If you are not going to be able to run in 10 days I would consider seeing if you can defer your race and defer your plane ticket and other travel arrangements.

If not you can go an walk the marathon part.

Swim and ride, no running. Suck it up come race day. I can't imagine putting in 5 months of IM training (not to mention to expense of travel to China) to not at least walk the marathon.

I'm really sorry to hear that. An anesthesiologist would be able to go through your options with you (injections) - but those are usually for chronic and persistent long-term pain. Of course, pro athletes get this done prior to big games so if you really want to compete, then you could get this done by a sports doc or anesthesiologist. I'm not sure I'd do this though...

My advice to you would be rest, ice, and compression until the race - 3x a day for 30-45 minutes each session. In addition, it its a tendon injury, compression on that area during the race may help you complete the marathon. Prewrap, a stretchy compression bandage such as Nexcare Self-Adhering Wrap, and then a compression sock over that may do the trick to keep the pain away for long enough to complete the run. This would be a temporary fix to apply after bike, but may work. Try it out to see if the wrap helps.

I admit, the deferment may be a long shot but you never know.

The expense of an IM, especially one with international travel is something you just don't want to not show up for.

If you can't defer see what your Dr. says.

Maybe 10 days of R.I.C.E will do the trick.

Swim and bike fast and give yourself plenty of time to take it easy thru the marathon.

Good Luck! ;-)

I'd definitely suggest some sort of ankle wrap - in shorter distances I've had plenty of experience and success with a good tape job, but I doubt that would hold up over a marathon distance. Some sort of supportive, compressing bandage perhaps? Or even a brace? I've seen plenty of ankle braces used in ~10k distances, so I imagine they'd last longer.

Best of luck and a speedy recovery,
Anthony

Cho-Pat makes a great soft ankle brace that I used in my last two ultras after spraining my ankle at the JFK 50 miler. Neoprene bootie and velcro strap.
Just go walk it with running breaks if you can. If Desiree Ficker can walk an IM marathon in 7:09 (IMLP 2005) you can do it!
I guess now, you get to see what kind of Iron your made of.

So even before your first IM, you've learned the first rule of IMs - anything can happen!

I hope you can find a way to complete your IM, maybe with combination of a good wrap, walking and running if you can manage it. I've attempted two IMs and the first one I had to drop out the week before the race so I know first-hand it is emotionally wrenching to do so, especially after all that training! The 2nd one, I had a foot injury occur in the swim (of all places) and did the bike and run with a dislocated big toe, so I also know how hard it is to gut through the run with a lot of pain and injury. But, I finished it and actually had a great time, so I know it can be done. Ironman is a lot of training and one long day so I'm sure many folks have been in similar situations with something unplanned happening and trying to make the best of it.

Best of luck to you, whatever you decide to do! And remember that if for some reason you can't complete it this time, it doesn't have to be your last. You are young and can come back to tri again another day.

thanks for all this guys, i think i'm leaning towards the walking / taking it really easy on the marathon portion, racing in China is only half "race" anyway, as much an adventure & cool experience.

firegirl - if i had a cortisone shot just to keep the pain away, my odds of tendon rupture are pretty slim I assume? I realize i shouldn't dismiss the potential risks even if so, but just to get through it? i don't want to do anything stupid here, but REALLY want to do this

everyone's comments are good. Again, just ice and use some of this time to taper and take it easy. If your such a strong runner, definitely dont do any running 10 days before so you have time to heal your injury. You shouldnt have to worry too much about losing too much fitness by just biking and running. Maybe your marathon time will suffer a little bit, but its better to lose some time rather than drop out of the race entirely or not even be able to start the race. ITs too bad that this happened, but it does happen, so dont kill yourself if come race day you have to drop out. But i definitely wouldnt recommend running right now.

i'll answer your questions in order.
1. yes, simply tendonitis may be aided with compression to jog a marathon; arch support may help as well, but difficult to say exactly without examining.
2. tendonitis is common in runners; ptt dysfunction is more common in sedentary people, but either may occur in people with flat feet; attritional tears are likely in longstanding conditions; acute rupture is not terribly common.
3. a partial tear can be helped with injection in a very temporary situation (like this one) as it helps to cause the inflammation that likely lead to the tear, and is usually a large component of the pain generator. as we discussed before, though, injection can increase the risk of rupture and in a tendon that is already weakened, this is a pretty big chance to take.
4. physical exam by a qualified surgeon will give you 90% of the diagnosis, but you are right on the money that further imaging would give you the most bang for your buck; MRI would show whether the tendon is intact, inflamed, partially torn, etc.
nutshell-- if it was my foot, i'd tape/compress/support the crap out of it and jog-walk with the NSAID of your choice on board (aleve, ibuprofen, celebrex, etc); but i would not inject; if OP isn't planning on winning this IM, rec getting the experience and coming back healthy next year.

i prefer 'scrubs.'

ortho md.

will keep medical prosyletizing to a minimum :-)

+1 scrubs is the bestest

general medicolegal disclaimer: nothing i say should substitute for seeing your doctor. :-)

clarification:
- nsaids before & after, not during; scheduled for 3-5days prior to the race can really help with inflammation and pain and will not affect renal function in pts without renal disease; i'm not sure what you mean by "in the volumes required" but you shouldn't be taking more than the recommended doses unless you are actively followed by a doctor who recommends this (rx doses of ibuprofen are 800mg 3x/day, aleve/naproxen 500mg 2x/day)
-anti-inflammatories can affect renal function, and hydration is definitely key; a seasoned triathlete or someone followed by a sports md/trainer, etc may be able to achieve the necessary hydration and nutrition balance to take meds during the race, but for anyone else i would not take the chance.
-ironmom had an excellent point that most nsaids can cause GI upset, so i wouldn't take anything new before a race; they should also be taken with food. the amount of food most athletes take in during a race is probably not adequate to protect your stomach, but you have to know your body.
cheers.
fg

wow! sorry to hear that. Kentucky should be pretty warm too