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Achilles tendon + Ribcage
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lilybart
Posted 2008-01-25 10:54 AM (#102429)
Subject: Achilles tendon + Ribcage


I have two questions for the many wise members of this forum...

1) I have been having a strange sensation in my Achilles tendon when I choose to jump/ "float" from downward dog to Uttanasana. As I land, if my alignment is not perfect, I have a "twanging" sensation in my right Achilles tendon. This will also occasionally happen when I step forward into a lunge position. It is not painful, but definitely seems like the kind of thing that if I don't figure out how to take care of it, there may be problems down the road. At least this is my guess. Any ideas for stopping these problems in their tracks?

The right side of my body is less flexible than my left. I have heard that Achilles problems can be related to stiff calf muscles? I have been an avid hiker/cyclist/walker for many years (and was previously a runner before it led to knee pain) and my journey into yoga has helped to unravel the tensions that these sports have built up (as lovely as they are).

2) I had never noticed until I started doing Bridge Pose that one side of my ribcage juts out (the left side) while the right side quite a bit lower. I thought at first that I was holding myself improperly but no amount of changing position elevates the right side. I am wondering if this has anything to do with my spine? Or can a ribcage be asymmetrical? I have never been diagnosed with scoliosis and I'm 27 years old. I'm curious for any opinions people might have.

Ciao!
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kulkarnn
Posted 2008-01-25 1:45 PM (#102445 - in reply to #102429)
Subject: RE: Achilles tendon + Ribcage


As you asked for, I am giving my opinions with ===> below.

Best luck
lilybart - 2008-01-25 10:54 AM

I have two questions for the many wise members of this forum...

1) I have been having a strange sensation in my Achilles tendon when I choose to jump/ "float" from downward dog to Uttanasana. As I land, if my alignment is not perfect, I have a "twanging" sensation in my right Achilles tendon. This will also occasionally happen when I step forward into a lunge position. It is not painful, but definitely seems like the kind of thing that if I don't figure out how to take care of it, there may be problems down the road. At least this is my guess. Any ideas for stopping these problems in their tracks?


The right side of my body is less flexible than my left. I have heard that Achilles problems can be related to stiff calf muscles? I have been an avid hiker/cyclist/walker for many years (and was previously a runner before it led to knee pain) and my journey into yoga has helped to unravel the tensions that these sports have built up (as lovely as they are).


===> Considering all what you wrote above, stop the jumping practice and take up static practice at least for a sufficiently long time.

2) I had never noticed until I started doing Bridge Pose that one side of my ribcage juts out (the left side) while the right side quite a bit lower. I thought at first that I was holding myself improperly but no amount of changing position elevates the right side. I am wondering if this has anything to do with my spine? Or can a ribcage be asymmetrical? I have never been diagnosed with scoliosis and I'm 27 years old. I'm curious for any opinions people might have.

===> In this case, approach a non expensive good Chiropractor and check your body out. You shall come to know this cause in a better and full way.

Ciao!
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lilybart
Posted 2008-01-25 4:45 PM (#102461 - in reply to #102445)
Subject: RE: Achilles tendon + Ribcage


Thanks Neel. My intuition has told me to hold off from the jumping—although it seems like part of the problem has been the way my foot lands when I jump, maybe. I've gotten a lot more "even" in my landing, by trying not to favor putting my weight slightly on one side or the other, and that has made the "twanging tendon" not show up as often. I have stopped working on my "floating" for now. But is that enough to resolve it?

Seeing a chiropractor is good advice, but might not be feasible for me at the moment. There is a teacher at the yoga studio I go to who is also a physical therapist—she might be a person to ask, or perhaps set up an appointment with.


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tourist
Posted 2008-01-25 8:29 PM (#102471 - in reply to #102461)
Subject: RE: Achilles tendon + Ribcage



Expert Yogi

Posts: 8442
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Re: bridge - my guess without seeing you is that you have something going on in one of your shoulders. Or maybe you do have some scoliosis. Quite a few of my students have been totally surprised when I asked them about it as they had never had problems. Some whose scoliosis is less visible have terrible pain. Interesting condition. But I would bet on the shoulders Send photos. We LOVE photos here!
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kulkarnn
Posted 2008-01-25 8:36 PM (#102472 - in reply to #102429)
Subject: RE: Achilles tendon + Ribcage


Each and everyone who drives car regularly has scoliosis without any exception in the world. Only the amount differs.
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lilybart
Posted 2008-02-24 1:33 PM (#103948 - in reply to #102429)
Subject: Updates on Tendon


I haven't checked this thread for awhile and have some updates on my foot. I feel like I've been given a little bit of a run-around over the last month. First I had to set up an appointment with a Dr. at the Health Center covered by my insurance. She said that this was not the Achilles tendon bothering me, but the posterior tibialis (the tendon on the inside of your ankle).

She gave me a referral to a sports therapist (I am grad student, so this is all through the health services of the university). At the time of the FIRST sports therapy appt, I was not in any pain—just that strange "popping" or "guitar string" sensation during certain weight-bearing movements. She watched me walk, and spent an hour testing the strength of my legs, hips, the dorsiflexion of my foot, etc. She noticed that I don't have a flat foot but tend to pronate and my ankles turn in slightly, meaning that the posterior tibialis is doing more work than is ideal. I left that appointment with some information about how my body works and plans to come back next week to learn exercises to strengthen the tendon. She couldn't tell me what the popping sensation was, however (from my own research I now assume that the tendon is inflamed and the sound/sensation is the inflamed part rubbing against the sheath) and was vague about advice as to what activities I could do or not do. "I don't want to tell you to give up yoga, but..." Etc.

Over the next week I adapted my yoga routine, doing all forward-bending poses with bent knees, no more "floating" from down dog to forward bend. I experimented with the Warrior poses but was uncertain about how they might be affecting the tendon.

Then I decided to go x-c skiing after a sleety snowstorm. Whoops. A mistake. The snow was crusty, I was in a bad mood, and I kept breaking through the snow. Because the surface was unstable, my ankle twisted around a number of times. I came home, did some yoga (including standing balancing postures, possibly compounding the problem even though I had no "popping" feeling)... and by the next day, PAIN. An aching soreness with the occasional zapping pain all the way up the calf (where the posterior tibialis runs up the leg). I spent two days icing the ankle and doing nothing strenuous, quite depressed. The pain went away and now/lately it aches on and off, especially at the end of day. It is not a consistent pain and there is no swelling in the area.

During the next appt with the sports therapist, I updated her on the situation and she gave me a few exercises to do with a stretchy band-thing, and had me crunch a towel and pick up marbles with my toes (all thins to do daily at home). She said No weight bearing exercise while you recover, maybe some light cycling as long as it doesn't hurt. She also put some steroid cream on the foot (I can describe this in more detail if people are interested; this post is already unbelievably long) and made appointments for me to come back and she'll do this again. Under the recommendation of a good friend, I made an appointment with an acupuncturist but that's not for another week. I also bought Superfeet inserts for my shoes and I wear them whenever I'll be on my feet.

Mentally, I'm finding it very difficult to be less active. I've been doing my little leg exercises, some seated yoga poses, and a 25 minute pilates dvd that doesn't call for me to stand. Sometimes I do 10-20 minutes of very light cycling on my trainer to warm up the muscles, but I'm nervous about making things worse.

I was wondering if anyone had come across something like this before, had any advice or comments, or might be able to suggest some yoga poses that could be helpful. February tends to be a difficult time of the year for me and I usually make it more enjoyable by spending time in the snow... right now I can't do that. However, I really want to look to the long-term and try to take of myself as much as possible now so that there's less of chance that it will get worse over time.


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Nick
Posted 2008-02-24 3:24 PM (#103950 - in reply to #103948)
Subject: RE: Updates on Tendon



20005001002525
Location: London, England
Hi Skye,
Where odes the popping sound come from? And which weight-bearing exercises produce this popping sound? If posterior tibialis is too tight, it may actually be better to work on the opposing muscles, like tibialis anterior, which are often very weak:

http://wiki.w2n.net/pages/Tibialis_posterior_muscle.w2n

I find that very often, yoga practicioners do postures in such a way that the tibialis posterior tightens, when they should be encouraging the opposite, byy tightening tibialis posterior. It's all to easy to adopt a practice which inceases muscle imbalance, rather than optimizing it, as I know from personal experience
By all means, go in to more detail on the treatment, if you think it might be helpful, and it often is, to help gauge what was interesting, or of concern, to the therapist. And hey! Can't you do lying-down postures in the snow?

Nick

Edited by Nick 2008-02-24 3:27 PM
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lilybart
Posted 2008-02-24 3:53 PM (#103953 - in reply to #103950)
Subject: RE: Updates on Tendon


Nick, thank you for your thoughtful reply. Yes, I probably should go sit in the snow for awhile...

Let's see... my replies:

1) About the popping sound: my best guess is that it comes from the inflammation of the tendon sheath. Although the ankle area is not swollen, if I flex my foot outwards (evert it), i can feel a little little knot behind my ankle. Could the sound be the inflammation rubbing against the tendon sheath? The "popping" sensation has not occurred for a couple weeks because I've stopped stepping from down dog to forward bend or into lunges. When I began to think back over this injury, I realized that I've had the same sensation during hikes, but it is harder to notice with boots/shoes on.

2) It seems that tendinitis problems are linked to over-pronation. My ankles try to collapse inwards (although I am not flat-footed), placing extra stress on the tibialis posterior. PT Tendinitis is an overuse injury—my PT has not been strong enough to keep up with my activity level. I think that strengthening BOTH the posterior and anterior tibialis(es?) is ideal, but that the first focus is on the PT. If you don't strengthen the PT, eventually it stretches out to the point that your arch will collapse (or the tendon can rupture—yikes!).

3) Excellent point about imbalance. This isn't only a problem of the feet, it's a knee issue as well. My knees tend towards the slight knock-knee pose (Knockkneeasana) in their daily existence... which contributes to/is caused by over-pronation of the feet, which causes the ankles to go inwards, which places the stress on the tibialis posterior... So in the long run I want to train them to line up properly, like well-disciplined little knees.


Here's a bit of info from a site I found helpful:
"If you become thoughtful about your troublesome tibialis tissue, you will come to the perhaps-startling conclusion that the rehabilitative movement which will keep you away from tibialis-posterior injury is the exact movement which has produced your injury in the first place. Remember that tibialis-posterior tendinitis is an overuse injury which begins because your tibialis posterior and its tendon are not strong enough to stand up to the training you are doing. Thus, it is important to strengthen the specific, previously harmful training movement greatly (without inducing further damage), so that your muscles and connective tissues will not be harmed significantly when you begin working out strenuously again."

http://www.sportsinjurybulletin.com/archive/tibialis-tendinitis.html

thanks again for your response. I welcome any comments!

Edited by lilybart 2008-02-24 3:56 PM
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Nick
Posted 2008-02-25 2:08 AM (#103962 - in reply to #103950)
Subject: RE: Updates on Tendon



20005001002525
Location: London, England
Oops made a mistake in that last post:

"yoga practicioners do postures in such a way that the tibialis posterior tightens, when they should be encouraging the opposite, byy tightening tibialis posterior"

The last part of the sentence should read "by tightening tibialis anterior." Sorry about that.
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tourist
Posted 2008-02-25 9:43 AM (#103970 - in reply to #103953)
Subject: RE: Updates on Tendon



Expert Yogi

Posts: 8442
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lily - are you supporting the ankle with a wrap of some sort during the day? I have off the shelf ankle and wrist wraps from the drug store that are really helpful for my (admittedly minor) joint aches from time to time.
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lilybart
Posted 2008-02-25 10:42 AM (#103977 - in reply to #103970)
Subject: RE: Updates on Tendon


Tourist, good idea, about the wraps—I have to stop by the drugstore later on and will take a look. I have been wearing new sneakers/trainers with Superfeet inserts whenever I'm on my feet. The new sneakers give more ankle support than my other shoes. I also got Superfeet for my, er, fashionable shoes, but I think I need to put aside my pretensions at foot fashion for awhile.

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