Update

Bringing this up to speed since my last post, the NSAID patches and run/walk progression weren't as successful as hoped.  This was the first thing I had tried under Dr. Nicola.  The next step was to get an MRI, which I did a couple weeks ago.  Due to some vacationing of both Dr. Nicola's and mine, this morning was the earliest I could get in.

Dr. Nicola wanted to see (via the MRI) if there was any scar tissue around the tendon due to the original injury/impact.  There was not.  There was a bit of fluid somewhere down there and also a tiny spot of something else (I'm a bit fuzzy on the details), but neither was very near the tendon, which is in fact intact.  So that's generally good news.

In the two weeks we were waiting since the MRI, I had the green light to sort of train based on feel.  I started doing about 8 to 10 miles every other day or so, sometimes multiple days in a row.  And this all generally was fine, not getting any worse or anything.  The ankle would be pretty tender the first couple miles, but then it would warm up and I'd feel about 95% after that.

The plan now is to be very proactive with massage (both daily self-massage and biweekly massage from a therapist), ice, and some additional stretches, while keeping up with the running, potentially every day.  Dr. Nicola labeled it as mild tendinopothy with reactive stiffness on the form for the PT.  So while I'm not 100% by any means, I'm definitely a lot better than I was four or even two months ago.  The hope is that with really getting after the ancillary stuff here, we might be able to finally really turn the corner.  If not, in about three weeks, we're going to look into some prolotherapy.

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