Darby came in to see us at Dynamic Sports Physical Therapy in New York City after experiencing some ankle problems. She had been training for the NYC Marathon when she started noticing pain, swelling and tenderness on the inside of her right ankle. These issues were getting in the way of Darby’s training plan, so she got proactive and sought out a solution at our clinic.
Upon the initial evaluation, Darby’s therapist noticed that her swelling and tenderness were located right over the posterior tibialis tendon. This tendon holds up the arch of each foot and provides support to the feet, and for this reason, it’s one of the most important tendons in the leg. A movement screening also showed that Darby had decreased stability in her right ankle and foot, difficulty controlling her knees from moving inward during a single leg squat and reduced flexibility of both calf muscles. Strength testing revealed some weakness at her outer hip muscles as well. Based on these findings, Darby was diagnosed with posterior tibialis tendinitis, which is an inflammation of the posterior tibialis tendon.
When Darby’s ankle was less painful and the swelling went down, she was analyzed on the treadmill to see if her running form might be contributing to the ankle pain. We found that she tended to land with excessive crossing over of her right foot, which leads to an increased demand on the posterior tibialis muscle to stabilize the ankle when accepting weight. This was likely a contributing factor in Darby’s injury.
What we did at Dynamic Sports Physical Therapy in New York City to address Darby’s injury
To target Darby’s ankle problems, treatment started with Active Release Technique to improve her calf flexibility and ankle mobility. Next, she followed an exercise program that consisted of foam rolling, calf stretching, hip strengthening, and balance/stability exercises performed on one leg. An emphasis was placed on hip and ankle/foot stability when she completed all standing exercises. Once Darby was ready to ease back into running, her therapist gave her cues to help her reduce crossover landing on the right. She was also given a specific warm-up routine to complete before each run.
After just five weeks of therapy that included a progressive return to her running routine, Darby successfully completed a Ragnar Race, during which she ran a total of 18 miles. She how has her eye on the NYC Marathon in November, and we have no doubt she will shine there.
Here at Dynamic Sports Physical Therapy in New York City, we’re thrilled to see that Darby was able to get back into her running routine so quickly and that her plan to run the NYC Marathon has not been jeopardized by her injury. So if you’re experiencing any pain of your own, whether it’s related to running or not, we invite you to come in for a visit so that you can experience similar outcomes to Darby. Call us at 212-317-8303 to schedule an appointment today, or click here to read our last blog.
