Excercises for tendonitis? (posterior tibial)

[Euan Uzami]

I have  got a bit of  posterior tibial tendonitis in my left leg, and was just wondering if anybody else has had it, or knows of any good exercises to strengthen the muscles/tendon in order to relieve it.
I have been to the physio for it in the autumn and he gave me some insoles which make me pronate less which i'm sure have helped, and it's much better than it was, it came on in the summer and has got better since then. Can still feel it however after a hard ride.
I should mention as well as cycling i do also play squash and when i mention this to the physio there was much sucking-through-teeth and frowns of disapproval, but it feels like it's more cycling that causes it but doesn't suffer from it, but squash that doesn't cause it but suffers from it , if that makes sense (it holds me back somewhat from playing hard if it's slightly inflamed, but with cycling i can usually only feel it afterwards ).

However i'm not sure what if anything about cycling aggrevates it more than others, whether it's riding hard, riding in too high a gear, riding on too low a gear, or what, really - 'cos i've done some rides which haven't aggravated it much at all.

I had a look at this, and tried up to exercise 4, but i'm not sure i'm doing it right... with exercise 3, it doesn't feel like i can move that much until my shins touch each other, or until my knees touch the wall - and with 4, it feels  like it's exercising my hip, not my lower leg, and i'm not sure whether you're supposed to keep the leg that's touching the floor straight? and whether you're supposed to be balanced, i.e. apply no pressure to the wall with the hands (I can't...)

I also think from reading on the net that the degree to which i've got it is pretty mild compared to some cases of it, but if I can cure myself of it by doing exercises or avoiding things which aggrevate it more, then i want to try to.

any other tips on curing it/living with it?

[mattc]

Well it looks like I'm not the only one who is not familiar with this problem! So here is my paltry contribution:

* that site you linked to reckons this can be related to ITB problems. There is plenty of ITB-related stuff on this forum, Search and ye will easily find.

*reading the same site, my hunch is that the twisting/turning moves in squash would stress that tendon much more than cycling. (But then you probably spend more hours on the bike, so who knows?)

* you mentioned new insoles; I would imagine these are setup for walking/running. As cycling is a ball-of-the-foot exercise these are probably irrelevant. I had some physio last year where I was looked at on the bike - the treatment focused on relative positions of hip-knee-ankle while attached to my pedals, and consciously altering my posture/alignment. Insoles were a last resort (and in fact weren't needed). Might be worth bearing in mind ...


Good luck!

[Euan Uzami]

Well it looks like I'm not the only one who is not familiar with this problem! So here is my paltry contribution:

* that site you linked to reckons this can be related to ITB problems. There is plenty of ITB-related stuff on this forum, Search and ye will easily find.

*reading the same site, my hunch is that the twisting/turning moves in squash would stress that tendon much more than cycling. (But then you probably spend more hours on the bike, so who knows?)

* you mentioned new insoles; I would imagine these are setup for walking/running. As cycling is a ball-of-the-foot exercise these are probably irrelevant. I had some physio last year where I was looked at on the bike - the treatment focused on relative positions of hip-knee-ankle while attached to my pedals, and consciously altering my posture/alignment. Insoles were a last resort (and in fact weren't needed). Might be worth bearing in mind ...


Good luck!

Thanks, Matt. You're right the insoles are for walking (not running, they are far too hard).

What was the aims of the conscious alterations, if you don't mind me asking? I only ask because I wonder if I could do with, say, making any adjustment that would cause the inside of the leg to be stretched less on the downstroke, that sort of thing. Although I wouldn't want to just guess which sort of leads me onto the next question which is how did you find a physio that specializes in cycling/looks at your position on the bike?



*reading the same site, my hunch is that the twisting/turning moves in squash would stress that tendon much more than cycling
(But then you probably spend more hours on the bike, so who knows?)

Exactly.

the last audax i did, in nov, gave me no problems whatsoever, but if I was otherwise able to play squash for anything like that time, then it would probably cause me more pain than that did (if i didn't pass out first).
It doesn't cause me problems playing for an hour, but then i'm never really required to play for longer than that.

[mattc]

What was the aims of the conscious alterations, if you don't mind me asking? I only ask because I wonder if I could do with, say, making any adjustment that would cause the inside of the leg to be stretched less on the downstroke, that sort of thing. Although I wouldn't want to just guess which sort of leads me onto the next question which is how did you find a physio that specializes in cycling/looks at your position on the bike?

I had a different problem, and the fix was moving my knees further out so that they were in line with the hip joints. But I could not have done this without an expert eye watching me on the bike - the change was far too subtle.

I just got lucky (!) with this lady. I've been to numerous physios who did nothing like this analysis, and her sessions ended up being the best money I have ever spent on myself. She's mainly into running but finds the knowledge transfers OK.
Might be worth phoning round a few, ddescribe your symptoms and see what they say. Unless you're really in the stix I bet there are loads of possibles in your area.

(I've also used a McTimoney practitioner who did a good job, although I don't pretend to understand how their system works at all  Sometimes you just have to be open-minded and try some weird shit.)