also put in some time on a balance board or inverted half bosu ball. this will greatly enhance your proprioception (your body's ability to know where its constituent parts are in space) and balance. once that feels better, progress to more tennis specific movements such as side-stepping and lunges.

i'd honestly recommend taking a bit of time off. a few weeks won't really hurt your game that much, it'll take you maybe a couple of days to get your timing back, but it will really help your ankle. also, while you're away, you might as well work on your overall leg strength. every part of the body is inescapably functionally interconnected, so if one part is weak the others will take over. definitely make sure you strengthen your calves, as the calf is the muscle that supports the ankle joint, much like the quadriceps support the knee joint.

when you come back, make sure you're wearing stable shoes with a good amount of comfort, the Barricade 4's and the Asics Gel Resolutions are excellent bets for protecting your ankles. make sure you keep on wearing that ASO, though it might be tempting to take it off, look at guys like roddick and hewitt, they wear their ASO's even during practice because some people just have a natural propensity for rolling ankles.

hope that helps, let me know if you have any questions! good luck buddy

 

[bertrevert]

^^^ Hehh heh heh great answer, aint life reat sometimes... thanks Doc

Yep have the ASO brace now for 1 or 2 years (preventative initially to stop any further nasty rolled ankles) and now it's permanently on my right ankle. Yes the physio was impressed by my v flexible supple... extremely rollable ankles. He said "great ankles, just not great for tennis" ... anyone for ballet....

Yes running is just brute strength but it does nothing for the lateral movement... seems obvious to me now... am going to have to work on the ankle stability.

Thanks for the tip on the calves - hadn't thought about those muscles playing a part.

Thanks again... I have my marching orders.

ps.

 

[SplitSecond]

You have inflammation of the peroneal tendons. Left untreated, it will worsen and immobilize you, like it did to me.

 

[bertrevert]

Yep those are them - thank you very much for identification.

Of course, persisting in my internet evaluation I googled the term, and here's a good description
http://www.footphysicians.com/footankleinfo/peroneal-tendon.htm

Hmm, ok am going to have to go down the path of MRI and seeing a real doc...

This is just not getting better really and has already taken a long time, obviously I need to dom something about it, though I've held off thinking it would just get better...

 

[ksqwqb]

You have inflammation of the peroneal tendons. Left untreated, it will worsen and immobilize you, like it did to me.

this is correct. I have/had the same thing. Saw an orthopedic surgeon. He made me some inserts for my shoes, they raise the lateral part of your foot a few mm. At first I thought he was crazy, thought there's no way changing your foot position that little would make any difference. But it has helped a ton! I wear them religiously in both my work shoes and tennis shoes and have been pretty much pain free for the past year.

 

[albino smurf]

See a doctor. A friend o mine had a similar pain and had had his ligaments in his ankle slip out of place and by contnuing to do stuff on it they stretched and required a grafting surgery.

 

[dtd82]

There are two peroneal tendons; one connects as you describe, on the outside to the base of the 5th metatarsal bone, the other to the bone just below the big toe. I've had both operated on, with the most recent 8-ish weeks ago, fixing a complete rupture of the one going to the big toe. Did the one going to the 5th met just after college, years ago.

Get to a Orthopedic doctor, and get a set of x-rays and mri's done. People with high arches are very prone to problems with these tendons.

And they hurt, and they only get worse.