Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group AS and injuries?

Based my meager experience, I will second what most others are saying. Separate hairline fractures of the metatarsal in my left foot and the little finger have not completely healed even now.

Saurabh

hi mig,

i'm just echoing what my doctors have told me and taught me.
but i do agree with part of what you have said. some of the tendinitises are just that, inflammation, and "overuse" makes it more inflamed. but some of the tendons and ligaments probably have been torn as dx'ed by doctors. and the problem with tears is that they don't show up even with general MRI unless its a significant tear. but the doctors that have dx'ed some of the tears have done it by listening to how it happened and then by what makes it worse. so they are the ones saying that i am tearing / straining / spraining things.
so i think its both. the tough part has been trying to get to the bottom of it, the why is it happening. the doctors know what is happening, but so far, not why. Ehlers-Danlos Syndrome has been ruled out. endocrine problems and spondy are what the docs are working on now. what i really don't understand is "how is inflammation of the tendons and ligaments localized right at the joint not enthesitis?" i think its one in the same. and i think the reason i've torn some of my tendons and ligaments is due to this inflammation. time will tell.

sue

Hiya Karen,... um, I can't answer that one for you either but suspect you'll arrive at your own answer to it at some point, knowing yourself the best.

In my experience, activity may help to loosen up 'stiffness' but more commonly will aggravate areas easily prone to flaring badly, either escalating existing pain or bringing on pain that had quieted for a time. However, for many kickers gentle exercise will help to relieve pain. There is a great deal of commonality between all of us, as well as very individual and unique patterns of involvement.

It's true what you've noted, that non-ASers who swim regularly are only apt enjoy the benefits of better muscle tone... and isn't tendinitis just another name for inflammation?

Wish I could be of more help.
Hugs!
mig

Hi Sue,

I think I was responding to your lack of wrestling alligators and having 'injured' yourself "all during trivial daily activities". Just not sure how you are so busy tearing anything. I realise it's a matter of semantics to an extent yet docs will rely on what they hear from you as well as see upon examination, in the course of trying to determine cause. To me, I might sustain an injury by tripping down stairs or catching my arm in a door as it swings shut... but not by pouring a pot of tea!

I was happy to read that your GP is actively trying to help you and am keeping my fingers crossed that you're nearer to reaching an answer. Hope someone might send you for a bone scan or MRI. Yep, enthesis is the point where ligaments and tendons insert or attach to bone and a common target for inflammation in SpA's, which can make it more prone to tearing but more often is just terribly painful.

Hugs for luck,
mig

thanks mig,

but i do wish i had better stories to tell when i go to the docs. rather than, "when i was pouring this pot of water into the sink, i felt something "give", and now i can't rotate my wrist and it hurts like ____ whenever i move it", i'd rather say, "when i got bucked off the horse in the rodeo competition...."

thanks for the thoughts,

sue

It sounds as if Sue and I have some commonalities here.

Or did I forget to mention my rodeo riding?

Here is another example. In another post, I mentioned soreness at the base of the big toe. Now that the pain has settled in, I realize my original post wasn't quite correct.
The joint at the base of my big toe is sore and movement is restricted there. I'm also sore farther back on the foot on the proximal end of the metatarsal that goes to the big toe. So the whole end of that metatarsal is sore.

I can point to a few things which might have aggravated this area:
1) After spending months in PT because I was not pronating, I am now overpronating just a bit. Mind you, it's a very small overpronation, though.
2) I have a bad habit of rocking my weight forward onto the toe end of my foot when I am standing rather than standing so that the weight is spread out approximately equally over my whole foot.
3) I've been walking pretty much lately, but I'm not exactly walking 5 miles a day or doing 10 mile hikes.

And, boom! the base of my big toe is hurting! I know very well that there are plenty of people out there who are serious overpronators, who have worse standing posture than I do and who walk more than I do and they have no pain at the base of their big toes whatsoever.

I seem to be incredibly hypersensitive to this sort of thing.

Being aware of #1-3 above, I made the following changes:
1) I added a bit more arch support to my shoes to reduce my pronation.
2) I added more cushioning to my shoes to pad the sensitive area.
3) I saw a chiro who used some manipulative techniques to loosen up the restrictionas around my big toe and in my feet in general. I'll see him again next week.
4) I'm being more careful about how I stand. That's easy to do because now when I rock my weight forward, I hurt within about 15 seconds, causing me to make immediate adjustments to my standing.

The big toe isn't 100% better, but it's much improved with just these changes. Also, within 48 hours of increasing my arch support height, the nagging knee pain which has been dogging me for the last couple of months cleared up completely. I think the knee pain was being caused by my very mild overpronation also.

So is this AS-related? Or am I just aware enough of biomechanics that I recognize how I'm straining at sensitive areas? I don't expect you to be able to answer this question; I'm just shouting it to the winds in the hope that an answer will come back from somewhere.

I just don't know, but the question is driving me nuts, because the answer to that question determines what treatment will be appropriate for me.

My current hypothesis is that I have AS, given my HLA-B27 positive status. I just keep wondering if there is something else going on which is making me injury prone or if it's the AS which is doing it.

Karen

Karen,
If you figure it out, please let me know! I have the same problems and questions....

You too, Megan? Do you mean you injure yourself incredibly easily?

Karen

Thanks for your responces what alot of you experience seems very similar to what Iv had. Since 17 anything repeditive seemed to result in my having injuries? Usually dont remeber a particulal event?