Wednesday, March 24, 2010

Day 73: Help me, Google Wan Kenobi, you're my only hope!

First, welcome to the new followers!  Thanks for playing!

Second, stupid stupid leg ouchie ouchie ow.  Good news, it's no worse than yesterday.  Bad news, it's not really any better either.  Good news, I don't think it's Achilles tendonitis (or tendinopathy, as apparently it is now deemed).  Bad news, I think it may be peroneal tendinopathy.  This is where my Dr. Google skills come in handy.  Walk with me.

With acute tendonitis, you have:
  • Gradual onset of pain over a period of days.  Nope!
  • Pain at the onset of exercise which fades as the exercise progresses.  Nope!
  • Pain eases with rest.  Nope!
  • Tenderness on palpation.  Nope!

With chronic tendonitis, you have:
  • Gradual onset of pain over a period of weeks, or even months.   Nope!
  • Pain with all exercise, which is constant throughout.  Eh, sort of, although I haven't tried anything other than walking or running.
  • Pain in the tendon when walking especially up hill or up stairs.  Yes.
  • Pain and stiffness in the Achilles tendon especially in the morning or after rest.  Not really, it's fairly constant.
  • There may be nodules or lumps in the achilles tendon, particularly 2-4cm above the heel.  Nope!
  • Tenderness on palpation.  Nope!
  • Swelling or thickening over the Achilles tendon.  Not really.
  • There may be redness over the skin.  Nope!
  • You can sometimes feel a creaking when you press your fingers into the tendon and move the ankle.   Nope!  Kind of creepy though if I did. 

 Dr. Google concludes that this diagnosis isn't a very good fit, particularly since I have zero tenderness on palpation, meaning when I give my achilles a good feel it doesn't hurt.  Let's look at peroneal tendinopathy instead, which thankfully has nothing to do with your peritoneum: 
  • Pain and swellilng on the outside of the ankle or heel.   Yes!
  • Pain is worse during activity and gets better with rest.   Yes!
  • Pain when pressing in on the peroneal tendons.   Yes!
  • Pain when the foot is passively inverted (stretching the peroneal muscles) and with resisted eversion.   Yes!
  • Calf muscles may be tight.  Always!

 In case you're wondering (and I know you are), the peroneal tendon runs behind the lateral malleolus (the bony bit on the outside of the ankle). The peroneus longus tendon runs around the back of the lateral malleolus and under the foot to attach at the outside of the first metatarsal and cuniform bones. The peroneus brevis passes around the back of the lateral malleolus and attaches to the outside of the foot on the base of the 5th metatarsal. The muscles act to plantar flex the foot (point foot downwards) and evert the foot.

"Evert" may be my new favorite word.

Here is that above explanation of the peroneal tendon fits me.  The pain is at the outside of the bony bit on my ankle, and that's where the slight swelling is.  How they describe the peroneus brevis going around and hooking to the foot at the base of your pinky toe?  That's precisely the spot I started having periodic localized pain several weeks ago.  It often feels like the bones across the top of my foot are being stretched apart, or are too tightly bound together.  Weird, huh?  It's also the peroneus longus muscle (basically, part of your calf) where I had the problem last Sunday, up at the top.  Right now the only spot at which I feel any discomfort on palpation is at the base of my calf muscle, where it attaches to the achilles tendon. 

Isn't Latin cool?  Don't running injuries suck?  I'm going to be rather upset if I'm knocked out of training at 11 weeks. 

Treatment is rest (check), NSAIDs (check), calf stretching (sort of check, I have to go easy), and massage (where is Carlos the Pool Boy when I need him?).   Pretty easy, except that rest means no running in this case.  Even if I walk too quickly right now, I have pain.  Actually I have pain when I'm not even moving the leg.

I'm going to go cry now. 
the CilleyGirl


  1. I hope you heal up quickly so you can get back to running.

  2. Thanks Nica! I appreciate the healing thoughts :)

  3. I'm currently going through kind of the same thing.. my MRI was a mess and I'm scheduled for surgery. :( I hope youre doing better! Getting some running/walking in for me!