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Medial malleolus problem, keeps coming back

post #1 of 6
Thread Starter 

My partner has long had a tendency to suffer from medial malleolus pain from ski boots, which can get bad enough to stop her from skiing. Some years ago, while skiing in Fernie, she had work done on her boots and liners by the bootfitters there which helped a great deal (punching out of the shells and cutting out material from the liner, IIRC), but after a few weeks of skiing the pain came back.

 

So two years ago she went to see a highly respected (and excellent) bootfitter (a regular on here), who set her up with some new boots (Salomon Idol 85CS) on which he did some extensive fitting work to reduce the pressure, although there was limited scope for punching out the shell at the main pressure point because of the location of a rivet. But whatever he did worked - problem solved, pain free skiing! Or so it was, at least, for the next six weeks of skiing - but now the pain is back again. The initial trigger seemed to be an afternoon of ski touring, where she had the boots slightly looser, and I wonder whether that might have meant a kind of backwards and forwards motion over the area which caused a problem. But since then, the boots have come to be more painful on her medial malleolus for normal downhill skiing as well.

 

The obvious question is why it seems to be OK for a few weeks after work being done, and then the problem recurs? My own conjecture about this is that it might be that the liners are packing out somewhat and thereby meaning her ankles are not being held in quite the same position. I have ZipFit liners and I wonder whether these might work for her, too, on the basis that they don't pack out at all over time. But I'd be very interested to hear of any ideas the experts have about this. It's really affecting her skiing enjoyment.

post #2 of 6
Quote:
Originally Posted by J2R View Post
 

So two years ago she went to see a highly respected (and excellent) bootfitter (a regular on here), who set her up with some new boots (Salomon Idol 85CS) on which he did some extensive fitting work to reduce the pressure, although there was limited scope for punching out the shell at the main pressure point because of the location of a rivet. But whatever he did worked - problem solved, pain free skiing! Or so it was, at least, for the next six weeks of skiing - but now the pain is back again. The initial trigger seemed to be an afternoon of ski touring, where she had the boots slightly looser, and I wonder whether that might have meant a kind of backwards and forwards motion over the area which caused a problem. But since then, the boots have come to be more painful on her medial malleolus for normal downhill skiing as well.

 

The obvious question is why it seems to be OK for a few weeks after work being done, and then the problem recurs? My own conjecture about this is that it might be that the liners are packing out somewhat and thereby meaning her ankles are not being held in quite the same position. I have ZipFit liners and I wonder whether these might work for her, too, on the basis that they don't pack out at all over time. But I'd be very interested to hear of any ideas the experts have about this. It's really affecting her skiing enjoyment.

As you go up in flex numbers on any brand of boot you will find that (generally) the  liners become more dense and will hold up longer with less packout over time---so a 110 should hold up longer, given the same amount of weight and use.

 

My first question would have to be does she have custom insoles in her boots, if not then getting some would be a logical next step as they will stabilize the ankle joint medially/laterally and improve control and spread out loading on the bottom of the foot, all good.:)

 

http://www.epicski.com/a/boot-fitting-which-boot-will-work-for-me

 

Read through the above article and pay close attention to how to "shell check" a boot and then do it with her boots. (the place to start)

if her boots turn out to be too big you will not be able to solve this problem until she gets into the right size.

 

mike

post #3 of 6
Thread Starter 

Thanks for the response. The bootfitting she had was pretty thorough and, I believe, pretty expert, with a proper shell check, etc., and custom footbeds made up. The guy who did it has an excellent reputation, and I can't imagine he'll have got much wrong. The question for me (and my partner) really is what could possibly have changed since? The shells won't have altered. Could the footbeds themselves be collapsing and failing to provide adequate support after only six weeks of skiing? This doesn't seem likely.

 

Clearly the best thing to do would be to go back to the guy who did the work, but he's a long way away and if there's some simply things she could try out in the meantime that would be helpful.

post #4 of 6


Does this feel like

 

1)  a rubbing pain (on/off, from movement or motion)?
2)  a pressure pain (constant, and always the same)?

 

 

1 =  we need to make the boot smaller, and tighter, as you are moving around in it a bit

2 = we need to make the boot larger, as you are being crushed by it.

post #5 of 6

Don't know the time between ski trips, but is it possible that while touring (especially with loose boots for skinning) she bruised her malleolus and now it simply has not thoroughly healed?

 

Lou

post #6 of 6
Thread Starter 

Coming back to this thread a year later primarily to apologise for not having responded to the last couple of posts - most rude of me! The season came to an end and I had forgotten about this thread.

 

Anyway, just as a brief follow-up, my partner has in fact now gone for ZipFit liners in the hope of fixing the problem once and for all, and we'll be off skiing in a week or so's time. Given the malleability of the cork material, I'm confident that even if they're not great on the first day, the area around the ankle can be moulded in a helpful way. I'll post back.

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