Physical Therapy



Thirty days until the marathon and here I am.

I thought my ankle had been improving and so I ran on Tuesday. That went just fine. I tried to run 9 miles on Wednesday and it was not fine. The sensation in my ankle went from just a tugging feeling to pain.  Pain even when I walked.

So I made an appointment with a physical therapist to see if we could modify my training plan and get to the marathon.

The therapist saw me bright and early at 6 a.m. today.  The less this interferes with my day the better, so for me first thing is always best.

He thinks it is one of two things.  More likely it is “posterior tibialis tendonitis”.  Tendonitis.  Been there, done that, think we can work through this.  Less likely it is “medial tibial stress reaction”.  Don’t know what that is exactly, but from what I gather it could put me on the path to a stress fracture.

Either way, he believes this was caused by running shoes that were too flimsy for my heavy overpronation. I have high arches and my ankles noticeably roll inward when I walk.  He thinks the shoes I have, Nike Zoom Structure 17,  are not stable enough for me.  You may remember in my Marathon Essentials blog post that those Nike shoes were recommended by a running store after they watched my gait and they recommended them for this very problem.  And that I saw a podiatrist about this before. I did everything right, or so I thought, but I guess they underestimated just how much I overpronate. Next time I buy shoes I will ask for the most powerful shoes they have.  He also mentioned custom orthotics could help. I have had those before but quit buying them because I stopped noticing the problems that led to getting them years ago.  Given that I am never running marathon training distances again and that I just replaced these shoes I have chosen not to get custom orthotics or buy another brand of shoes.  Instead I’m focusing on following instructions vs recommendations.

If you are considering a marathon, I recommend getting multiple opinions about shoes to avoid my mistake. Don’t just visit one running store. Visit a few.

I did physical therapy this morning on the assumption it is tendonitis with instructions to make an appointment with a doctor to get an MRI of the ankle and officially rule out the other thing.   I am traveling next week and so I won’t be visiting the doctor or the physical therapist again until a week from Tuesday.

First up was icing my ankle. You can see that in the photo above. Next was a series of stretches and balance exercises.  This was hard.  The calf on the ankle I’d injured was too tight for me to do one of the stretches, so I did a modified version. The balance exercises on that leg were also hard. I guess if it were easy though I wouldn’t need therapy. We also did the electrode things. If you have had physical therapy you know what I’m talking about, those things with wires they stick on the injury and run current through.  He would have done ultrasound but until I get the MRI to rule out the other injury he couldn’t do that. We ended with heat therapy and taping. I’d never heard of this taping thing before. It is shower proof and should last 3-5 days.  It is funny looking.




My instructions are ice the ankle every day, whether I run or not, ten minutes a day. Stretch.  Run if it doesn’t bother me and if it does stop immediately. Make sure I get my MRI and another therapy visit a week from Tuesday.

I feel good now that I have a plan of action. Game on!




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