44 Year Old Runner having pain in flexor hallucis longus

by RunningMan44

Hi Joshua,

I'm a runner having a problem with my flexor hallucis longus (and perhaps posterior tibialis). I've sent you 20$ on paypal for Quick Response, but you don't need to stress.

The problem started after a very hilly marathon 8-9 months ago. I got a little pain in the back/bottom of my right heel and my right ankle. I started running only on flat asphalt as that felt better.

Unfortunately, the pounding soon led to a metatarsal stress fracture. As I was sure the heel problem would go away while the fracture healed, I didn't really care about it. However the pain persisted and got worse when I started running again. The ankle also hurt, but wasn't really a problem, I would just put the foot in a bucket of cold water after running. The heel however made it even difficult to walk.

MRI showed that the sheath around posterior tibialis was full of liquid. I then got a cortison injection guided by ultra sound in the sheath. The doctor also saw that the FHL was full of liquid and gave it a shot too. After a week I was pain free and started (stupidly) to run daily again. The doc and the PT were not happy and told me to calm down. They also gave me exercises for posterior tibialis.

After a period of rest and exercices I started gentle running and cross country skiing. But after a few weeks the heel pain was on return. This time I also got some tenderness in the lower inside of the calf.

Until then my focus had only been on posterior tibialis, but I suddenly remembered that I also got a shot in the FHL. When I googled FHL, I found exactly my symptoms: pain in the back and bottom of the heel, pain around the malleolus, plantar fasciitis-like pain under the sole and pain in the lower calf.

Now a crazy thing happened. After this discovery I did 10 minutes of my usual posterior tibialis exercises on a balance mat, but this time I tilted more onto the big toe. Then I tried to stretch the FHL specifically. Lo and behold! The heel pain I had had for 7 months disappeared instantly!

However, my calf was still tender, so I waited a few days before running again. At this point I also started quite regular icing following the advice on your web site.

Unfortunately, when I stepped up the running, the tenderness in the calf began to sneak down into the malleolus area (which I could always ice away) and then into the back/bottom of the heel.

When the pain reaches the heel, I cannot run, and it will sit there for at least a week of total rest. It even hurts walking. The inside of the foot sole is also tender, so I believe it's the FHL and not the PT that is the primary problem. Though it may well be that PT is still not 100%.

Right now I've had some rest and I'm only a little tender in my calf. But I know that if I run daily for a week, the pain will soon start to move downwards and into the heel.

Stretching definitely helps when it hurts, but I think it's difficult to stretch the FHL properly.

So what should I do to get 100% injury free?


Running Man (44)


Joshua Answers:

Hey RunningMan44.

I had to laugh. Yep, that was dumb. Going for a run a week after Corticosteroid Injections was pretty dumb.

Having said that, having not run for a month or more after the shots wouldn't necessarily have produced any different results.

Pain is just a symptom. There's a dynamic in there that -causes- pain, and' it's still htere whether you're feeling any pain or not.

Along with all your specifics of what muscles are affected, etc,
you have an entrenched Pain Causing Dynamic. Which means that over time, muscle and connective tissue has gotten tighter and tighter (some more than others, which throws things off even more), and a Process of Inflammation has been doing it's thing.

And, as an avid runner, the toughest aspect is that you've had a compensation pattern getting worse and worse.

There's two levels here.

One level is the basic aspects of muscle and connective tissue tightness, and inflammation, and nutritional (in)sufficiency, etc.

The other level, is electrical disruption, and compensation pattern.

Reversing Achilles Tendonitis ebook or 'The Plantar Fasciitis Treatment That Works' DVD and the Quick Start Companion ebook that comes with it will take care of the first level.

That may be all you need.

But if you're a stereotypical runner (wanting/needing to get back on the road more than anything and willing to run though injury if at all possible), and you want to put down miles and miles until you're 90, I suspect that you need a bigger gun.

Don't get me wrong, my stuff will make a huge difference for most people. I'll put it up against anything that's out there.

But. I can't even begin to compete with The ARPwave System.

Want to run 93 marathons in 93 days? Helene Did.

Want to -fix- all aspects that whole foot/lower leg problem you got going on?

Want to take 10 years off you body while you're at it?

It takes some work, and it may or may not be in your price range (just all depends on your motivation levels), but the ARPwave System corrects the electrical disruption that keeps your muscles from firing optimally.

Know why you got that stress fracture in your foot from running? It's because your muscles weren't firing correctly. A muscles's job is to absorb force. If it doesn't, all that force has to go somewhere. In your case it when to the spot of the stress fracture.

There's a lot more to that conversation, of course, but basically:

1. Over time your muscles have fired less and less optimally. FYI, the problem was in place long before you started to feel pain. It just got worse from there.

2. Compensation pattern developed, and continued to compensate. This is not a good thing, ultimately.

3. See: What Is Tendonitis. Tightness and dysfunction causes inflammation and fluid build up.

4. Pain, etc.

5. Wasted time at the doctors office, etc.

6. More attempts at running, body not performing as it 'should'. Repeat.

7. Then what? Quit running, or find a fix.

Will it go away on it's own after a year of Rest? Pain will go away, but if you get back to running, it's incredibly predictable that it'll come right back.

Why? Because the structural aspects and compensation pattern and electrical disruption is all still in place, even if pain goes away.

What's a fix? Maybe my Eboook or DVD. But definitely the ARPwave System. For you specifically, I'd highly recommend that you take ARPwave up on their offer of a free, no risk in-home eval/treatment.

You just may be VERY surprised what can happen in that single eval/treatment.....

Check out the ARPwave System link above, then ask any questions.

Related: Want to make sure that fracture heals strong and optimally? Make sure you have enough Vitamin D and Magnesium in you, so your body can utilize it's Calcium to heal the bone strong.

Related: Kudo's for experimenting and finding the specific FHL stretch. Much of fixing pain is trial and error; it's necessary to learn what one needs to learn.

Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

And, comments have a 3,000 character limit so you may have to comment twice.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert

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Jun 19, 2012
Success! (but I never learn)
by: Anonymous

Hi Joshua,

I just wanted to give you an update. After three days of massive ice dipping back in January, I started running again. Rather easy the first week but then I logged 90 consecutive days of running, averaging more than an hour a day (then I had to do some traveling). And remember, that was after more than half a year of almost no running.

So, tremendous success! Thanks!

A minor mistake I did in the beginning was to only massage the muscle belly of the FHL. So when I switched from ice dipping to ice massage, I quickly got pain in the heel and under the foot again. But ice massaging everything (knuckles, bones, heel pad, etc) from the big toe to half way up the calf fixed that.

A bigger mistake is that I stop massaging when I don't feel any pain. (I'm lazy) and then it starts sneaking back after a week or so. I've set up a rigorous program now though.

However, my biggest mistake was that I didn't care about the other leg. And last week pain struck in the left heel too. But I'm confident I will work my way out of this quickly.

Anyway, thanks for your great advice and keep up the good work!


Runner 44


Joshua Comments:

Hey, we're all lazy.

You are, in fact, far from lazy. You get results because you pay attention and do the work.

People that do the work get results, with rare exception.

I'm glad you're back on the road! And yes, both legs. :)

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