Friday, May 13, 2011

What's Up Doc?

Over the last year or so, I've been plagued with some pain in my shins, or more specifically, my tibia bone, on both legs.  It started around last February, when I decided to try a new, highly intense run program, without really building up to it first.  That was mistake number one.  Mistake number two was not allowing myself the proper amount of rest between runs.  I would typically do my runs, as well as play around three hours of basketball a couple times per week, on a tile court.  Mistake three was not recognizing that I had developed a pretty severe case of shin splints, and should have taken time off to heal, which I did not.  So this leads me to where I am today.  Having to hang up my running shoes for at least two weeks, hopefully not any longer.

Last year, once I had realized that my shin splints had lead to a more serious problem, I stopped running for about three months.  I was fairly positive that I had developed tibial stress fractures in both of my legs.  I went so far as to have an X-ray done, which came back negative (side note: X-rays are not an appropriate way to diagnose stress fractures, as they typically do not show up.  The more appropriate way is through a bone scan.  Unfortunately, it's pretty difficult to convince a doctor that you should get a bone scan, as they feel an X-ray will suffice.).  The reason I believed I had stress fractures was because of the associated symptoms.  Unlike shin splints, which cause pain along most of the shin, I had paint at one specific point on my tibia/shin bone.  It didn't typically hurt when I was walking around, but when I started running, it would hurt for the first five minutes or so, and then the pain would dissipate.  From all of the research I did, I had a classic case of a tibial stress fracture.

Through my research, I also found that there isn't really any treatment for stress fractures, other than rest, which is why I took those three months off.  And taking those three months off seemed to have worked.  I did all my training to qualify for Boston without any problems.  Last Monday, however, I started to have some pretty severe pain in my left leg, at the same exact place where I had the previous stress fracture.
Right where my finger is touching my leg is where I feel discomfort.  It's basically at the same spot on both legs.  If I push on my shin bone at that exact spot, I feel pretty awesome pain.
I've been in contact with a Physical Therapist (we'll call him Doc), and he made me not so happy.  Doc confirmed two things - that what I described to him did indeed sound like a stress fracture, and that there really isn't any treatment, other than rest.  Tibial stress fractures are typically pretty slow to heal, so I have to be committed to my rest.  Doc advised that I not participate in any activities that cause me pain.  This means that running is most definitely out.  The good news is that cycling and swimming don't cause me any pain, so I will be continuing to participate in those sports.  However, if at any point I begin to feel pain, I will stop immediately.  On the running side, I'm going to be using an elliptical machine to at least get some sort of running-type activity in.  If, after two weeks, I feel that I'm pain free, I will begin some light running on a treadmill.  If I'm not better, then I will continue the non-running for another week and then evaluate.

Needless to say, I'm pretty bummed out about this.  The run that I did on Monday was a great run, even with the pain (I did twelve quarter-mile sprints in 1:19 each, which is about a 5:16/mile pace), so it sucks to have to take at least two weeks off, maybe more.  But, I recognize that it's much better to take the break now and miss the training while I still have a lot of time before the big dance, instead of not letting myself heal and compromise being able to race at all.

So if you see me and I look depressed, this is why.  Hopefully things will be back to normal in a few weeks!


  1. I just randomly came across this post last night when I was googling the same thing! I'm writing right now because after seeing three doctors, the chiropractor today was the only one who helped! I had the x-rays done before (nothing showed up of course). I saw another doc who told me it might be a stress fracture and to stop running. When that didn't help I saw this new guy today who pin pointed the exact pain and it's not a stress fracture. There's a tendon that run from the bottom of your foot near the big toe, up along the arch, around the back of the inner ankle and then attaches exactly where you (and I) was feeling pain on the shin. Try rubbing those areas and see. He massaged those areas (which killed) and did ultra sound and then I iced them. He said that should help and I should be able to keep running. I just thought you may want to know because I was so frustrated seeing docs and searching online but was happy today to finally figure it out. Best of luck!

  2. Thanks for the comment! It sounds like you are talking about the tibialis posterior, and more specifically, tibialis posterior tendonitis. It is a possibility that this was what I was experiencing, however injury with this tendon is typically visualized by a slight flattening of the arch. I was able to rest my legs for about 2 weeks, and the pain in my legs has been basically eliminated, so I am unable to rub the specific areas on my foot/leg that you are referring to, and therefor cannot test to see if I have this issue. If I ever have a flare up of lower leg pain again, I will definitely take into consideration your experience and use that to help me figure out what is wrong. Thanks again and good luck to you!

  3. Hi Jason,
    Wanted to see how the recovery went on this injury. Today I come off an 8 week recovery for Stress fractures and would welcome any tips you have.

  4. What' up TP? The recovery was definitely a slow process for me. I knew that there was really only two options for treatment, and those were rest or surgery. I wanted to avoid surgery, so I did some serious resting. After about 3 months, I eased back into running very, very slowly. In fact, when I started running again, I did ALL of my running on a treadmill (softer on the legs).

    This injury that I wrote about in this post was a little flare up of my old injury. I didn't do any running for about 2-3 weeks, and then eased back into it starting on the elliptical machine (lame, I know). After a week or two of that, I started up with some slow, easy running. It wasn't for another month or so that I started picking up the pace again and adding some speed work.

    I now take glucosamine and chondroitin, and things seem to be going well. I just make sure to stay very aware of any pain that I feel in my shins. If I do feel any, I back off and take a day or two rest before running again.

    Good luck with your recovery!