Peroneal Tendonitis from Walking and Hiking
by "Hooked on Hiking"
For the past 10 years I have walked / hiked 500 to 725 miles per year. I am 64 years of age. 5'5". 120 lbs. In good condition, generally. Excellent health.
On 12/30/10 I finished an 8 mile walk on pavement and felt fine. In the evening I started to have discomfort / pain in my left foot, in the area of the 5th metatarsal. At first I thought I had a stress fracture. Internet told me it wouldn’t show up on an x-ray for some weeks until the healing commenced. So I waited.
1/25/11 saw a foot specialist. X-ray indicated no fracture. Symptoms indicated and diagnosed as peroneal tendonitis. Rx = physical therapy for 4 to 6 weeks. Followed this Rx 1 x week with an experienced physical therapist. Lasered the area. Stretching and strengthening exercises. Massage.
Exercise during this period included elliptical trainer, stretching and strengthening. Icing once or twice a day. I am very diligent about this. I’ll get up at 4:30 a.m. to exercise and ice before going to the office.
It is now 2 months since the discomfort began. I don’t feel I’ve made the progress I’d hoped for.
I saw the doctor again today because in 36 days I am due to do 3 days of rock scrambling in NV. He confirmed the diagnosis. Most of the discomfort is in the area of the peroneal tendon, however getting some at the front of the heel and in the arch as well.
He does not think it is a tear. He suggested Aleve for 5 to 7 days to bring the inflammation down. Continue the exercises I learned in PT, but not necessary to go for more PT. I asked him if the discomfort continues, and since I’ve already paid for my 3 days of scrambling and all expenses to get there plus hotel… would I be doing any permanent damage if I did my canyon adventure.
He said I may irritate it, but didn’t expect any permanent damage.
I am continuing the icing, will step up the massage and will work on strengthening exercises unrelated to tendon movement to keep muscle strength and tone.
Would be interested in any additional suggestions.
“Hooked on Hiking”
First off, rock on for being so active!
So guess what happens with each and every step you take? Stretching and strengthening. If you walk so much, your muscles aren't in need of strengthening. Stretching maybe, but it's physiologically impossible to stretch muscle, so really you're lengthening connective tissue.
Microfracture? Maybe, though unlikely unless you switched shooes or had them too tight or are short on Vitamin D and Magnesium and thus developing weak bones. (And just because you're outside a lot doesn't mean you're getting vitamin D, depending.)
The doctor really thought (hoped) that 7 days of Aleve would fix you? Crazy.
Would you be doing permanent damage if you go rock scrambling? Unlikely. Might you irritate it so much it will become disabling pain? Possibly.
If you don't have any actual damage at the moment, then it's unlikely you're going to get damaged. If you just have an irritated ecology right now, which is what really happens in most cases of Tendonitis
Remember, There Are Two Types Of Tendonitis
. One with damage, on without.
Now I have some questions.
1. How exactly are you icing? And where?
2. How exactly are you massaging, and where?
3. Did you do anything new, as far as shoes, jumping, running, etc?
4. Happen to know your Vitamin D level. (Here's where you say 'I live in Hawai'i and I'm out in the sun all the time so my Vit D level -must- be fine.' and I respond with 'Do you wear sunscreen, do you wear long sleeves and hats? Do you shower with soap after your walks, which washes away the oily layer on your skin where pre-production of vit D takes place?'
5. What's your daily food intake look like? Meat eater, vegetarian, etc? ----------------------
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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expertwww.TendonitisExpert.com