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What's Your Niggle?

  • 21-02-2020 10:19am
    #1
    Moderators, Arts Moderators Posts: 3,550 Mod ✭✭✭✭Myksyk


    Injured and depressed ... more so because my niggle is so subtle ... ankle ... some sort of strain I'm guessing but can't pinpoint the thing at all. Pretty much painless walking, jumping etc but then I'll put on a sock and feel this slight twinge from front to around the back to achilles. Running definitely aggravates so I've thrown the hands up and resigned myself to time off. Over a week now and not feeling better despite usual RICE-ing. Will have to go to the physio next week if it doesn't improve. Incredibly annoying.


Comments

  • Registered Users Posts: 946 ✭✭✭KSU


    Myksyk wrote: »
    ankle ... some sort of strain I'm guessing but can't pinpoint the thing at all. Pretty much painless walking, jumping etc but then I'll put on a sock and feel this slight twinge from front to around the back to achilles. Running definitely aggravates so I've thrown the hands up and resigned myself to time off. Over a week now and not feeling better despite usual RICE-ing. Will have to go to the physio next week if it doesn't improve. Incredibly annoying.

    I am guessing the walking, jumping etc is done with leg straight vs bent knee putting on socks and running? If this is the case make sure to let your physio know this when you get it seen to (won't make a diagnosis online but this can be telling)

    RICE is not a solution and needs to be put in the graveyard as a myth, it is a way of alleviating the symptom (i.e pain) rather than the cause. Even the guy who coined the term RICE has debunked it.
    Myksyk wrote: »
    Injured and depressed

    A bit of a jumping off point but I think you have touched on a good point i.e coping with injuries.

    I think many people feel helpless when they get injured and feel it is out of there control but truth is there is plenty you can do while injured so you don't feel completely helpless in the situation.

    1) Isolate the issue - get it seen to immediately to find out the problem. Without this you won't be able to make a plan for going forward. Physio/therapist shouldn't be the last option it should be first unless you are fully confident in your own ability to diagnose the issue.

    2) Make a plan - The goal should be getting back moving as quick as possible. The body has a miraculous ability to heal itself but a plan is needed to put into place to facilitate this process. If there is swelling that is restricting movement ice may bring this down initially. After this you need to stage movement and loading at appropriate levels.

    3) Facilitate - Things like bone or muscle damage have an impact on caloric requirements so you need to adjust appropriately. Many people are afraid to eat more while injured for fear of putting on weight but in truth many people actually require more nutrients to aid the recovery process. We tend to be good at this post intense workouts yet don't equate the same during injury.

    4) Reflect - Asking why we got injured. Training will be normally the go to but also look at other factors, did we try do 5x1 mile 2 days after illness or a bad sleep and keep the pace the same. A bad night sleep and skipping breakfast to fit the run in and didn't adjust intensity? Did we hammer an easy run the day after a session because had a bad meeting in work and had to blow off steam. Likewise it could be muscle imbalance and in that case need to look at how to correct that so that the body is moving effectively

    5) Learn and adapt - Once you have the why you start to change things to make sure that we don't make the same mistakes over and over. A mistake is a positive as long as it is a learning tool rather than and repetitive inevitability


  • Moderators, Arts Moderators Posts: 3,550 Mod ✭✭✭✭Myksyk


    Thanks. Great reply.


  • Moderators, Arts Moderators Posts: 3,550 Mod ✭✭✭✭Myksyk


    Right. Went to Physio this afternoon and have a plan for rest and rehab. Will see how it goes over the next week.

    Would be interested in other's niggles and how they're dealing with them.


  • Registered Users Posts: 2,575 ✭✭✭monkeysnapper


    Hi...

    Your story sounds a bit like mine ....I had a niggle end of October and I just tried to keep going but it didnt go away and got worse....I decided to take a few weeks off and made no difference ...

    I find myslef in mid feb this week finally going to see physio and he says I'm fine but badly need to do some strengthening and a few other things ....

    What KSU said above is exactly what I needed to hear aswell .. thanks ;)


  • Closed Accounts Posts: 24,878 ✭✭✭✭ Khari Billions Rationalization


    Myksyk wrote: »

    Would be interested in other's niggles and how they're dealing with them.

    I'd a pain and swelling on my left 5th metatarsal bone for the last week or so, decided to go see my physio this morning and she suspects a stress fracture so I've a doctors appointment (he'll refer me for an x-ray) on Monday.

    Years ago I'd have panicked and gone into denial & trained through it until it developed into a full fracture but experience with injuries over the years has taught me to first stop training on the injury and see the physio ASAP.

    I'm a bit peeved off because I'm not a natural runner and any break (no pun) really sets me back however I swim around 7000m a week and cycle so I'll stay sane.

    I'd just paid for a place in the Great Limerick Run on 3rd May (I'm doing the 10k) so hopefully I'll be back in training in time for a comfortable 10k.

    Another thing I do when I'm injured is cut down on my carbs and up my protein, oh and my parkrun gets a volunteer for the next few weeks lol


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  • Moderators, Arts Moderators Posts: 3,550 Mod ✭✭✭✭Myksyk


    Guys, not looking for medical advice, just people's experiences. My niggle remains unchanged, is weird and incredibly frustrating. No running for a month now. Has anybody had anything like this ... If I press a very small area about the size of a pea just where my laces might tie, it creates a 'pain' or something like a pain in my heel area in the lower Achilles area. Yet I can press, rub, squeeze, pull my Achilles with no pain. I'm going to follow up with physio but just interested if anyone has had something similar. My theory is it's a nerve based issue as the pain has more of that feel about it than a muscle/tendon issue.


  • Registered Users Posts: 13,822 ✭✭✭✭Zebra3


    Trying to shake off a groin strain. :(


  • Registered Users Posts: 8 SportPhysio


    I'm a sports physio - who has decided to stop seeing patients and close up to try and help flatten the curve. Happy to help with any queries or questions.

    I've moved to working towards telehealth - or virtual assessments and rehabilitation now and looks like I could be doing this over the next few months.


  • Registered Users Posts: 1,850 ✭✭✭Marty Bird


    I have had an issue with the peroneal longus pain it is always tender and sore when I press in on the outside of my lower leg and aches at night. I’m sore everyday with it

    My training load would be high is it just a case of stopping? and can you recommend a recovery stretch or to strengthen it? I do roll it after running but that hasn’t made a difference this is a problem I’ve had the last 9 months and it’s starting to happen with my other leg too.


  • Registered Users Posts: 8 SportPhysio


    Marty Bird wrote: »
    I have had an issue with the peroneal longus pain it is always tender and sore when I press in on the outside of my lower leg and aches at night. I’m sore everyday with it

    My training load would be high is it just a case of stopping? and can you recommend a recovery stretch or to strengthen it? I do roll it after running but that hasn’t made a difference this is a problem I’ve had the last 9 months and it’s starting to happen with my other leg too.

    Peroneals work to evert the foot - which means move the foot outwards and also plantarflex. Peroneus tertius - dorsiflexes but I don't believe you are referring to this muscle.

    First thing to make clear would be is to ensure there is no 4/5th metatarsal pain on palpation here. Peroneus brevis - the smaller muscle attaches to the 5th met and I just would want to ensure there is no stress fracture.

    After that from here I would look at your loading - and have a proper look at it. Although limited in it's use the 10% rule is somewhat helpful here. There is also the acute chronic workload ratio which has it's recent detractors.
    A:C ratio - means what was your running like this week = Acute vs what was the average of your weekly mileage over the previous 4 weeks. They talk about a sweet spot of it being between 80 and 130% for it to be reduced injury risk.

    Other things I would watch is have you changed footwear recently. Are you walking around in slippers now that you might be working from home? Have you started some strength and conditioning on top of your running?

    The final thing after ruling out a stress fracture of the fibula or of the met, is that it could be shin splint pain. What's your calf strength like? Gastroc and Soleus checked separately?


    Few things to think about there - really keeping an eye on your training load is one of the most important controllables to be controlled.

    Hope this was helpful


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  • Registered Users Posts: 1,850 ✭✭✭Marty Bird


    Peroneals work to evert the foot - which means move the foot outwards and also plantarflex. Peroneus tertius - dorsiflexes but I don't believe you are referring to this muscle.

    First thing to make clear would be is to ensure there is no 4/5th metatarsal pain on palpation here. Peroneus brevis - the smaller muscle attaches to the 5th met and I just would want to ensure there is no stress fracture.

    After that from here I would look at your loading - and have a proper look at it. Although limited in it's use the 10% rule is somewhat helpful here. There is also the acute chronic workload ratio which has it's recent detractors.
    A:C ratio - means what was your running like this week = Acute vs what was the average of your weekly mileage over the previous 4 weeks. They talk about a sweet spot of it being between 80 and 130% for it to be reduced injury risk.

    Other things I would watch is have you changed footwear recently. Are you walking around in slippers now that you might be working from home? Have you started some strength and conditioning on top of your running?

    The final thing after ruling out a stress fracture of the fibula or of the met, is that it could be shin splint pain. What's your calf strength like? Gastroc and Soleus checked separately?


    Few things to think about there - really keeping an eye on your training load is one of the most important controllables to be controlled.

    Hope this was helpful

    Thanks so much. I will definitely look at the load ratio more now that you mention it. I haven’t changed my footwear recently so I can rule that out.

    Calf strength is good I had stopped running for 2 weeks recently due to a strain but apart from that they are good.

    Thanks again for the advice.


  • Registered Users Posts: 8 SportPhysio


    No problem, glad to help.

    I am trying to offer a telehealth system now with video calling and exercise software which is working quite well.

    P.M me if you want further information about this service.

    Also I am online here for the next while to answer anyones questions.


  • Moderators, Arts Moderators Posts: 3,550 Mod ✭✭✭✭Myksyk


    Just an update ... Niggle is essentially gone. Had to stop running for 8 weeks which was frustrating ... and screwed up my 1000 mile challenge which was proving a great motivator. No definitive diagnosis but I think logically it was something like a pinched/compressed nerve where I tie my laces and referred pain to the achilles area. Anyway, it has gone away with patience, which I guess is one of the most important attributes for the person interested in keeping up running over the long term. I have made a couple of changes since restarting ... I upped my shoe size a half size and I'm amazed at how much better that feels and I have stopped over-tightening my laces and have stopped using the 'runner's knot' which uses the top two holes for the laces. This has taken almost all of the pressure away from that area and does not affect my comfort at all. Onward we go.


  • Registered Users Posts: 10,177 ✭✭✭✭greenspurs


    Just tipping away upping the kms after a break …
    An old achilles niggle came back, and as a result I just rest it for 8 weeks... It was damned sore at the end of every day after walking at work, so I knew when it was ok!

    Two runs back in to it , just doing 5kms at 5.30per km pace, and I got a sudden pain in my right shin. Just down the outside of it. I thought shin splints , but I do have a 'protruding' vein just there on my leg, so it may have been that ?? It hurt even when I bent down using that leg (to my right hand side)

    Another weeks rest and its a bit better.

    Sick of being flipping crocked ! Aging is crap …… :D

    "Bright lights and Thunder .................... "



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