A Difficult Foot

FINALLY!!! I saw the podiatrist and got some information that actually makes sense. First off, I obviously have plantar fasciitis.  I think everyone has agreed with that since day one.  But the real question I had- and the reason I asked for the MRI- was the pain I have on the bottom lateral edge of my foot.  He put his finger immediately on the exact spot, and told me it’s peroneal tendinitis. Ah… we meet again. Peroneal tendinitis has the dubious distinction of being the very first running injury I ever had, when I was twenty years old.  The reason I didn’t recognize it this time is that I feel it in a different place.  Let’s look at this picture… You can see where the peroneus longus and brevis tendons run along the outside of the foot.  Where these are colored red is where tendinitis pain usually occurs, just under the ankle.  That’s where mine was so painful years ago, but it doesn’t hurt there at all now.  See how the peroneus longus tucks under the foot?  THAT’S where my pain is.  It attaches to the bone on the bottom of the foot, and therefore is considered “insertional tendinitis.” After looking at the MRI, the doctor told me I have a “difficult foot.”  (Oh really?  I hadn’t noticed.)  He said I have an extremely high arch, and also that my foot turns in a little, which causes me to over supinate. It’s incredible to me that he was able to tell that without even seeing me walk, because I am pigeon toed on that left side- I was born that way.  I actually had a night brace when I was a baby, and then a brace I wore all the time in first grade, which forced my feet to turn out. Ugh… I hated that brace SO MUCH. It went around my waist, then had two bands that went down the outside of each leg, attaching to sturdy orthopedic shoes.  Luckily I was too young to realize I looked like a total dork- what I hated is that it was so uncomfortable.  It forced my feet into a turned-out position, and every once in a while it was adjusted to turn out even more.  Whenever it was adjusted, I could hardly walk at first.   Eventually the problem was corrected as much as possible.  But my left foot still turns in. I want to say this picture makes it look worse than it really is- I did pick a shot where it’s especially prominent… but the camera doesn’t lie, right? Backtrack to the peroneal tendinitis when I was twenty… the podiatrist I went to back then made me some custom orthotics, which I wore for years and years.  Somewhere along the way I stopped using them… I think after I had my kids my feet changed, and those orthotics were no longer comfortable. I decided that I didn’t really need them.  I bought into the theory that most people don’t need orthotics, and that injuries should be addressed by strength training and focusing on correct running form.  I thought people should just run the way they run naturally, and make it work.  Well, I guess it’s not working for me. My doctor today told me that I am definitely one of those people who truly needs orthotics, and they need to be custom-made.  Generic over-the-counter orthotics are made for people who over pronate, and I have the opposite problem.  As he was explaining what the orthotic would do, he was holding my foot in a neutral position and showing me where the support would be… and just having him do that felt so good.   Yes!  Give me orthotics immediately!!!  But, he said he wants to heal up the foot first, then fit me for orthotics.  He wanted to do shockwave therapy.  I told him my old doctor already tried that and he said his shockwave machine is the real thing (WHAT? My old doctor had a fake one???) and that he’s had a 100% success rate with it.  AND, he said he could treat the plantar fasciitis and insertion of the peroneal tendon in the same session. So I had the first (of four) shockwave sessions today.  Yes, it hurt, but that’s okay- when does that foot not hurt?  But here’s the best part- I asked him if I could run and he was almost surprised by the question.  He was like “Oh yes- running is great!”  Ha ha, well, I think we agree on just about everything.  He did caution not to run too far- but my foot already lets me know when it’s too much, so there’s no danger there. I’m feeling really good about this!  I know it’s going to take a while.  I have three more shockwave sessions, scheduled one week apart.  Then I have to be fitted for orthotics, and then I have to get used to them.  But I’m optimistic that I’m on the right track.  I really want to break out of this continuous cycle of injuries and do some fun things with my running.  Onward! Tune in on Friday where I promise, I will not talk about my foot at all!  I think we all need a new subject, right? Have you ever worn orthotics?