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  • in reply to: Peroneal Tendon Dislocation advice #75648
    AvatarKent Zelle
    Participant

    So it’s been over a year since I’ve suffered from this overuse injury to my peroneal tendons on both sides. What a crazy journey I wish to never repeat! If I have one word of advice for you… it’s to be patient, because it’s taken a long time but I’m getting back to not having my ankles interfere with my ability to exercise.

    What I’ve learned so far…
    This injury was not JUST an overuse injury, but an injury due to compensation. It seems that my peroneals were taking over because I did not have a strong inner thigh or properly functioning obliques. All the lateral stability that my core and inner thigh was supposed to offer was not there and so my peroneals were taking over to prevent my leg from rolling past midline by everting the foot. I has a bad issue of walking on the outside of my foot through my gait and I’m working to consciously step through the center line of my foot, using my breath and inner thigh to re-pattern. I also make sure I’m walking with my feet straight (look at the out edge of your foot, not the inner) and externally rotate the femur (i suffered from internal femur rotation, ugh!). 
    They still get sore from time to time but I am no longer running or cycling. Cycling I think was the link to causing the lateral stabilizers to weaken, then when I started running all hell broke loose since I was no longer strong and able to keep from rotating and use my core correctly. 
    I really NEEDED to exercise for my sanity to I went back to riding horses (yes, folks- its a sport! It aint easy.) Jumping, riding bareback, and doing strength work to ride in better form really got my core working and my inner thigh muscles turned back on!!! My psoas released and my lower back lengthened. My calves started to relax from the heels down position in the stirrup. My lats began to turn back on from the rein use and jump position. I was able to walk farther and jog farther (not for exercise but, literally, just across the barnyard without fearing that I would roll my ankle.)
    I also did Yoga dvds- jill miller Core integration, hips, shoulders. Pretty much all of her videos. foam rolling, all the mobility wod stuff for warming up and getting my joints to move in full range. I did this to unwind from riding and now to unwind for crossfit. And especially after road trips. I hate driving in that car! Katy Bowman’s boot and tips on making sure the femur is straight was helpful. I gave up sitting in chairs for like 4 months, unless I couldn’t help it.
    I also recently started Crossfit. (yay!) and that has been the real fix. Getting stronger, especially my core and being more aware of mobility and breathing has allowed me to fix what the peroneals were compensating for. I can now run for the warm ups, walk 3 miles without too much of a reminder (I can feel them burn and tighten, especially if I haven’t been aware of tying in my obliques or inner thigh when moving) I can squat ATG with no issues in my calves and keep my feet straight. I could NOT do this EVER before in my life. I can fold into a sitting position from a stand and get back up with no stability issues (sit from a stand and get back up without using your hands and stay stable and smooth- it’s not as easy as it sounds- atleast it wasnt for me!)
    I found that NO amount of rolling the lower leg helped, no amount of massage, trigger release, strengthening, etc, helped my peroneals. Taping helped them to have a break was helpful, but turning on and using properly, the muscles that werent carrying their load was the ultimate cure. Opening up the front of the hip, releasing the psoas, strengthening the lower abs, lengthening the lower back helped me to get a better pelvis alignment so my core, inner thigh could work correctly. I also stopped sleeping with a pillow to get my tspine to stop being forced into flexion. This helped my low back to lessen the curve from APT. 
    Also, no amount of liniments helped or meds. Anti-inflammatories did nothing. Methocarbomal (muscle relaxers) hardly did anything. Essential oil mixes like pan away or deep blue did help some. Serious rest, with NO ZERO NONE… no use is what healed them, but until I fixed what they were compensating for, they kept getting sore again. I took b vitamins, fish oil, d3, bcaa, k2-mk7, magnesium to help boost healing. I guess it helped.
    I can still dislocate the left one by moving my toes. I can feel it slip out of it’s groove and go back in. It stays in otherwise. I also have to pop that ankle sometimes or it feels strange. My right it much better. But that’s also my “gimpy leg” that does less work. Maybe a leg length issue or a hip alignment issue. No other issues that prove which. I think it’s a neuro or patterning issue that I’ll be addressing in CF, for sure.

    Going barefoot for the majority of my work or day time and then wearing/walking in minimalist zero drop shoes but WITH cushioning helped alot too. The difference in the cushioning made a huge difference in the pain I had to tolerate while healing. Altra, Innov8, Merrell have good cushioning choices that are still zero drop. VFF were too harsh for my ankles and feet while I healed. Now I can wear them easily.  
    BRAYDON: I partially tore the sheath on the left. It healed itself. I never had a doctor look at me- no insurance when this happened. I just did alot of research. I avoided surgery but if it’s fully torn, you may need surgery. Tape it and stabilize it laterally Taping the achilles also helped me. Keep those peroneals from getting tight and pushing on the sheath. 
    Hope this helps. Send e any q’s as I know there is not alot of info about this stuff out there. 🙂
    in reply to: Peroneal Tendon Dislocation advice #72998
    AvatarKent Zelle
    Participant

    Update: so it’s been 10 days and I’m happy to say that with ABSOLUTE REST! and no nsaids, taping to inhibit the peroneals and some dorsiflexion (very stiff ankles!), heat pads for two hours a day or more… (LOVE the relaxing heat- it loosened up my lower leg and foot) and some mild gentle yoga stretching of my hip capsules to keep my knees, hips and legs from getting tight from all that ankle stiffness…THEY ARE IMPROVING!

    I’m happy to report that I progressed through to removing the tape, gradually feeling the spasms and the dislocation reduce to a minimum.

     I’m not back to walking as exercise but I can walk about 1 mi to son’s bus stop and only feel my legs warm and not tighten. GOOD!

    I tried to gently roll out some trigger point areas on the lower legs (ouch!) and was successful in releasing alot of knots and gaining more ROM without irritation to the injured area. I marked the points with a Sharpie marker and am keeping an eye on which is getting tight again or not. Very interesting.

    I am working to strengthen my feet and adductors, inverters and internal rotators. This seems to be helping my feet or atleast not aggravating it too much. Yesterday was an increase in foot strengthers and I have a little bit of imflammation near the dislocation are today. Not pain, but I can move my toes around and feel the ropy feeling. Taking it easy. Feet and low legs feel better though.

    We’ll see if this sticks and I can maybe ride the bike or jog like 25 feet in a few weeks.

     

    in reply to: Very old scar tissue around ankle #72995
    AvatarKent Zelle
    Participant

    Jgarc, you’ll actually want your shoulder to come up and do rotate your spine too. The idea is to get the flow and movement smoother and farther at each direction change as you “trick” the central nervous system to allow your muscles and joints more flex/range than they are used to. When you pull your knee down to the floor into the half happy baby allow your opposite hip to raise up off the floor but keep your leg in a straight plane. Straighten your leg and put your hip back down- see how it pulls your half happy leg back up? Rocking back and forth like this first, (half happy leg up and down with hip rotation) is a good warmup and then begin to pull that leg across to the other side. Do it until you feel warm, loose, open, and also meditative in the flow. Don’t push too far! Just go through the motions and feel it open your hip up. Test squat before and restest after flow. Does it help?

    in reply to: Very old scar tissue around ankle #72968
    AvatarKent Zelle
    Participant

    http://www.youtube.com/watch?v=00lB10oATck  This is the video that REALLY made in difference in my hips flexion. It’s frustratingly hard to do where it actually flows the way Jill does it but after a few months (twice a week or more) I could actually feel the benefit and see how it was working. I would recommend only doing this after your hips are warmed up. Maybe do some hip circles each direction making them larger and larger and them smaller and smaller on each side until the sockets are warm and then do this. You may need a strap (I use an old bike inner tube) if you can reach your foot. You know, if you look at the “half happy baby pose” it’s the same as the forward squat hip opener that Kelly shows, just upside down.

    in reply to: Very old scar tissue around ankle #72946
    AvatarKent Zelle
    Participant

    I had a similar problem. Can you do a pistol squat? I couldn’t. I learned that I needed alot more adductor activation and use to squat properly. Once my external rotation/activation was sufficient, I found that I needed to use more strength in my adductors to keep it all tight. Stretching my calves behind the knee to the heel (soleus, not gastroc) and the anterior hip was huge forme also. My calf kept pulling my heel up and limited my hips and then my tight anterior hip wouldn’t allow my pelvis to go into neutral when I was low (i had really bad butt wink) in order to rebalance or I’d just fall backwards. after lots of couch stretches, I can squat without falling back and I notice my torso doesn’t get “thrown” forward but can stay upright.

    AvatarKent Zelle
    Participant

    Any taping advice for “smartphone” thumb? I’ve narrowed down the pain when I use my phone to read. It’s a big phone and I have to contort my thumb to hold it. The right thumb is imflammed and painful at the mcp joint. There is a large bump forming on the top of it and I feel the need to pop the joint below (cmc) it to release some tension throughout the day several times. The ligament on the outside of the thumb (not the ulnar collateral to the inside) is sore and “loose” and allows the proximal to sit offset on the metacarpal. It’s like it’s sliding off the finger. It hurts like hell to push it back to sitting centered but then it feels better in a few hours. Like a good stretch. Taking it through all the range of motions and pulling on it a bit too. any wrist work needed? My pinch strength was down to nothing last week. The I stopped using the thumb to let it heal and its getting better so I’d like to tape it to help it along more. I’m off the phone for now but will be aware of how I hold it from now on.

    in reply to: What kind of shoes are good #72918
    AvatarKent Zelle
    Participant

    Check out the Merrel Barefoot line. I have had two pairs last me EACH over two years. And I still have the first for painting shoes. Those and fivefingers are the only shoes I wear beside dress flats once or twice a month. The soles are zero drop and very flexible. No squared edges, no foam so your foot is completely natural. Goretex models are water resistance and the mesh kind are cooler in heat.

    I second the fivefingers ankle issues. That’s my major problem lately. Even the mild difference from zero drop in my Barefoots to the fivefingers (they are a negative drop by ~3mm I believe), give me alot of wear on the ankle if I run or hike in them.

    I think you will really be happy in the Merrel Barefoot.

    in reply to: Peroneal Tendon Dislocation advice #72917
    AvatarKent Zelle
    Participant

    Thanks for the reply Kristian. I’m unsure what to do and yes, dealing with the frustration of not knowing if it’s will heal on its own ofr not. I guess if ‘m not in pain then I can rest and see if I’m one of the few that can heal on my own. I didn’t acutally injure or sprain it so I assume my issue is a chronic breakdown from tight peroneals and something finally gave. My right foot is also really twingy and weird like the left was before it brokedown. Great. I guess I had this coming. I’ve found that once you think you know something or are mastering one areas, then you get hurt or bonk in another. The journey of fitness, huh? I sound like such a fatalist. LOL Now I’m wiser. Just to figure out the way through this now. ( I actually have this strange recollection of this happening to me as a kid- no pain but knobby tendons on this same leg. I think I fell of a horse or got stepped on. Can’t remember exactly.)

    Heat REALLY REALLY helps relieve all the tight knots and spasms. Thank God for heating pads and athletic tape. I haven’t iced. No swelling. No pain with normal, mild, low impact walking and unavoidable stairs. Just some funny spasms and tension. Today, I’m sitting on my ass and eating junk food in front of the TV all day though. For like 2 more days too. (ok, organic veggies and dip. I am TRYING to be lazy…)

    Really not looking forward to being off my feet- my job requires that I’m on my feet all day training dogs and the chores accompanying them. On a monthly rotation cycle, I’d be out of business for an entire cycle! Ouch to my pocketbook… or my ankle. Only time will tell. Maybe I can plan the surgery around a “quiet” time in life. Then go insane since I’d be trying to do- like, yoga or something to keep myself busy- with a boot on. I’m picturing this. Laughing already! How’d you keep yourself from going crazy!?

    in reply to: Free Your Heel, Free Your Mind #72915
    AvatarKent Zelle
    Participant

    Thanks Kaitlin. Yes, I have all sorts of hip tightness that comes and goes based on activities. Arches are good. Sliding surface is ok but there is no skin slack to slide. Heel cords are getting tight. Just tore some peroneal tendon anchors. Oh joy. What role does the hip have with the calf, ankle. What “lack of” doe the hips present when the ankle has problems? Anterior hip stretching has been amazing for me.

    in reply to: Yoga Tune up ankle daily rx #72861
    AvatarKent Zelle
    Participant

    “Hi-bounce Pinky Balls” are a good alternative when YTU balls are out. They are at Dollar Store in kiddie toy section. $1 each.

    AvatarKent Zelle
    Participant

    Same issue with my cuboid. Damn soleus!!! 🙂 Where’s the bone saw?! Using LAX ball on it is gnarly! But hopefully will help. Keep us updated, please.

    in reply to: Super Frog… Is this the pain I’m looking for? #72859
    AvatarKent Zelle
    Participant

    My squat improved DRAMATICALLY after stretching my hip flexors. Do the couch stretch! I couldn’t get below vertical and even that was hard. Ankles were too tight and adductors couldn’t pick up their load. All seemed to get better once I freed up my pelvis to be neutral! No more butt wink at vertical. We’ll see how low I can go in time. Lots fell into place with work on the anterior hip.

    AvatarKent Zelle
    Participant

    Thank you for the encouragement! I’ll check out those shoes!

    Headed to a Pose Cycling instruction so I’ll update some key points that I learn.

    Not sure on how to sit better. I have to stay upright to keep on my sits bones or my spine falls apart if I get lower and then I’m on my pubic bone (not fun- taco fuego!) I still have alot to gain in hamstring flexibility and hip flexors. My shoulders and upper back (both need better function and strength) like the upright posture. It looks a little dorkier than I’d like though 🙂 hehehe

    To update, I’ve taken a huge jump into hiking (thanks husband 🙂 ) and after carrying 25-30lbs over 50miles or so, I’d say that carrying heavy stuff on your back is a supreme way of fitness. I’ve strengthened my hips, legs, back and shoulders, abs, etc… all by just walking up and down with heavy stuff on my back. not exactly the most fun of activities at first, but then I got a pack that fit like a dream (Boreas brand) and I loaded that sucker up and had a blast. I’m actually using it as part of my training daily health and fitness- 10lbs on short road rides, lunch on mtb and walks to the school bus for the kiddo. Haven’t hiked? Do it. Do it now! My posture on the bike has improved a ton after gaining certain strengths from loaded hikes. It feels almost too easy now 😉

    Still A-OK with insoles, rearward cleats, and position. Not having a huge issue with asymmetry on the right leg and left shoulder. Changing how I use my body on a daily basis and focusing on flat pedals on the mountain bike for awhile helped. Maybe I’ll go back to flats on the road bike? (gasp!) Science says we can’t pull up right? That’s poor muscle chaining anyway, right? (take the bait!)

    Working deeper into stretching the hip flexors- couch stretches are actually paying off now. Mobility work and yoga is a daily must and post-workout thing. I can look back for traffic now better and really know my joints and muscles like they are my friends (on most days…).

    Read a book called Squat Everyday and went with their suggestion of keeping out of the adrenaline response and doing more volume at a lower intensity and hitting it hard when I feel ilke it instead of just getting more tired. I’m responding MUCH better to this training instead of the “go hard and only go hard or go home” attitude. That put me out for DAYS. Now, if I don’t engage in physical activity and sweat, then I can sleep. Literally. I just lay there for hours and get this horrible sluggish thing the next day if I stop exercising for a few days. I eat like mad now, I have to exercise and then I can sleep. What all this about?! I like it.

    Cheers to my fellow cyclists out there!

     

     

     

    in reply to: Free Your Heel, Free Your Mind #72857
    AvatarKent Zelle
    Participant

    Goodness gracious! My cuboid had just popped out last week. I believe it’s from a combo of poor ankle rom, tight peroneus longus and tight calf muscles, all thanks to the increase in running I’d suddenly started. My ankle lacks ROM, especially extroversion and dorsiflexion (two that I really need for running! doh!) I think I smoked my calves and then was jamming my ankle on each landing. Baaaaad me, I know. (I Pose run, but just haven’t built volume up yet.) My Huz pushed my cubiod back in place (no joke! thank you google) and I experienced immediate relief and total relief of aches in about two days. Back to walking with a pack but not running yet. Serious calf soreness still. I’m massaging out and now a even tighter left ankle and heel with some arch twinges. Doing Yoga Tune Up Jill Miller feet and ankles “prescription” and it is helping but not enough.

    I understand that I could easily reinjure this and the ligaments could get lax if I keep straining it. What are some other things that need to be addressed that I’m missing here?

    Fibula, ankle work, foot work, calf work…any thing else to add? I agree- my ankles and heels are not moving…like concrete. Are there any “secret” parts that are tight that may be contributing to this cuboid giving way?

    AvatarKent Zelle
    Participant

    Thanks for the input! I will definitely look into that fit process. It sounds interesting.

    As far as an update to the previous posts I made, I’ve made some non-traditional changes to my bike setup with lots of warning from peers, of course. Here’s what I’ve done and noticed from it:

    Insoles: I have put firm, high arch foot soles in my shoes but still need to get custom orthotics to give proper foot support. I’ve noticed that my right leg, especially, has stopped caving inwards and collapsing at each pedal. I also removed the cant wedge from this cleat. The arch supports give a much more connected feel from the leg to the foot to the pedal. I also use them when I ride on flat pedals on my mountain bike. I’m much happier with the feel of power to the pedal and dont feel my legs caving in (valgus) when I stand either. This was a HUGE improvement for me and I would recommend, as Kelly and Nate have, for all cyclists to get orthotics to prevent arch/valgus collapse since it’s impossible to create proper torque while pedaling.

    Cleats: I have put my cleats farthest back on the shoe so that the spindle of my pedal is slightly behind the ball of my foot (closer to midfoot, as its described). Besides feeling more natural under the foot, its also much easier to clip in and out this way! I haven’t had problems with my toes going numb or my shoes twisting on my heels, as before. I have speedplay zeros and am limited on how far back I can move the cleat, plus it sometimes loosens and slides forward during a ride. I may switch brands to one that can not do these things. Any suggestions on a cleat brand/system that promotes a rearward position?

    Q-Angle on cleats: At first, I put both cleats to the farthest outside on the shoe so my legs would be closer together while pedaling. I took a few rides and decided that it was slightly tight, as I was getting just a bit of figure-eight torque on up stroke of my right leg so I moved both cleats in just a hair, equally. Ahhh. Perfect. My legs drop without twist or flare in or out. I realize that this torque issue could have changed as my legs adjust so I will move them back in to see how it feels again in a few weeks. To compare, I ride with my feel touching the cranks on my MTB but they are still just a bit wider than the road bike. My feet no longer swivel and have play inward or outward at the ankle now. My heel used to move all over the place. I ride in free float and now my feet are finally quiet, even when I get tired.

    Seat: I ride an Adamo Breakway (amazing road saddle!!!) and pushed that baby all the way forward on my seat post to put my hips over the bottom bracket in order to utilize my body weight on the pedals better. I raised my saddle because of this but kept it slightly on the low side to make up for any hip drop or leg length difference that I may have been compensating for. Not only did this place my knee over the ball of my foot at 3 o’clock and a real sense of balance and control over the bike, but I feel much more powerful in climbs and in general more fluidity in my pedal stroke. I’ll admit that I follow the Pose Cycling method of pedaling technique and fit as it’s decribed by Dr. Romanov (I Pose Run too) and am very happy with the changes I’ve individually noticed. I like my saddle height and have noticed improvements in my cadence, and being able to stay seated without adjusting every mile for discomfort. When I do move on my seat, it’s because I’m changing my technique to either climb, descend or turn and it all feels better. I also am sure that my seat is perfectly level and flat, although on my MTB, I like it just a little dropped. I may need to get a straight seat post and move my saddle even further forward to get over the bottom bracket as I tend to sit on the nose of the saddle more becuase I like the way my legs feel over the pedals, but then get sore from that sitting area. Yes, I’m noticing using my glutes more and I like it!

    Handlebars: I raised my handlebars all the way up on my road bike and mtb. I was unable to acheive a neutral spine with my handle bars dropped at seat level of below. Now they are about 1in or so above the seat. My hands no longer hurt and- I can actually breathe now! My hips are much more opened up and I no longer have low back or upper t-spine pain. My t-spine still gets fatigued but I’m working on keeping my shoulders down and back, using my lats and not pressing out my back when I get tired. I also am careful to notice where my head it. I tend to overextend my neck and now I focus on changing where my eyeballs are, not moving my head up, and keeping my chin down and head aligned. This is hard but it’s keeping the pain away. I don’t need to be aero and I don’t care about looking cool. When my core and shoulders are stronger and if it’s comfortable, I’ll lower them and see how I like it. I do want to experiment on an aero position for time trialing but at this point, this bike doesn’t have the geometry to get laid out and keep a neutral spine. I’d need a whole new bike.

    Strength Training:  I spend alot more time doing mobility work and yoga, using weights and cross training than I do on the bike now. I ride low and slow as recovery and for fun instead of just blasting in zone 3. As for MTB, I also ride for recovery and just enjoy the sport. When I’m off the bike thought, I try to stay consistent on doing core work, and crossfit-style strength training/movements. This has made me fitter and stronger than any day of bike riding did. Now when I ride, I am barely pushing it but still giong faster than when I used to. As for running, I’ve gone from a 9:30 mile to 7:50 and still getting faster, so I feel that is helping too. I am not a runner. I can now get into a proper squat and dead lift. My hunched shoulder and poor posture are improving and my core strength is really improved. Breathing exercises are making the most difference and I don’t huff and puff at every climb now. I train dogs and work them soley ont he left side of my body. My left shoulder is cocked about 1in higer than my left and it’s noticable. I’ve begun working dogs on the right jsut to see if it’s related- bingo. Major neck and shoulder and hip soreness after a few days of using the right side- but atleast I know what my be contributing to imbalance now. My left shoulder/collarbone & right leg is still asymmetrical, slowly improving and it puzzles me but I will just learn something from it so I continue the journey…

    This is what I’ve learned so far. Any tips or comments?

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