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Ankle pain skiing - should I see a boot fitter or a physio?

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 kathrync 29 Feb 2016
So, I get pain in my right ankle when skiing. I think it is stress rather than pressure. On a day of skiing easy groomed runs, it hurts towards the end of the day. If I am skiing harder stuff or stuff that is chopped up, it will hurt earlier in the day and it can also be brought on by prolonged traverses or awkward button tows. Once it begins to hurt it doesn't really subside until an hour or so after I have taken my boots off, but putting my boots in walk mode can give a bit of relief (slackening or tightening the buckles doesn't make much difference). The pain is from the just behind the ankle bone on the outside of my ankle and radiates up the outside of my calf just in front of the big muscle at the back of the calf to about half way up my lower leg. I have injured that ankle a couple of times in the past. I have always had the same pain to a greater or lesser extent in every pair of ski boots I have owned or rented - but as I am pushing my skiing more and getting off the groomed runs it is becoming more of an issue.

So, where should I spend my pennies to try and sort it out? Not sure if a boot fitter or a physio is more appropriate here! Anyone had similar problems?

Thanks
 ClimberEd 29 Feb 2016
In reply to kathrync:

Potentially both.

1st stop - the best bootfitter you can find. If your boots don't fit properly nothing else will help.

2nd stop - once the boots fit, if the pain continues, physio, as ski boots shouldn't hurt (whether touring, downhill, bumps, whatever)

FWIW as a moderately (very by British standards) experienced skier, it sounds at least somewhat boot related. A common problem is doing them up too tight to compensate poor fitting which then leads to pressure problems. Slackening the buckles won't help much once the problem has been triggered on a given day.
 Jim Hamilton 29 Feb 2016
In reply to kathrync:

I had "outside" ankle pain solved by adjusting the cuff "canting?".
OP kathrync 29 Feb 2016
In reply to kathrync:

Thanks both. I do have a tool thing for adjusting cuff alignment so I will have a play with that as it is the obvious thing that I haven't looked at myself. I'll make an appointment with a boot fitter too as my footbeds are in need of replacement anyway.
 summo 29 Feb 2016
In reply to kathrync:

If you have enough ski experience you probably have an idea on how good your boot fit is.

A physio who skis, or connected to the sport. It could be that your old injuries are niggled by the stress skiing places on different bit, that does not show in other sports.

OP kathrync 29 Feb 2016
In reply to summo:

> If you have enough ski experience you probably have an idea on how good your boot fit is.

Yeah, overall I think it is pretty good. I don't have any spots that rub/blister/pinch, no hot spots, my feet don't get numb or cold, and my feet don't move forwards/backwards or roll in my boots. My left foot is absolutely fine. I do think cuff alignment is worth a look though.

> A physio who skis, or connected to the sport. It could be that your old injuries are niggled by the stress skiing places on different bit, that does not show in other sports.

Yeah, I was wondering about this. I do occasionally get similar pain traversing on slopes while walking, more so in crampons - but it is much less pronounced than when skiing. As suggested above I will look at my boots first - but the physio I see for running niggles is a skier, so I will go and talk to him if that doesn't resolve it.

 SiWood 29 Feb 2016
In reply to kathrync:

This sounds like the problem I get on an intermittent basis. For me it is related to tightness in the calf muscles (both) which is made worse by the forward tilt of ski touring boots (and when extra pressure is put on them either traversing or in crampons in normal boots).

The only solution that has worked for me is to slacken the boots at the beginning of the day to allow some muscle expansion. It is definitely worse if I have to ski something difficult at the beginning of the day without warming the calfs up in slightly slackened boots.

It has got better thye more skiing I have done but still seems to be related to the amount I can warm up on any particular day.

Reducing the forward lean position on your boots may help - but might not be beneficial to your skiing style!
 summo 29 Feb 2016
In reply to kathrync:

Sounds like injury related if you have something similar when traversing in crampons, roughly vertically body, rotated or angled foot with weight committed etc..

It is of course possible one boot fits better than the other. Have you tested your niggle, left and rightward turns, say carving on something pretty steep and wide, so you can build up some pressure and get chance to try and identify where it is initiated?
OP kathrync 29 Feb 2016
In reply to SiWood:

> Reducing the forward lean position on your boots may help - but might not be beneficial to your skiing style!

It might not be great for my skiing style, but it has to be better than skiing (very carefully!) in walk mode, which is what I resorted to on Saturday!

OP kathrync 29 Feb 2016
In reply to summo:

> It is of course possible one boot fits better than the other. Have you tested your niggle, left and rightward turns, say carving on something pretty steep and wide, so you can build up some pressure and get chance to try and identify where it is initiated?

Interestingly, I did Gillian Culshaw/Parker's ski performance course the other week and on video review it was quite obvious that I carve turns to my right (where more weight is going through my left foot) and skid turns to my left, where the right foot is taking the brunt of the force. I am wondering if I am subconsciously trying to avoid putting too much pressure through the right foot.
 summo 29 Feb 2016
In reply to kathrync:

> Interestingly, I did Gillian Culshaw/Parker's ski performance course the other week and on video review it was quite obvious that I carve turns to my right (where more weight is going through my left foot) and skid turns to my left, where the right foot is taking the brunt of the force. I am wondering if I am subconsciously trying to avoid putting too much pressure through the right foot.

everyone has a stronger or favourite side, but if yours corresponds with your injury it's unlikely to be coincidence.
OP kathrync 21 Mar 2016
In reply to kathrync:

Update:

I went to see a boot fitter last week (SolutionsForFeet in Bicester for anyone who cares). He made me new custom insoles (I was using custom insoles before, but they were old and falling apart), added heel lifts, and made some minor changes to the shell. Apparently the root of the problem was poor range of motion in ankle flex - my boots were forcing me to flex more than was comfortable, causing pain.

I skied over the weekend - I kept it easy, but it was wet heavy sugary snow that would usually have caused me pain, and it was fine. As an added bonus, I am finding it easier to control and engage my inside/uphill ski.

So, anyone swithering about going to see a boot fitter, do it!
 Edradour 21 Mar 2016
In reply to kathrync:

> It might not be great for my skiing style, but it has to be better than skiing (very carefully!) in walk mode, which is what I resorted to on Saturday!

Doesn't help with your pain at all but skiing in walk mode is very good for your skiing technique as it keeps you centered on your skis!

Not something to try on hard, steep stuff though...

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