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01 Sep 2007

tendonitis?
Hello. I've had a sore ankle since January this year. I'm overweight and have started doing 10km races since late last year. The ankle pain does not go away in between races, but during a race it gets progressively worse to the point where I'm limping for a while after the race. In between races I'm not limping normally, I feel the pain if I bend my foot outward, but just a nice stretch if I bend it inwards.
I took a break from walking for the Winter (last race was 2nd May, I saw an orthopedic surgeon just after this race and he said it was overuse wear on a tendon just below my ankle, and that with rest it should be fine), but during this long break it did not heal - just mostly subsided into a dull disomfort, especially after a long drive; the discomfort not only in my ankel but stretchin past my knee to my thigh (it felt like I constantly needed to have someone hold my leg and pull - bad enough that I had trouble sleeping) and actual pain whenever I had a long day on my feet at work.
I saw a Biokineticist and he said my right leg (the one with the problem ankle) was cm shorter than the left leg, and that I run with a bend to my right leg, but he provided no clues as to a way forward. Last month I saw a different GP (my ankle was still sore after 2.5 months of not walking/ running), and he gave me a steroid injection and some pills - I also saw a physio around the time, so I don;t know what did the trick but the pain/ discomfort went away.
I walked my first 10km since May last Sunday, and it's back - my ankle's been sore (painful) the entire week. It started about a km into the race.

Please let me know what specialist I should be seeing - my last Doctor said maybe a Sports Physician, and maybe I might need a stepped shoe if my leg really is shorter? Please advice?
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Expert
FitnessDoc
fitnessdoc

01 Jan 0001

Hi KB

I'm not going to question the diagnosis, and so I will assume that both the orthopedic doctor and the biokinetcist are at least partly correct. The problem with seeing so many doctors (and it's common, believe me), is that each one tends to be biased towards an area that he/she is more competent at. So your bio suggests leg length because in his experience, that's been the answer to previous cases. The orthopedic guy says tendonitis because his training and experience tells him that. More than likely, they are all correct, in parts. It's mysterious to me why none have given you any kind of long term plan here. Everyone you've seen has seemed to give you one assessment, a diagnosis, and a bit of treatment, and then it's over. Now, what it more than likely needs is a prolonged period of rehab. There is clearly a weakness there, whether it's a leg length thing that can be corrected with shoes, whether it's weakness in muscle, I'm not sure. But it's not something that will be fixed up in one session.

So my advice is yes, a sports physician, so that you can get a overall diagnosis. They'll look at the problem from all points of view, hopefully. But then, more than likely, you will be seeing a physio or a bio again, referred by this doctor. And that must be a long term thing - it might be 3 or 4 weeks of a session a week, plus exercises that you do every day at home. But time is important - overnight fixes don't work, so it needs you and whoever the doctor suggests to work together on this to sort it out.

I hope you can get this problem solved, it must be terribly frustrating.

Best of luck
Ross
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