Posterior tibial tendonitis is frustrating. You feel it in every step you take, and it drives you insane when you are sitting on the couch instead of out for a run. I’ve been there, and I never want to be there again.

I am a firm believer that injuries are your body’s way to alert you to an imbalance or weakness, and mine has spoken loud and clear.

I have spent the past year scouring the Internet and talking to every specialist I’ve met (the amazing people at the RunSafe clinic, doctors, physical therapists, massage and bodywork therapists, other PTT athletes) to find the best exercises to treat my PTT and prevent it from ever (EVER!) coming back.

There are three main areas you need to strengthen if you are suffering from PTT (or any other ankle/foot injury) the feet, ankles/lower leg, and the hip. Instead of trying to explain how to do all of these exercises myself, I linked each one to more information and instructions.

Here are some exercises I’ve been doing, from the bottom up:

Feet

Whether you start with flat feet or PTT causes your arch to fall, chances are you are in need of some serious arch support. Realign your arch and reduce the stress on your plantar fascia with these exercises.

Toe curls with a towel

Toe squeeze and spread (rubber bands are great for a little resistance)

Doming

Standing on one foot/balance work
Without shoes, stand on one leg for 30 seconds or so and focus on maintaining an arch while keeping your balance. Once the 30 seconds gets easy, add time/sets, try it with your eyes closed, or really challenge yourself by standing on a Bosu or another uneven surface. Be careful with this one! Balance work can really irritate my tendons. Be sure to work up to it very slowly. I mean it when I say to start for just 30 seconds on each side.

Ankles/lower leg

For all exercises that you do with a band, you can buy a TheraBand (or any other therapy band) online.

Calf raises
Watch out! This is another one where you really need to ease into it. These irritated my PTT when I first started doing them. I had to start doing these sitting in a chair, just lifting the weight of part of my legs. Once I was able to do that, my physical therapist had me set a bit of weight on my knees (a heavy book works great if you don’t have access to hand weights). I did three sets of 10 reps (both legs at the same time) with the weight on my knees for about a week. Once I could do that easily, I moved on to leaning fairly heavily on a counter and lifting part of my body weight for three sets of 10. I’m currently doing three sets of 10 with my full body weight, but both legs at the same time. I’m going to progress to doing them mostly on one foot until I can do them one leg at a time with all of my body weight. If you are super advanced and you have gone through the whole progression, you can add weight, but do it slowly!

Ankle dorsiflexion with a band

Ankle inversion with a band

Ankle eversion with a band

Hips

Your hips are critical for keeping your gait balanced and even. Recent studies have shown that the hips are linked to everything from knee pain to ankle pain. These very well might be the most important exercises on the list. Don’t skip these! (Curious about where your hips are the weakest? Try this test.)

Side step with a band

Glute bridge
Weighted, unweighted, one leg, two legs – any and all variations are great!

Single-leg deadlift
Way less scary than they sound.

Squats

Side leg raises

Hip hikes

It turns out when my PTT flairs up, I give up on writing these updates. Which is sad because my life doesn’t stop, I don’t stop training, it just looks a little different.

So here it is, in all of its injury-interrupted glory:

3/2-8

I started March feeling pretty good. I had a solid plan for how I was going to slowly ramp up my mileage in time for the 10k I’m “racing” in April. I wasn’t worried about only having a month to go, and my body was handling the slow increase in mileage well.

Until it wasn’t.

Between a lot of balance work at CrossFit and the “extra” distance I was running, my feet fought back. I had started the week of 3/2 feeling strong with an accidental 3.5 mile run (I was shooting for 2.5-3). I followed that up with a CrossFit workout that had a lot of overhead work, and I never really bounced back. My short run on Thursday went alright, but after doing the 15.2 CrossFit Open workout that Friday, my feet were toast on Saturday for my “long” run. I had 4 miles on the schedule, but within a few steps my feet were killing me. I hobbled home after less than a mile and proceeded to feel sorry for myself for the rest of the day.

3/9-15

I accepted (mostly) the sate of my feet and took the week off from running. I did my best to reduce the strain I put on my feet at CrossFit by cutting out jumping and going a bit lighter on weights so I didn’t have to drive as much through my calves or struggle to stay balanced.

I also spent the time I would have been running working on my olympic lifts and strengthening my feet and hips to help stabilize everything when I run. Glute bridges, side steps with a band, ankle exercises with a band, and calf raises are all the rage these days.

I miss my morning run, but I can’t complain about starting the day with a nice quiet lift. #LikeAGirl #crossfitgirls #oly

A photo posted by Mandy Ferreira (@treading_lightly) on Mar 10, 2015 at 8:13am PDT

3/16-22

I started hesitantly running again. I’m still playing around with pacing, distance, and even taping my ankle/arch to figure out the best way to move forward. I did another whopping 7.8 miles for the week, but I didn’t get pain while I was running, which seems like a win if you ask me. I made it through my “long” run of 3 miles without incident and even woke up feeling alright the next morning. I’m calling it progress.

The real bummer of the week was the discovery that yoga is definitely contributing to my PTT symptoms. All of the balance on bare feet kills me. My arch can’t support itself well enough, and all of that tugging on my tendons gives me pain that starts in my feet and keeps going up my ankles. I have been taping my ankle and arches when I go to class, but it’s still not enough. I’m going to take a few weeks off to let my body calm down before I try it again (modifying poses of course to reduce the tugging on my inflamed tendons). Fingers crossed it works and I can run all three days this week.

I got lost down the rabbit hole that is the internet recently when looking for inspiration. I decided to find some of the top female professional athletes around the world and add them to my Instagram for a daily dose of motivation.

Instead what I found was depressing and frustrating.

The top searches were all about the “smoking hot” female athletes who frequently posted bikini photos. Most lists (like Bleacher Report‘s) somehow left out all of the photos of athletes in their element in favor of cleavage, pouty selfies, and poll dancing videos. And the athletes.

#FBF in honor of March Madness…. Final four in 2007…. Wonder wha I was bout to do? #LADYvols #FinalFour #Cleveland #YoungCP

A photo posted by Candace Parker (@candaceparker) on Mar 13, 2015 at 11:18am PDT

Women athletes are frequently only seen for their beauty, their bodies. Not what their bodies can do or accomplish, but what they look like in and out of a bathing suit (I’m talking to you Sport’s Illustrated). They rarely have news coverage where someone doesn’t talk about the way they look (from their smile to their waist size) or are asked questions no one would dare (or care) to ask a male professional athlete.

I want to feel like this again.

A photo posted by Lauren Fleshman (@fleshmanflyer) on Jan 7, 2015 at 10:09pm PST

Female athletes are so much more than what they look like. And yet they rarely make ESPN’s top plays of the night. They don’t make the front page of the sports section. Their names aren’t spoken over millions of dinner tables after a big game.

And it frustrates me. Why is it so hard for me to find female role models? Why are the Lauren Fleshmans, Annie Thorisdottirs, Alex Morgans, and Candace Parkers so hidden? Why do we hold male athletes in such high regard and think little of their female counterparts?

What do you call a runner that can’t run? Depressed.

Junior year of high school I went from being the starting point guard to the score keeper in a cast days before the season was set to start. With half the basketball season out of the question, I sat on the sidelines and watched my team move on without me. I spent more time crying and feeling sorry for myself than I did practicing.

Now it’s years later, my team is just me, myself, and I, and yet being forced to stop doing what I love feels an awful lot like that ruined basketball season. I spend my time obsessing over all of the things I can’t do and wallowing in jealousy over everything everyone else is doing without me.

Almost exactly a year ago I had my first inklings of pain in my feet. As my injury progressed, I spent two months unable to run (and  losing my mind). I didn’t know what to do with myself, and the thought of losing all of the strength and endurance I worked so hard for for years just wasting away while I had to rest physically hurt almost as much as my feet and ankles. I tried running and not running, doing yoga, going for a swim, riding my bike, but no matter what the pain followed (and often worsened). Meanwhile the weeks ticked by and my half marathon grew closer and my mileage goals for the year more impossible.

Trying to undo all of the training mistakes I made this week with some #yoga and #mobility. #PlantarFasciitis

A photo posted by Mandy Ferreira (@treading_lightly) on Feb 23, 2014 at 3:24pm PST

With each doctors appointment, new shoes, new inserts, etc. I got a sense of hope and would finally start to feel my mood lift. But days or weeks later when there wasn’t any improvement and I couldn’t sit still without thinking about the pain in my feet, I was right back under my dark cloud that rains all over me. I was desperate for a turning point and for some real hope. I started to throw myself into my PT exercises, contrast baths, and everything else I could do to heal faster. I stayed away from sugar and other foods that are taxing on my body. I pushed through some pain and pulled back before I made things worse. I listened to my body (and hopelessly ignored it). And it worked. I slowly got better. I got stronger. I ran a half marathon. And then another eight weeks later. All the while I lived in fear that my pain would return, that I would be broken again. Sidelined. But after a while the fear faded, and with it went my adherence to my exercises, the contrast baths, the self-massages, the intuition to listen to every little twinge in my body.  

 

I’m still flying on my Nike Women’s SF finish. #tbt #runchat #werunsf

 

A photo posted by Mandy Ferreira (@treading_lightly) on Oct 30, 2014 at 3:08pm PDT

 

I got careless.

And I paid for it.

It’s a year later, and my PTT is back. Another flair-up. Another setback. Another frustration.

But this time I know. I know I need to be doing my exercises. I know my shoes aren’t going to be a magical fix. I won’t suddenly wake up one morning able to run 13 miles.

Comeback’s are a struggle. But they are worth fighting for. I have four weeks until I run my first race since October, and I am sure as hell going to be at that starting line strong. I am going to strengthen my hips, my ankles, my feet. I will create a solid base that will keep me going through the summer and into the fall. I am going to have months without pain, without limits.

Instead of feeling sorry for myself, I’m looking forward to being set free, to being stronger than before.

Monday

I went into Monday feeling pretty good. I took a much needed complete rest day the day before. But after WAY too much squatting between the scheduled workout and my insistence that I needed to do my squat program, I felt my workout all week. #SomeoneCarryMePlease. If you think walking is overrated you should definitely try this workout.

Tuesday

This was one of those “runs” where barely moving feels like an all-out effort. My tired legs carried me (very slowly) 2.5 miles.

Wednesday

Despite declarations that Fridays are for squatting, I had to switch up my schedule and squat today instead. On paper it seemed totally fine. Trying to convince my legs to squat when they were quite sore after Monday was a challenge. I hit unexpected traffic on the way to the gym and ended up having to go to a later CrossFit class, which meant I got my squats in before. I squeezed my full program into the 30 minutes before class and tried not to cry on every wall ball after.

Thursday

I hobbled through another 2.5 miles. Nothing major to report.

Friday

Despite the fact that I’m not actually doing the CrossFit Open, every class is doing the open workouts on Fridays. Last year I was determined to do all of the workouts, but after my first introduction to tendonitis (hello double-unders, oh how you ruined my feet for a year) after 14.1, I was less than interested this year.

As much as I hate toes-to-bar, I wasn’t dreading this workout too badly.

15.1

9 minute AMRAP
15 toes-to-bar
10 deadlifts at 75 lbs
5 snatches at 75 lbs

15.1 A

Max single rep clean and jerk in 6 minutes

I know I made a lot of progress doing a few cycles of the barbell class, but I didn’t realize quite how much until this workout. The weight on the snatches felt totally doable for me and I got pretty darn close to my actual PR on the clean and jerk. I was pretty happy with my score of 113 reps/128 lbs.

Saturday

I broke up my longest run in months with a nice walk on the beach to check out the tide pools. I ran about 3 miles and walked another half mile.

Sunday

I ditched the yoga class I was planning on going to and did an hour of PT instead. Both probably would have been better, but my ankles have been feeling better without the stress of balancing/standing barefoot during yoga.

Overall stats:

• 2ish hours of PT (Mostly stretching and releasing my calves and hips with a lacrosse ball. I did some of my exercises… but not enough)
• Ran 8.82 miles
• 3 hours of CrossFit
• 2 squat sessions

I haven’t done a weekly update in a while, mostly because announcing to the world that I only ran six miles the entire week makes me never want to get out of bed. But I realized that those six miles matter, and everything else that I’m doing is worth talking about. So here it goes, what life really looks like when you’re chipping away at a comeback.

Monday

I started the week with the day off (hallelujah!). To celebrate I slept in and skipped my usual CrossFit workout. Instead I went to the gym late and did my third week of the Hatch Squat program. My legs were so happy to do this workout fresh. I usually squat after my regular workout, and man do my legs hate it.

Big girl weights only

Tuesday

Despite tired legs (hello squats) I got in a slow and careful 2.5 mile run (which if we are being real is a 2 mile run, .5 mile walk).

Wednesday

Sometimes overhead squats feel like you are dying. Sometimes you feel like you can lift the world. Thankfully I felt pretty good for this workout. The best part? I didn’t even have to do more squats after.

Thursday

Given that more is always better (uhhh or not), I decided to go for a short 2.5 mile run (which ironically is currently the same length as my long run) and followed it up with an hour and 15 minutes of heated power yoga before work. Yoga has been huge in helping me release tight hip flexors and keeping my lower legs loose. The only problem is that standing on one leg really tugs on my tendons and it’s super easy for me to inflame my PTT without realizing it. In this case, tired legs + a fair amount of balance work = unhappy tendons & disappointed Mandy.

Friday

Fridays are for squatting! (I’m trying really hard to make that into a thing. So far no one will join me.) After an hour long CrossFit class I was at it again for my second day of my squat program. I would love to say I was feeling great for this workout, but the truth is that after finding a two rep max power snatch and doing more than 60 pull-ups and dumbbell snatches, I was not feelin’ the squats. It took me almost an hour to get through my front and back squat sets. But I did have a great time sitting and chatting. (Maybe Fridays really are for socializing?)

Saturday

Since I was feeling super energetic the night before (see Friday), I decided it would be a great idea to go for a run and a swim before lunch. I wouldn’t recommend this tactic. It results in homicidal hunger and the inability to get anything else done all day. If you are hoping to take an intense nap, this workout might be for you.

Sunday

I had originally planned on doing another hot power yoga class, but given the state of my body (and my sudden inability to make it through a day without a nap) I decided to skip it and rest my legs. My tendons thanked me… ha. I wish.

Overall stats:

• 2 hours of PT (Mostly stretching and releasing my calves and hips with a lacrosse ball. I did some of my exercises… but not enough)
• 1 sweaty yoga class
• Ran 7.5 miles (and proud of it!)
• 3 hours of CrossFit
• 2 squat sessions for a total of 5.7 tons (over a ton more than the average car) squatted. Ouch.

I’m ready for my comeback.

This past year I’ve had so many ups and downs. So many “I’m almost healed” signs only to have a major setback. So many “we’re going to make it out of this” moments. I’m ready for a full comeback. I’m ready to run without abandon, to stop telling myself to slow down, to hold back. I’m ready to jump and climb and do whatever I damn well please. I’m ready to be fully me.

I’m shifting my focus from being upset about all of the things I can’t do yet to all of the things I should be doing to ensure that I make it back and stay back this time. Heel raises, clam shells, banded exercises, I’m doing it all.

I’m coming back stronger than ever.

I cannot get rid of clutter fast enough these days. I’m so desperate to clear space that I’ve taken to living vicariously through other people’s decluttering (anyone who has ever watched Hoarders knows exactly what I’m talking about. To everyone who has been blogging about cleaning their closets, I thank you).

I’ve been hunting for quick fixes for my current obsession, and getting rid of old running shoes sure hit the spot. I had a pair lazing around under my desk at work that I had reserved for wet, muddy recesses with my coworkers. But after the intense ankle pain I got the last time I wore them, it was time to let them go.

What to do with old running shoes:

1. Reuse them! Hello new gardening, painting, really-messy-activity shoe.

2. If you didn’t wear your shoes for too many miles (every runner has a shoe or two they just didn’t mesh with), donate them to a local charity or drop them off at a MORE Foundation pick-up location. Runner’s World also has a great list of other organizations that match your shoes with a new home.

3. Recycle your beat up kicks into something new. You can drop off your pair (or that random shoe you can’t find the mate for) to a local Nike store where the soles will be shredded and turned into a new track or field.

PS. Don’t forget these tips to make your next pair last longer.