Extensor tendonitis - minimal pain but crepitus still there (Read 44 times)

Hi all,

Leading up to Christmas, I was happily logging over 80mpw and loving every mile. Until I was hit with hip tendonitis. It was extremely painful and and took me out for 2 weeks, but I managed to return to around 40mpw for the first week without the hip pain returning, but never managed to get any run over 10 miles before then developing extensor tendonitis. I thought the hip tendonitis was bad enough, but this has been even worse and whenever I have tried to run on it for more than 10 minutes the pain afterwards was excruciating.

I have not ran in 3 weeks now and it feels like eternity to me, having not previously had an injury that takes me out more than a few days. It feels like I'll never be able to run how I wish to again, and it's killing me psychologically. I rely on it to keep me sane and happy, and have been a depressed mess since the first injury.

I have instead tried to substitute cycling on the stationary bike at the gym but have burned myself out on that. I've been aiming to replace the time running on the bike but It's torturously boring and taking a toll on me mentally, but don't want to lose all of my aerobic fitness.

Long story short, I can't stand it much longer. The pain seems to be gone but there is still creaking / crepitus on dorsiflexion that doesn't seem to be going away. I am terrified of trying to run and being back to square one, but am losing patience.

I have had many other tendonitis' before but have been able to either train through them or be back in a day or two previously, but this is much slower healing.

I was wondering if anyone here has had any experience with this specific type of tendonitis and if so how did you return to training? How did you know when you could start easing back into running again?

Thanks!

The pain seems to be gone but there is still creaking / crepitus on dorsiflexion that doesn't seem to be going away. I am terrified of trying to run and being back to square one, but am losing patience.

The creaking/crepitus is likely due to stiff tissue that hasn't been used.  That won't go away until you start using the tissue again.  It's no wonder that rest isn't improving it.  If it was me, I'd start with some walk-running - 30 seconds jog, 60 seconds walk for about 10 minutes.  Take the next day off, repeat the following day.  Then slowly build upwards from that, tracking how things feel, and being mindful that things like crepitus and creaking tend to fade away gradually rather than vanish.  Heat the area before, ice it after.

But, you should never listen to anyone on the internet (including me) for medical advice.  I think a few sessions with a running-focused PT to plan out how to return to running would be a very good investment.

A few things.

 

1. Any discomfort with walking and have you been walking regularly?

2. Do not rush back.

3. Loading a minor tendon injury is good but not overloading. Do no further harm This is where walking comes into play or foot motion, toe taps etc or NMES like MarcPro to keep circulation wnd lymphatics stimulated without harm.

4. Crepitus normal and is exacerbated by doing nothing as weakness and  faulty scar tissue can contribute to these symptoms.

5. Have you had a plan of attack? Addressing possible cause? Strengthening calf on up through the hips which affects loading on foot? A professional can help with this.

6. When you come back you have to be on a gradually plan . I am on board with what Darkwave states with every other day gradual laoding aside from icing. Heat is your friend for tendons including very warm hot Epsom soaks or infrared heat (my go to) and MarcPro warmups and recovery sessions.

 

The body knows how to heal. My focus is always to do the right behaviors to coax it along vs getting in the way. Impatience doesn't help. I just went through a 10 week layoff....never off more than 3-4 weeks in 35 years of running. I stayed smart throughout the process and did all the right things. It is hard. I did a ton of weight, core and elliptical. I was rewarded with my patience and have been slowly building up over last month and need another month to keep building running strength. Always have a focus on the long term and not jeapardizing the future. Set backs are devastating.

Thanks for the reply. I have been walking at least 5 miles every day and that hasn't been aggravating it. As for the cause, I don't believe it is a weakness issue as I had been doing all my strengthwork religiously leading up to the injury and my physio agreed there doesn't appear to be any weakness or imbalances, but I will look into specific exercises to strengthen the extensor muscles. I think one cause could be my shoes being too tight around the area and compressing the tendon. I'm struggling to find decent running shoes because I don't live near a store where I can try them on in person.

I agree with the icing, too. Any tendon injury I have ever had I have noticed ice increases the pain rather than decreases it. And my feet and ankles are always cold which is an issue probably contributing due to lack of blood flow.

The planning is the difficult part for me. I end up spending so much time trying to find the perfect plan and it takes it out of me. I am incredibly indecisive and struggle with this, not knowing how quickly I can return after an injury requiring more than a few days out. Can I ask you how quickly you built your mileage back up after your injury / injuries? Have you managed to return to your previous mileage yet? Thanks!

Another frustrating thing is that after the fact, there's no way of knowing whether treating the injury differently would have had a better or worse result.

Yeah that's another thing. Uncertainty. I suppose at this point I just want hope and reassurance that I will be able to run again without pain.

Another frustrating thing is that after the fact, there's no way of knowing whether treating the injury differently would have had a better or worse result.

'It feels good in 5-7 days and you test it and get little relapses and it just nags along for a month'

 

Yes, feels very much to be at least at this stage. In a constant repeating cycle where it just comes back each and every time I try to test it. Didn't feel any pain at all today or yesterday so decided to try a short 2 mile run. We'll, sure enough, the pain and creaking are back worse than ever. Extremely discouraged and feels like I'll never be able to run again.. I am only 20 and would think my body would be a bit more resilient.. Sigh

Testing too often is not ideal. OR, a do shorter test. One mile mixed in with some walk then quit. This becomes a win and you build from it. It depends on the area and degree of injury. The problem is when we feel good we want to over test meaning we keep going until the pain comes back vs stopping and still feeling good. This is why it's wise to have a coach or professional or PT guide you and I only say this  if you are serious about this. Most recreational runners I would say don't run for a month and just walk and strengthen kinetic chain and slowly build back up as the body will heal. Serious runners want to try to work through tweaks and injuries and this where the challenge begins mentally and physically as you are now realizing.