I visited an ortho surgeon this morning. After a ridiculously long wait, and having my chair stolen by an elderly lady, who then skipped the line in front of me [khaaaannnn], I saw the doc. The x-rays came back clear of any fracture or bone injury, so the conclusion was soft tissue damage, specifically to the anterior tibial tendon.
The thing that I loved about him is he “gets” runners, and his prescription for therapy and recovery was to benefit my running and not to merely give an “easy fix.” So what he said was this. Apparently during my training for Rocket City, and likely during or around my last 21 mile run before the taper, I developed some micro-tears in the tibialis anterior, the tendon that runs on the top of your foot and dorsiflexes the foot upward. It really inflamed during the marathon with slight swelling. Since then, I have nursed it, stretched it, rehabbed it, cross-trained it, and stayed away from running. It has, to his judgment, healed. BUT, a small degree of scar tissue remains on the tendon and that scar tissue irritates the sheath in which the tendon rests, and THAT is what I feel upon dorsiflexion and when running after 2 or so miles.
So, he said that normally he’d give non-runners a cortisone shot and tell them to rest it. But he KNEW runners and our desire to run, and explained that a cortisone shot would not FIX the issue–it would only enlarge the sheath to prevent irritation and would wear off later. So, he prescribed a super anti-inflammatory and instructed me to continue my stretching and rehab activities and add to that self-massage of the scarred area, which I can feel on the tendon as a thicker portion than the rest of the tendon.
The million dollar question was, then, can I run? He asked me my mileage per week. I told him 25-35 depending on the training cycle. He said to half it, run small increments until I “felt pain,” and then back off. Gradually increase the mileage until I can run again without issues. Irritation is okay, pain is not. GREAT news.
This means that Myrtle Beach Marathon is still a definite possibility, likely even, and that with some aggressive (you have no idea how OCD I can get on a rehab!) recovery, I’ll be good as new soon.