Ankle pain while foot dorsiflexed

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Ankle pain while foot dorsiflexed

Post by AD » Thu Aug 12, 2010 1:23 am

I am a runner averaging about 40-50 miles a week. I routinely stretch calves independent of one another 1-3 times a day. While standing up straight, I place the ball of my foot over a sharp edge so that I can drop my heel and stretch the calf using my body's weight. While stretching the right calf, I have begun to experience pain on the front side of ankle. More accurately, as I hold the stretch on upwards of 25-45 seconds, there appears to be a tenderness/weakness on both the lateral & medial sides of the ankle joint but anterior to both malleoli. Subsequently, I need to release the stretch slowly using my left foot to raise my body's weight off the right foot. I don't have any complaints while running, before, during, afterward and do not experience symptom while stretching left calf. Just trying to gain some insight so as to prevent injury.

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ApolytonGP
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Post by ApolytonGP » Thu Aug 12, 2010 2:50 am

I have no clue on the anatomy or condition. My Boston marathoning PT has some ankle issues, but says standing calf raises (BW singles) help him with them. Have no clue if will help, but just a thought.

Is the pain more there when you have bent knee (solues stretch)?

Have you tried Thompson test for achilles connectivity? (Jungledoc will be along to abuse me for suggesting this. :green: )

Then there's issues people can have with the plantat muscle and or the peroneals (more lateral though).

Could just be Achilles tendonitis.

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Post by jml » Thu Aug 12, 2010 3:33 am

Do you have one of these (http://www.thestick.com/)? Apparently they help a lot with ankle/knee problems caused by running.
Is there a reason you need to run so much? Do you do any strength training for your lower body?

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Post by Proper Knob » Thu Aug 12, 2010 5:08 am

ApolytonGP wrote:I have no clue on the anatomy or condition.
Which begs the question, why are you offering advice?

To the OP, i would suggest going to a physio. It's far better for a qualified physio to assess your ankle rather than leaving it to people scattered around the globe offering advice based only on some descriptive text.

But to back up jml's advice, do you do any strength training? If not, you'd be wise to.

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Post by Jungledoc » Thu Aug 12, 2010 7:47 am

ApolytonGP wrote:I have no clue on the anatomy or condition.
1. This makes your input particularly valuable.
ApolytonGP wrote:My Boston marathoning PT has some ankle issues, but says standing calf raises (BW singles) help him with them. Have no clue if will help, but just a thought.
2. Ah... You know someone who is a PT and who has ankle pain. That does increase your expertise considerably. Please forgive any sarcasm you may have sensed in #1.
ApolytonGP wrote:Is the pain more there when you have bent knee (solues stretch)?
3. The OP has told us that his pain is nowhere near his soleus.
ApolytonGP wrote:Have you tried Thompson test for achilles connectivity? (Jungledoc will be along to abuse me for suggesting this. :green: )
4. Here I am. I have no idea what "Thompson test" is. Here I must bow to your more prompt use of Google.
ApolytonGP wrote:Then there's issues people can have with the plantat muscle and or the peroneals (more lateral though).
5. See #3, inserting "peroneals" in place of "soleus." Also, I don't know what the plantat muscle is. I did not get a perfect score on my musculoskeletal gross anatomy practical exam. Perhaps that's one of the ones I missed.
ApolytonGP wrote:Could just be Achilles tendonitis.
6. See #3, inserting "Achille's tendon" in place of "soleus."
Also, see #1.

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Post by Jungledoc » Thu Aug 12, 2010 8:08 am

OP--Welcome to the forum.

I was going to apologize for Poly (every family has a wayward son or two), but then I remembered how I feel about people seeking this sort of help on a forum like this. You're bound to get stuff like Poly offered. Ordinarily, I wouldn't get involved in these sorts of threads, but I think I actually know what is going on with you, so I'm going to barge ahead.

Why do you do this particular stretch? Why do you need it? Maybe it's the stretch itself that is causing the problem. Stop doing that particular stretch for a while and see if the problem goes away. Here's what I think is happening. When you force your ankle into this extreme dorsiflexion, you are wedging the calcaneus up into the mortise, the space between the distal ends of the tibia and fibula. You have stretched your ankle so much that the range of motion allowed by the connective tissues now exceeds the practical ROM of the joint. You don't need that much flexibility. Your connective tissues can no longer protect the joint in the way that they were designed to do.

By the way, this maneuver is done as a diagnostic test for tears of the interoseous ligament. Forcibly dorsiflexing the ankle drives the tib and fib apart.

So, stop using the entire weight of your body to stretch your ankles. You just don't need it. In fact, you probably don't need to do any sort of calf stretches for a long time. Just warm up by running slowy and gently the first few miles.

This reminds me of KPj's often-given advice "don't stretch just to be stretching." Have some good reason for any static stretching, more than that it's just the routine that you follow. If a muscle is really too short, or too tight, fine. Otherwise there's the chance of doing more harm than good.

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Post by stuward » Thu Aug 12, 2010 8:42 am

It's really odd that it's affecting both sides of the foot. It may indicate a problem in the knee or hip.

This is what came to mind at first due to the location.
http://orthopedics.about.com/cs/footpro ... tibial.htm

This might be related to stretching of bad footwear but I would definately see a PT about this. You certainly don't want it to progress.

Edit: I wrote this as Doc was writing. Try his fix first but don't let it go.

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Post by ApolytonGP » Thu Aug 12, 2010 3:12 pm

Plantar muscle (typo).

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Post by Jungledoc » Thu Sep 16, 2010 2:40 am

:spam2:

They are cute devices. I'm sure that they're perfectly useless, but they look nice.

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Post by Jason Nunn » Thu Sep 16, 2010 8:23 am

Jungledoc wrote:
ApolytonGP wrote:I have no clue on the anatomy or condition.
1. This makes your input particularly valuable.
ApolytonGP wrote:My Boston marathoning PT has some ankle issues, but says standing calf raises (BW singles) help him with them. Have no clue if will help, but just a thought.
2. Ah... You know someone who is a PT and who has ankle pain. That does increase your expertise considerably. Please forgive any sarcasm you may have sensed in #1.
ApolytonGP wrote:Is the pain more there when you have bent knee (solues stretch)?
3. The OP has told us that his pain is nowhere near his soleus.
ApolytonGP wrote:Have you tried Thompson test for achilles connectivity? (Jungledoc will be along to abuse me for suggesting this. :green: )
4. Here I am. I have no idea what "Thompson test" is. Here I must bow to your more prompt use of Google.
ApolytonGP wrote:Then there's issues people can have with the plantat muscle and or the peroneals (more lateral though).
5. See #3, inserting "peroneals" in place of "soleus." Also, I don't know what the plantat muscle is. I did not get a perfect score on my musculoskeletal gross anatomy practical exam. Perhaps that's one of the ones I missed.
ApolytonGP wrote:Could just be Achilles tendonitis.
6. See #3, inserting "Achille's tendon" in place of "soleus."
Also, see #1.
I just read this for the first time and almost fell out of my chair laughing so hard. Good job doc!

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Post by callipygian50 » Thu Sep 16, 2010 10:19 am

Jungledoc wrote::spam2:

They are cute devices. I'm sure that they're perfectly useless, but they look nice.
What?! They look very useful. They can keep your toes apart while you wait for nail polish to dry.

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Post by Jungledoc » Thu Sep 16, 2010 4:43 pm

:lol:

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Post by callipygian50 » Thu Sep 16, 2010 7:21 pm

For what it's worth, should you ever need toe separators for any reason, they can be had much more cheaply than from the link provided above.

Foam ones (even those with cute little cartoon duck heads for each toe) are easily less than $1 for a full set. Even the fancy gel ones can be had relatively inexpensively.

I suspect some women who wear very pointy shoes might occasionally like the toe separators to maybe un-compress their toes? Most the ads suggest they will help with the pain of bunions. I don't know. I go around in slippers, lose sandals, tennis shoes and other very lose shoes most of the time.

Anyway, I doubt this is the original poster's problem. But if he wants to try some sort of toe stretching product, he should search for "toe stretches" at Amazon.com. (You'll notice nearly all ads show women's feet with painted toe nails.)

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Post by Jungledoc » Thu Sep 16, 2010 8:37 pm

I think I can recall my sister with wads of toilet tissue stuffed between her toes while her polish dried. Can't get much cheaper than that!

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Post by callipygian50 » Thu Sep 16, 2010 9:19 pm

Maybe the foam doesn't fall out? I don't paint my toenails so I can't say for sure whether they have advantages relative to toilet paper.

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