Sore ankles

[clementyn]

hi again,

ok, so i have a few thoughts/best guess for you with the added info...

the description above makes me suspect a mostly muscular (mm.) origin. of course, with your sports/injury history, joint problems cannot be ruled out (you should, of course, consult your MD/orthopedist to help rule this out).

so here is why i suspect a mm. component. unlike when we are on land, where our muscles contract in combination against a fixed surface to stabilize us upright, in water there are many more degree's of freedom. fins are basically designed to extend our lever arm and surface area to give us more power. even though most of the 'downstroke' of the typical finning techniques should come from the larger muscle groups in your leg, the small mm. are working hard, contracting in all directions against eachother to stabilize the fin against the pressure of the water (and a high pressure at that because of the increased surface area and lengthened lever arm). they are also doing this at the most elongated point in the joint range of motion.

one clue to which mm. are bearing the brunt is your comment about pivoting on the ball of your feet. my best guess is that your inverters and everters (the mm. that roll the sole of your foot in toward midline or out to the side) are getting overworked (leading to hot swollen and painful tissues). many of the muscles and tendons traveling past the ankle going to the foot pass thru small compartments or sheaths. just like the carpal tunnels in your wrists, these areas can be very sensative to swelling (the body's natural response to repair damage) because they are such small spaces. many of our so called pain receptors are simply responding to this change in pressure at these tissues.

even tho your legs might be very strong from years of sports and supporting your frame, that may not be enough when you are using these same muscles in a non-routine way UW.

so what to do... first, i would consider the suggestion above to try our some different fins. try splits, try paddles of different stiffnesses. i have never tried any of the OPB fins personally, but rodales scubalab (FWIW) had mixed feelings on them and specifically commented on stress at the ankles with this type of fin (see the gear review for open heel fins from July 2003). second, consider practicing and switching to a frog kick - at least part of the time - to give those ankles some different angles of pull to help avoid the repetition. third, you could try some strengthening of those muscles in the off season. even just simple isometrics (contract the muscle and hold for a count of 5, then relax) could be the difference. zippsy is right too, balance exercises on one foot (with hand support like a counter top or sturdy piece of furniture for safety of course makes all of those small little intrinsic mm. work. sports med is not my clinical specialty, but my guess is that taping or bracing (strapping) would do little in this kind of environment. the purpose of most braces or taping is to stabilize the joint against the forces incured when you have a potential for one part to be fixed while another moves too forcefully for the soft tissues to withstand and keep joint integrity. this is not usually applicable in the UW environment until you are on the ladder or shore. last but certainly not least, you might try going back to the basics for helping inflammation - RICE - Rest Ice Compression Elevation, or consult with your MD regarding an anti-inflammatory.

hope you find a solution...
lorien

(normal healthcare practitioner disclaimer applies... comments are for discussion puposes only and are not intended as professional advice)

 

[beche de mer]

hi again,

even though most of the 'downstroke' of the typical finning techniques should come from the larger muscle groups in your leg, the small mm. are working hard, contracting in all directions against eachother to stabilize the fin against the pressure of the water

many of the muscles and tendons traveling past the ankle going to the foot pass thru small compartments or sheaths. just like the carpal tunnels in your wrists, these areas can be very sensative to swelling (the body's natural response to repair damage) because they are such small spaces. many of our so called pain receptors are simply responding to this change in pressure at these tissues.

even tho your legs might be very strong from years of sports and supporting your frame, that may not be enough when you are using these same muscles in a non-routine way UW.


(normal healthcare practitioner disclaimer applies... comments are for discussion puposes only and are not intended as professional advice)

Hmmm.

For one thing, the small or "intrinsic" muscles of the foot are not exerted in finning. They are moved passively. Finning comes from the thigh extensors and flexors. (Quads and hams.) And to a lesser extent, the calf flexors and foot extensors.

And unlike the flexor tendons of the wrists, the foot flexors are not constrained by a small fibrous tunnel and are therefore not subject to compression syndromes.

And if the pain was coming from the small muscles in your foot, you wouldn't feel it in your ankles. You'd feel it in your foot.

From the information you've provided, the most likely explanation is that you have some arthritis of the ankles which is being aggravated by them being passively and repeatedly taken through an abnormal excursion of movement.

IMO, your first instinct towards ankle bracing was correct.

By all means try split fins. They work in a different way from normal reactive fins and probably do not stress the ankle joint as much. My advice is also is to visit a sports physio with a view to ankle stabilisation. They deal with this sort of stuff all the time.

 

[clementyn]

hmmm, i politely disagree...


[[For one thing, the small or "intrinsic" muscles of the foot are not exerted in finning. They are moved passively. Finning comes from the thigh extensors and flexors. (Quads and hams.) And to a lesser extent, the calf flexors and foot extensors.]]

-- although it is a moot point since i agree that the power comes from the larger mm. groups, the emg studies of flutter kicking in swimmers do show that the instrinsics fire, but do not make a functional contribution to the power generated.

as i indicated in the previous post, the majority of the power of your kick is generated in the larger mm., but the key here, biomechanically, is really the cocontraction of the peroneals, tib. ant., EHL and EDL mm. to stabilize the blade of the fin as it meets the resistance of the water. the biomechanics of the ankle in freemotion must address the triplanar freedom of the joint. if these muscles were not cocontracting during the period of time that the blade of the fin is meeting the resistance of the water, the blade would take the path of least resistance by rolling (inv/ev aka sup/pron) onto one edge of the blade to 'cut' thru the water, producing far less propulsion. by cocontracting, the tib ant. and EHL oppose the combination of dorsiflexion, abduction and eversion (pronation) exerted by the peroneals and EDL and vice versa, holding the blade of the fin in the plane of resistance of the water. this plane of resistance obviously varies widely based on the design of the fin, but ultimately, irregardless of fin type, muscles around a joint will work in cooperation to stabilize that joint.


[[And unlike the flexor tendons of the wrists, the foot flexors are not constrained by a small fibrous tunnel and are therefore not subject to compression syndromes. ]]

-- the carpal tunnel of the wrist is the space between the carpal arch (formed by the carpal bones and intercarpal ligaments) and the flexor retinaculum, housing the long digital flexor tendons and med. n.
it is a transverse osseo-fibrous tunnel by design.

not only are the flexor tendons of the foot (FDL, FHL and tib. post.) contained by the fibrous flexor retinaculum, but so are the tib. ant. EDL, and EHL by the superior and inferior extensor retinacula, as well as the common tendinous sheath of the peroneals by the superior and inferior peroneal retinacula.

when retinacula form transversely making a loop attached at each end to bone (as opposed to vertically like the ITB whose structure and function lend it to transmit force between a muscle and a bone) their purpose is to form an osseo-fibrous channel to contain and prevent the tendon from bowing out during contraction. although overuse injuries of these mm./tendon complexes (causing inflammation/swelling as part of the repair process) are not as commonly encountered/treated as those in the wrist (largely because of the magnitude of the incapacity of not being able to use then hands/wrists functionally), they are still anatomically and functionally subject to compression syndromes. its more a question of what it takes to trigger the overuse threshhold - in this case, a week of prolonged, repetitive use without progressive conditioning, likely combined with some degree of degeneration.


[[And if the pain was coming from the small muscles in your foot, you wouldn't feel it in your ankles. You'd feel it in your foot.]]

-- right, however, my post re. intrinsics was suggestion of an exercise known by emg to recruit multiple mm. groups in a cocontration pattern to ilicit a possible progressive, resistive method of helping to condition the mms.

although this problem is likely multi-factorial, bottom line we can all agree on is that the solution will likely involve a proactive approach including seeking professional advice, trial of treatments to find the best combination of modalities and basic prevention strategies.

 

[beche de mer]

at 300lbs and 14 years of organized football, my ankles have certainly taken a beating.

Incidentally, hcs3, unless you are about 7 and a half feet tall, 300 lbs is probably too much for you.

A weight loss program might go some way to helping your problem. :banana:

 

[hcs3]

clementyn,

many thanks for your detailed response. now if i could only understand 1/2 of it i think i'd be better off

so, in layman's english, what you are saying is i'm SOL, eh?

beche de mer,

can't support your argument against clemetyn so you poke fun at my wieght? tsk, tsk. FYI, muscle weighs 3 times more than fat.

 

[IzzyTahil]

When I first started, I always had foot/calf cramps and sore ankles. I attributed this to being new, improper finning, and the fin itself. Since I was using flutter kick at that time, and wanted to continue using it, I switched to splits. I used the longer Oceanic V12s. For me, the effort in finning was virtually eliminated, not to mention inprovement in my air consumption. Try splits and seep it they will help. I find splits a pleasure to use in warm/recreational/no current situations. For cold/current situations, I use my jets with a frog kick without resulting cramps or ankle pain.

 

[clementyn]

sorry for the non-layman's jargon. basically, it is just a discussion of the specific muscles involved and how they travel past the ankle joint (bony suraces). the real key to overuse injuries is how the soft tissue reacts.

muscle does weigh more than fat, however, the kind of weight largely does not affect the cumulative wearing of the joint surfaces (esp. during wt. bearing) over time. usually tho, wt. bearing joints (like the ankles, hips and knees) tend to do better in grav. eliminated environments, like water, than worse. beche may be right with the assertion of stress at the joint lines themselves from the pressure thru the joint at the end of their range of motion could be contributing to the overall situation as well.

so back to your question of SOL...

i still think you should consider the suggestions made in previous posts by all of the posters, there are some good ideas there. to better understand overuse injuries, do a google search. try this article
http://www.physsportsmed.com/issues/1997/05may/oconnor.htm
for a good discussion of identification, treatment and prevention. pm me or reply to this if you need some clarification on any of the concepts. it's not too technical, but it is not written in completely layman's terms either.

basically, the key is to reduce the stress on the soft tissues. in the case of finning, it would be very important to look at varying the type and decreasing the duration of any one kicking type and trying to find a fin that is less likely to focus the stress on your ankles.

hope this helps.
lorien.

 

[beche de mer]

clementyn,

can't support your argument against clemetyn so you poke fun at my wieght? tsk, tsk. FYI, muscle weighs 3 times more than fat.

Didn't think this was the appropriate place to veer off on an esoteric debate which would be of no interest to anyone other than the protagonists. You said yourself you couldn't understand half of Clementyn's post.

Not poking fun at your weight, but weight is a very significant factor when it comes to ankle problems.

 

[hcs3]

Many thanks to all who have responded with assitance on this thread.

Prior to my next dive I plan to invest in a new pair of fins. Unless someone tells me otherwise, I plan to purchase the "winner" of the Rodales fin-test that was recommended to me earlier. This would be the Apollo Sports Black Bio-Fin Pro.

After diving activities are finished for the afternoon I plan to ice my ankles. Gosh, I'm gonna hate that. You'd think after 14 years of football I'd be use to that, huh?

Lorien, would you be aware of any excercises that I could slip into my normal daily excercise routine which would help strengthen the ankles? In addition to my normal leg workout and to avoid the high impact of running on concrete or tread-mills, I utilize an eliptical (similar to X country skiing if you are unfamilar) machine for 45min - 1 hour each day. This results in about 2.5 miles, give or take. Anything else you could recommend would be appreciated.

Thanks to all,

Henry

 

[scubatoys]

Prior to my next dive I plan to invest in a new pair of fins. Unless someone tells me otherwise, I plan to purchase the "winner" of the Rodales fin-test that was recommended to me earlier. This would be the Apollo Sports Black Bio-Fin Pro.

Make sure when you get the bio fins... you get the standard ones and not the XT. XT stands for Extra Torque - and they are made out of a higher durometer rubber, which will make for more effort. I've used the Bio Fin Pro's for years... in fact dove the original proto types from apollo - and have never looked back.

I think you will find a night and day difference!