Thursday, November 13, 2008

Extensor Tendinitis

I feel like that should be spelled 'tendonitis' but apparently the i is correct!

So that is my diagnosis. No stress fracture. Yeeaay! I took a very early flight back from Boston yesterday to see a doctor recommended by Jim (Thank you!). And it didn't take him long to rule it out.

After 2 longish runs the weekend before last my foot was really sore so I rested it all of last week. Of course I couldn't resist the BSC 6K last Friday (24:30 new female course record!)... which resulted in a very sore foot Saturday morning. By then I was in Baltimore for a conference. And that night flew up to Boston for a few days. I was so bummed to be in Boston in the Fall and not able to run! But misery loves company and Tanya happened to be there with work also - and was battling an injury - so we walked alot on Sunday! Thankfully Tanya's injury did not turn out to be a stress fracture either and she is cleared to do IM. I am very happy for her as she had trained incredibly well for this race. Hopefully her foot holds up okay for the run. Not that I wanted to be sidelined but I would have been less disappointed if I couldn't do IM :)

But with this diagnosis I won't do much harm running the marathon so tomorrow week I'll be flying down to Phoenix. If you are interested in knowing more about Extensor Tendinitis, read on...

The extensor tendons in the foot come from the relatively small muscles in the front of the leg. The two main extensor muscles are the Extensor Hallucis Longus muscle (EHL) and the Extensor Digitrorum Longus muscle (EDL). The tendons from these muscles cross the front of the ankle, pass across the top of the foot and attach into the big toe (EHL) and lesser toes (EDL). These tendons function to pull the foot upward and work with resistance from the Achilles tendon and the calf muscles (flexor muscle group) that pulls the foot downward. It's the tendon running down to my big toe that is inflamed. Right at the joint of the first metatarsal and medial cuneiform bone. And I also have a little bone spur which might get worse over time and is a prime location for eventual arthritis. But that's years off... right?!

As for the cause... in my case it's likely due to excessive tightness of the calf muscles and no doubt overuse. It probably started at Sawtooth as I had pretty severe shin pain which I'd never had before. So I guess a lot of stress on those extensor muscles. The treatment - lots of icing and stretching my calves.

Anyway, the good news is I can run. Sure, rest would help. But once I know it's not bone related I will be happy enough to run with some pain at IM. I just didn't want to risk anything that was going to cause long term damage. I will only run a little before then. Can't resist some time on the trails this weekend. But I did finally get around to pool running yesterday - 90 minutes - thankfully Tanya was there as I wouldn't have lasted 20 minutes by myself!

I am getting pretty excited about the race now. I know I haven't trained nearly as well as I had planned earlier in the year. But my swimming has come on okay in the last few weeks so I figure I'll manage 1:30. The bike is the part I am least ready for... running legs do not transfer to biking legs!! But I'm hoping I can do under 6:30. Add 15 minutes for transitions and that leaves me 3:45 for the marathon if I want to get under 12hrs again. Which I do! A long way off my original goal of 11:22 but I can't complain about the year I've had so a less than stellar IM will just have to do :)


SteveQ said...

If you make the mental transition of extensors in the hand for extensors in the foot and cut the tendons in half, you have half of my injury (broken bones being the other half).

Fortunately, your injury shouldn't affect two parts of your tri too badly. Heal fast!

Kel said...

I had a little bout with extensor digitorum longus tendinitis after the spring Superior races - probably from the steep and uneven footing after a winter of relatively calm running surfaces. A short barefoot run on asphalt the following week didn't help. Icing and eccentric strengthening got it straightened out to the point that I was basically asymptomatic in about 3 weeks.

Good luck with your race (and your tendinitis)!

d&p said...

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I have extensive experience in treating athletes with a variety of musculo-skeletal problems. Karate,judo, running, and boxing in particular, develop predictable problems with the elbows, wrists, shoulders and knees.

I currently use a non-prescription topical anti-inflammatory cream that I developed, originally for my daughter's horse.(her hobby) I introduced commercially, for human use 6 months ago.

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The blog site is:

The product is called “kink-ease.” It is a high concentration MSM lotion, and it is particularly useful for pain problems in the feet, hands, wrists, ankles and shoulders. It is somewhat useful in the hip and lower back, but only in slender people.

It is pharmaceutical grade and is priced very reasonably.

David S. Klein, MD, FACA, FACPM
Pain Center of Orlando, Inc.

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