How do I cope with an injury?

October 12, 2011 9:31 PM

Injury Filter: How can I cope with my tendinitis?

Background: I've developed posterior tibial tendinitis, which makes my life somewhat of a living hell now. Basically, my foot hurts if I try to put weight on it right now. My doctor has put me back in an immobilizing boot after giving me a magical prolotherapy shot because I've managed to hurt it again after finishing up my prescribed physical therapy (actually didn't even last a week after finishing). While I'm only in the boot for 2 weeks this time, compared to 9 weeks when I injured it the first time (then subsequently did lots of running/agility for a month before getting it checked out). My doctor is estimating that it will be at least 3 weeks before I can even think about slowly starting high impact activities again. Before getting hurt, I ran and boxed to get a lot of my stress out. Both options of de-stressing are clearly out for a while.

I've never had any sort of long-ish term injury like this before. Sprained ankles here and there, yes, but that goes away by itself comparatively quickly. I truly am at my wit's end!! My friends are taking much of the punishment right now just because I'm lashing out left and right due to frustration and stress.

My questions are now:

1) How the heck do you non-athletic people destress? I'm going slightly crazy here trying to do well in my last year of undergrad, looking and applying for jobs, working, and rehearsing for a chamber music performance in a month. The routine of collapsing in bed in tears followed by a 3 hour long nap is really screwing with my body's clock. Doing yoga is also considered "out" for me for at least a month.

2) To people who've dealt with this tendinitis before: what worked in terms of preventing another relapse? I was doing fine in the week before hurting myself with lots of running, agility, and cutting that comes with playing Ultimate Frisbee. What did me in this time was as mundane as walking down a slope.

3) With all physical activity pretty much outlawed to me for at least a month, should I cut down my caloric intake a lot, say down to about 1400-1500 a day? I gained a bit of weight in my initial time in the boot just because it took my body a bit to realize that I really didn't need 2500+ calories of food a day anymore.

4) What can I do to try to stay in somewhat fit? I was thinking push-ups and sit ups (I can't do a pull-up to save my life). Is there anything else that wouldn't require any weight bearing on my injured foot?

posted by astapasta24 to health & fitness (8 answers total)

4) What can I do to try to stay in somewhat fit?

Would swimming laps work with this kind of injury? If kicking is out I bet you could use a lot of energy using just your arms.
posted by UbuRoivas at 10:35 PM on October 12, 2011

What about upper-body focused workouts? Pull-ups, push-ups, not to mention the whole host of upper-body weight training workouts out there. You could do leg extensions and curls in the gym. Pistol squats on the good leg. Ab pulldowns on the knees, roll-outs on the knees . . . Maybe the exercise you're used to isn't an option, but you have three other limbs and the trunk of your body that still work.

Tendinitis requires patience and time. Even after the boot is off you need to be diligent about rehab, and after that's over you'll have to incorporate prehab work into workouts and go back into your workouts really slowly.
posted by schroedinger at 11:12 PM on October 12, 2011

astapasta24: " How the heck do you non-athletic people destress?"

Soft, relaxing music, or a podcast on a non-stressful topic. Preferably the podcaster(s) does not have an annoying voice. I love the HowStuffWorks podcasts, especially Stuff You Should Know and Tech Stuff. I often fall asleep just from listening to their voices.
posted by IndigoRain at 1:51 AM on October 13, 2011

You may find you need to change what you do about shoes or inserts or a brace once you're out of the boot. After a broken ankle I found I needed to wear a brace while playing soccer for more than a year so check with your doctor or PT about that once you can get active again. You'll probably have to change some things to accommodate your injury. Thinking of it as a long-term situation rather than something you've completely recovered from will help. Tendonitis is the sort of annoying thing that can linger on for ages unfortunately.

Swimming and upper body stuff sound like possibilities in the meantime. My daughter is recovering from a broken metatarsal and has been doing a lot of core workout stuff while she isn't allowed to do more weight bearing workouts.
posted by leslies at 4:59 AM on October 13, 2011

As opposed to cutting total calories, look at cutting carbohydrate intake. They're very useful when you're doing high-activity sports like Ultimate, but much less useful when you can hardly walk. Eat meats and dietary fats and you'll still feel full.

For working out, consider Convict Conditioning - if you do a subset of the exercises you won't have to put any weight on your foot (like air squats and leg extensions). The key is slow, controlled movements.

Now would be a great time to get into pull-ups. The over-door ones are actually pretty good, and you can start out with shoulder shrugs and reverse pull-ups (start at the top, hold it as long as you can, then lower yourself slowly).
posted by bookdragoness at 5:50 AM on October 13, 2011

Mine was a somewhat less athletic injury (too much knitting!) but I had some of the worst tendinitis in my hands that my physical therapist had ever seen. I had to use my elbows to open heavy doors. Physical therapy did nothing for me, until I went to the somatics institute in my town. They teach stretches that fix the source of tendon problems (in my case, my shoulders/back), and give you exercises to do on your own every morning. It sounds ridiculous but it worked fast and I've been able to prevent any serious relapse by doing these stretches whenever I'm typing or knitting a lot. Maybe this is something you've already tried, but if not, give it a go. Hope you get better soon, I know how frustrating it is.
posted by chaiminda at 6:54 AM on October 13, 2011

This is not helpful in terms of giving you more options, but do be careful when swimming. Crawl is great, but the frog-kick required for breast stroke ends with a kind of ankle extension that might be super painful.
posted by dizziest at 7:26 AM on October 14, 2011

I understand reform pillates attempts to work within individual limitations, so perhaps it may be a good source of exercise. I also recommend guided meditations for stress relief if you are unable to exercise.

In addition, IANAD, and I only proceed to write as a cautionary tale. I ignored the pain (as many musicians are taught to do) and pushed through for around a year. I now have adult acquired flat foot, meaning that the joints and bones have re-alligned in the time I did not seek care for it. Please be sure you have seen either an orthopedist or podiatrist regarding this condition. Unlike typical tendonitis conditions, where a common treatment is an injection of cortisone, my understanding is that it is absolutely contraindicated with the posterior tibial tendon, due to very poor blood flow in the area, unless there is concomitant complete immobilization of the joint (such as a cast).
posted by k8oglyph at 9:10 PM on October 14, 2011