I am a lady golfer 52yrs old. Since a few years, I have tendonitis in my ankles more in the left one. I wear orthotic heel cups. I have used ice for months, been to a physio for massage and ultra sound, took antiinflamatory meds, regularly stretching.
MRI showed chronic inflammation of boths Achilles tendons and peritendonitis of the left ankle. I have finally accepted one shot of steroid which gave me some relief for 2 months. Now it's back and I do not know what further course of action to take. I did stop golfing for some time, but walking is enough for it to be back. I am afraid of going back to steroids as I have heard that it could lead to weakening of the tendons.
Hello plgolfer, I admire your quest to correct this problem. It is always so difficult to heal feet issues as it's impossible to commit to long-term disuse. I do have a few questions and it would help me to be most specific to your issue.
How is your weight? What types of therapy did you use and for what duration? How is the pain if you palpatate the tendon? Is the pain altered with large range of motion or with sudden movement? Are your ankles stiffer in the morning or as the day wears on? Do you have knots around the tendon? Do you hear a popping sound, similar to but different than a cracking as in an adjustment? How effective is the ice in relieving the pain? Have you used any natural products on the tendon; arnica is on my mind. Are you presently doing any exercises for your ankles.
I know this seems tedious but I want to be effective as oppossed to just dumping out a lot of misdirected suggestions.
Glad you are on this great site. I will be more dilligent in my responses as my computer is not back on line. Look forward to your clarifications. Hang in there, with some time and deliberate attention, this too shall pass. Vickie
mb6606 is right, this is a very correctable condition if you understand the origins of the problem. First, though, is to eliminate some more serious structural issues than just muscle confusion. From that point it is just a matter of better negotiating the tensions of the hips and legs that contribute to the symptom, in this case plgolfers formidable discomfort; for others the symptom might have manifested differently.
plgolfer, I would also like to know if you have pronation in your foot placement. I am sure you have discussed much of this with your PT so let's work with what you know and then make applications of good information specific to your case.
I find the majority of people are unwilling to follow through allocating the necessary time and effort it takes to correct a problem. It takes work and most problems are fixable.
mb6606 is right, this is a very correctable condition if you understand the origins of the problem. First, though, is to eliminate some more serious structural issues than just muscle confusion. From that point it is just a matter of better negotiating the tensions of the hips and legs that contribute to the symptom, in this case plgolfers formidable discomfort; for others the symptom might have manifested differently.
plgolfer, I would also like to know if you have pronation in your foot placement. I am sure you have discussed much of this with your PT so let's work with what you know and then make applications of good information specific to your case.
Vickie
Hi Vickie,
I am actually plgolfer's wife, and I forgot to sign my name which is Odile. Sorry for the confusion.
Vickie, I am so glad to read the replies to my letter. This is really a great site, referred to me by my husband. Already I am feeling relieved that there could be a solution. So to answer your questions:
How is your weight?
I am 5ft 7 high and weigh 63 kg.
What types of therapy did you use and for what duration?
Firstly I have had this problem since 5 years.
I do have the left foot a bit shorter since my childhood and my hips are not level. My feet are very arched, and I am not sure that I have pronation in my foot placement. The doctor says that I have short tendons. I have been wearing heel support orthotics to help relieve my tendons. The pain is not severe and I feel my ankles stiff out of bed in the morning. Pain is not due to sudden movement. but will appear gradually from midday to end of day. I can feel my tendons specially the left, are hot and swollen. When I touch them it's painful. I have a knot on my left tendon.No popping or cracking sound in the tendons. No use of natural products or arnica.
MRI reports "mild fusiform thickening of both Achilles tendons with no significant intra substance signal changes. Appearances are consistent with chronic bilateral tendonitis, On the left, the maximum thickness of the tendons measures 9 mm and on the right 7.5mm. ( The normal values range from 4 to 7mm.) A small amount of free fluid is noted posterior to both talar bones suggestive of bursitis. No othe significant abnormality, no osteochondral lesion and the othe tendons around the ankle joints appear intact."
Therapy have been:
1 Using ice everyday and antiinflammatory gel. This has been quite useful in reducing the pain.
2 Oral antiinflammatory medicines, and acupuncture.
3 1st shot of cortisone in 2002, and the tendonitis seemed to have been resolved.
4 In 2006, tendonitis reappears and I started the same process as in 1,2 above, and I had 15 massage and ultrasound treatments of my ankles. That seemed to work for the right ankle but it was not efficient for the peritendonitis of the left.
5 In December 2006, I decided to have a second shot of cortisone injection. I had 5 weeks rest from golf. The pain disappeared. Inflammation was gone @80%. But now since end of March, the tendonitis is back and its again the left ankle which is more swollen.
I realise that this is a long reading for you. Thanks in advance for your patience and dedication.
Odile, You are so great with sharing your information and there is much to consider. Beyond the amount of time you have suffered some of your symptoms and indicitive of an advancement in the condition. These issues are more complicated and require more careful speculation before you just set out on a program. So before I move forward, and now that I know how indepth you will be, allow me to ask a couple more questions. Any way you can send me a few pictures on the pm of the front of your thighs to your feet from the front and the side, to your hips would be even better in form fitted clothing? This would answer the issue of pronation and give me some ideas of your hip instability; and I assure you this is a part of the origin. Secondly. If you kneel on the floor and sit your buttocks on your heels; can you do it without pain and is the front of your ankle on the floor or is it all too difficult to straighten out your ankle, and where is the most discomfort? How soon after you added the heel cups did you see relief and do you wear them in all your shoes? Do you have an orthodic in your golf shoes? Would you say that your calves feel tight? You didn't mention any exercises you are doing from your therapy. I'd like to know what has been applied, what you've continued and avoid redundency. Often the effectiveness, or lack thereof, illuminates our process.
Cortisone is a great relief and notorious for loosing it's effectiveness over time. I am surprised you received such a short reprieve. It just further indicates that your only choice is to do the work of bringing your legs into conjuction to alleviate your ankle disorder. It is the only way to avoid an actual rupture. But you already knew that.
Look forward to reading more. Vickie
P.S. I promise I will get to some recommendations soon. It's always a little easier when I can see the whole body function and do some testing. I appreciate your patience.
Wolfman (whom I believe is a podiatrist if memory serves me correctly) hit the nail on the head. Steroid injections of the Achilles tendon are a HUGE NO NO. Sometimes a brief course of oral steroids may help, but I would never allow anyone to inject mine. Will defer to podiatrists/orthopedists/Vickie for further discussion. Dr Dave
Wolfman (whom I believe is a podiatrist if memory serves me correctly) hit the nail on the head. Steroid injections of the Achilles tendon are a HUGE NO NO. Sometimes a brief course of oral steroids may help, but I would never allow anyone to inject mine. Will defer to podiatrists/orthopedists/Vickie for further discussion. Dr Dave
Yes, I am a podiatrist. Since this was originally addressed to
Vickie, I was going to stay out of the thread.
When I saw that she had been injected at least twice, I couldn't refrain from replying!
I will add my other 2 cents if asked. Although, I must say I am interested in Vickie's whole body evaluation and recommendations.
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