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Monday, March 03, 2014

Unexplained swelling of the inside of the ankle explained

Hi Gary, Every so often, I get some swelling on the inside of my left ankle just below the ankle bone. It can be quite debilitating and the first time it struck me, it affected me for several months, limiting my ability to walk. One time, it went away after doing some pilates for a few weeks. (Who knows if that the was the reason it went away). Another time, it went away after being predominantly barefoot for a while. (This was on the advice of my physio who is a big advocate of barefoot running). 

This most recent time, I was being barefoot as much as possible for a week and a half. Then I found your video (your most popular one), suspecting that it might have some thing to do with a weak tibialis posterior. After a couple of days of doing the exercise (as well as being barefoot), it seems to have resolved itself. 

Do you think this is an exercise I should continue to do? Or should I just keep it up my sleeve if the problem returns.

Cheers Malcolm
Video: 370,000 views and increasing by the day!

Malcolm: What you are describing is most likely caused by a tendonitis of the tibialis posterior tendon where it wraps around the ankle bone on the inside of the foot (refer anatomy diagram above).  If the foot is excessively pronating (flattening) during exercises such as walking and running, it is possible that the tendon is being further aggravated by pinching and excessive angulation as the foot flattens.

The exercise in the video is the most effective one you can do to alter foot posture and strengthen the muscles that maintain a strong foot arch.  It works but must be practiced several times a week - constantly - even when there is no pain.

You can also support the arch and foot by fitting a pair of heat moulded Formthotics Shock Stop innersoles which are designed to support the foot while not interfering with natural biomechanics (a most common fault of orthotics inserts).

You may also find it beneficial to firmly massage the inner part of the ankle.  If you are ever in Wellington, I can show you exactly how best to do this.

Getting about barefoot may be beneficial, especially walking and jogging on grass and sand.  However; running barefoot on pavement, even with "barefoot" shoes carries with it an increased risk of injury.  Although I personally get about more often barefoot each day than in shoes, and I do have very strong feet, I would never dream of running anything more than a few hundred meters barefoot on pavement.  Its just far too harsh on the legs.  Stick to grass and sand if barefoot running.

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