What causes this back-of- foot pain?

Yo Sake · Feb 12, 2011

First of all, whatever this is causes no pain during a run. So that is good news. This shooting, oh, how to describe... 'zap' (as if you were zapped with electricty or something) pain started Monday evening when I was doing downward dog pose. No other strethces, ankle rotation, up/down-ing of foot, or calf stretching with toes up didn't cause this pain at all. And over the last 5 days or so, I kept my running (since it didn't bother me at all, no reason to stop). Tue, Wed, and Thurs were TM runs. Fri/Sat, outside. And it was slowly getting a little worse. Now I can feel it time to time (not always) when sitting on the floor with my legs straight out and pull the toes toward you. Below the big ankle bone (outside of foot) has a very sore spot if I press. It is not achilles itself. I am icing and taking anti-inflammatory. What could this be? What area needs to be stretched/masaged? I am running on TM awefully a lot this year due to the weather and more pace works each week (I don't own a GPS watch). Also, I am wearing Mizuno Rider (I think), about 100miles into it which seems to be less comfortable/supporting as my long-time friend, Asics Nimbus. 
 
I am trying to take care of this before it becomes bothersome during a run. Haven't seen a massage guy yet about this. Any insight would be appreciated. 
 
Thanks!

juliemboyle · Feb 12, 2011

I would consider going to the podiatrist and see what they think......

cak73 · Feb 12, 2011

Or, go see an orthopedist...

Zdoc · Feb 13, 2011

Sounds like a peroneal tendon injury. Perhaps acute injusy from the yoga pose and/or some overuse exacerbated by running.
I'd probably uses NSAIDS for a few days, rest and see what happens.
if you can, Ultrasound or cold laser treatments are very helpful.

hobey · Feb 13, 2011

Sounds like you have the opposite injury from me. I've got tendonitis in my left post tib tendon (around inside ankle bone). Dx from my DC was tape, ice, PT exercises to strengthen the area. He did some ultrasound and muscle stim last week.

pcsronbo · Feb 13, 2011

That might the soleus attachment maybe? Anyway, I am dealing with that now too. Treadmill and plyometrics does it to me. Ice, ultrasound, being going to it, massage.
 
I'd go to a PT for an "eval" instead of the docs IMHO.
 
Get a massage, heat/ice alternate. I've been trying Epsom salt bath/wraps
 
Sword class does this to me a lot because we bounce around a lot (ala plyos)
 
Preventitive is better stretching
 
are you doing treadmill @ 1%? that helps me

Yo Sake · Feb 13, 2011

Thanks all for your input.
 
Zdoc - A friend of mine who are familiar with all sorts of foot injuries mentioned a possible involvement of the peroneal tendon. Though up/down movement of the foot didn't cause any discomfort, she wasn't sure. 
 
I am keeping icing/NSAIDS. But rest - not happening. It doesn't bother me at all during a run. Massage, for sure. I am thinking to visit A.R.T guy I trust as well. I don't have a P.T. I rely on, unfortunately.

pcsronbo · Feb 14, 2011

<div class="quote-container">Quote:
<div class="quote-block">Originally Posted by Yo Sake <a href="/forum/thread/72581/what-causes-this-back-of-foot-pain#post_1983326"><img alt="View Post" class="inlineimg" src="/img/forum/go_quote.gif" style="border-bottom:0px solid;border-left:0px solid;border-top:0px solid;border-right:0px solid;"></a> I don't have a P.T. I rely on, unfortunately.
</div>
</div>
 
That's too bad. I'm blessed, my PT guy got certified in ART recently.
 
Really, I'd invest some time meeting the PT staff in your area and ask around. There has to be someone worth a damn

Yo Sake · Feb 17, 2011

The discomfort wasn't disappearing though it wasn't affecting my running, so I went to see a podiatrist. The 'zapping' pain was a nerve pinched/irritated by irritated bursa by tight tendon(?) in the region affected by Haglund's heel spur. Something like that. Wearing heels quite a bit last week, along with running shoes which got almost 400miles, and TM runs, blah blah blah, on top of the tight calf, and high volume all seemed to contribute to this. So. I got a steoroid injection. I should have asked point blank, "Can I run 10miles in 2 hours"? But I didn't. He said, take it easy for the next few days. I struggled with letting today's key workout go. (What I should have done is to run first then visit the doc.) But after realizing I couldn't feel anything in the injected area, my wisdom won. Missing a few days now is not a big deal. 
 
So, zdoc, can I run about 35miles for the next three days?<img alt="wink.gif" src="http://files.kickrunners.com/smilies/wink.gif" style="width:16px;height:16px;">

cak73 · Feb 17, 2011

Glad you got some answers and, hopefully, some relief! 
 
My DH has bone spurs on his heel and has had to take the better part of the last year off of running...was even in "the boot of shame" for awhile. I should re-introduce him to the foam roller.

Zdoc · Feb 18, 2011

Are you asking me to reply as a doctor or as a runner (because the response you get may vary).
A few points to ponder:
If the podiatrist feels you have a Haglund's deformity (previously called "pump-bump deformity" brcause of it's propensity in pump shoe wearing women), you may always have a spur that rubs on the tendon. Sure, a cortisone shot will temporarily calm it down, but will not necessarily fix the problem. If it was more an irritation based on all of the reasons you mentioned, this may do the trick. If he took a plain x ray and saw a spur, maybe not.
The next question is when to run. A steroid shot may cause some weakening of the tendon. There are reports of tendon rupture with a too soon resumption of activity. So, give it a few days and start back slowly (my doctor response), or, since it feels great let's just pretend it never happenned and go like hell (my runner response)
Anyway, good luck for a permenant solution.

Yo Sake · Feb 18, 2011

Thanks for your input zdoc. Dr. took a x-ray and it showed a minor level of Haglund's deformity but he definately downplayed that after seeing the actual x-ray result, compared to his diagnosis before taking x-ray. He thinks this injection does the trick, along with calf stretching. From his explanation, the level of deformity has been always there (and not changing), and I have never had this issue during my 8-yrs of running, that is not the root cause in my non-medical opinion. So, other factors contributed to get the areas irritated. 
 
In short, I am taking your opinion as a runner. WIth a full caution. Not running when running doesn't cause any discomfort/pain just doesn't sit well with me. The injected area is still somewhat numb though. I have been testing if I feel the pain by doing down dog here and there. So far no pain at all (maybe because it is a bit numb?).

What causes this back-of- foot pain?

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