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1022 Views 1 Reply Latest reply: May 22, 2013 11:41 AM by JamesJohnsonLMT
megzie1234 Rookie 1 posts since
May 21, 2013
Currently Being Moderated

May 21, 2013 6:47 PM

Inner ankle/shin pain. Has anyone had this?

Since March, I've been dealing with shin splins. (I had my 3rd full marathon scheduled for May). I got an MRI per doctors orders, and it came back clear. (This was about a month ago). I took a few weeks off running, and then I ran the marathon anyways by doing a walk/run split. I know it wasn't the smartest decision, but it happened, and I know not to do that again.

I ended up feeling great after the marathon, I ran 3 times the week after, and 3 times the week after that. Sticking to 3-4 miles. I've bumped it up to 5-6 now. I started to notice that the very inner part of my bone hurts in just one spot. When I press on it, it has a very strong burning sensation. I cringe when I press on it. But it's pressed on firmly, so maybe it's in my head? So I've continued to run, thinking the pain is in my head and that I'm not actually injured. It hurts to run, starts out sore, and just gets worse as I run. By the end of the run, I'm limping, and after I'm sitting down for a while (with some ibprophen), the pain subsides for a while. I've had shin splints before, and usually it's a muscle pain. Although my calves tend to ache. This feels a lot deeper. I've had stress fracture scares before, but this is a lot different and actually hurts quite a bit when I run and my foot start to ache too when I'm running (on the same leg where there's pain). I'm able to run through the pain, I don't know if I'm just a stubborn runner, or if the pain just isn't that bad. I do have a high pain tolerance. Also, it doesn't hurt much if I hop on one leg once, but it aches if I do 10 hops, and it hurts to go up the stairs if it's a jog. My leg isn't swollen, maybe a little more cushioned around my ankle than the other, but no huge difference. The pain seems to ache even when I'm not running but at very random times during the day, and usually it's BEHIND my ankle, which I find strange. I'm larger boned, and about 10 pounds overweight. Not sure if that would have anything to do with it.

Has anyone dealt with this kind of pain before? Can you please share your experience? I know you can't diagnose me, as I have a dr appointment but not for a whole week.

  • JamesJohnsonLMT Legend 1,291 posts since
    Aug 23, 2009
    Currently Being Moderated
    1. May 22, 2013 11:41 AM (in response to megzie1234)
    Re: Inner ankle/shin pain. Has anyone had this?

    I suspect you know what your doctor will tell you. The urge to continue to train is well understood by users of this forum, but I think all would agree to give you permission to stop training until this issue is resolved.  It's OK.. We get that you are highly motivated, and definitely not a wimp.


    While it is fairly well known that certain benign forms of muscular soreness can respond well to the circulatory benefits of continued exercise,The old adage "listen to your body" applies here.  If it does not seem like the usual muscle pain with which you are already very familiar, it probably isn't. I agree that increasing pain during exercise, and intermittent pain at rest, are not good signs. You have been very observant and your account is detailed.


    Though length of down time is an important factor for determining how long it will take you to regain your fitness after you solve this recent issue, the amount of time you spend running through pain can set you back much  further than rest time. To put it another way, trying to exercise until your doctor tells you not to, makes it seem like you have no control over your health and fitness, and you certainly do. You have the primary responsibility for putting on the brakes when signs point in that direction.


    One metaphor for what may be happening involves an understanding of diagnostic imaging, and the diagnostic process itself. For example, it takes about 8 years for a cancer to develop to the point that it can be detected by conventional means. Another example is the typical stress fracture: not visible until calcium deposits begin to form. In other words, waiting for a concrete diagnosis can be the same as waiting until it is too late to reverse the condition you  fear. Anybody can have 20/20 hindsight. You want to develop the ability to ameliorate problems before they develop out of control. This recent setback is a concrete example of that.


    I  think it is useful to view recovery time as money in the bank. The interest may appear small, but it still accrues in a positive way. Running injured, on the other hand, is like a payday loan. The interest is much higher, in a negative way. Bottom line is, you will get better  overall results by undertraining, than by overtraining. You can always live to fight another day.


    Regarding any techniques for self-diagnosis, I think you have offered an abundant amount of evidence for any competent physician to use, so your efforts to muddle through have not been completely wasted. Sometimes people give up too early, and it puts a lot more pressure on the doctor to come up with a  solid diagnosis. However, there are diagnostic tests that can deliver most of the same knowledge as the school of hard knocks, in less time, with less potential damage.


    I'm not sure which bone you  feel pain in, but I'll assume from your mention of "shin splints" it is  the Tibia. The anterior/medial surface of the Tibia has no muscle, so  pain from pressure on the bone is often assumed to mean a bone problem. Fair enough, but there are plenty of places on the human body that are  sensitive to touch without any injury present. If you checked the same spot on the other leg, and it was not as sensitive, there is a better chance you are on to something.


    However, tissue  near an injured site often has enhanced sensitivity. There could be  portions of the periosteum covering your bone that are sensitive due to damage or inflammation nearby. Your sense of depth can be quite  misleading. For example, a strain where the rear calf muscle Soleus attaches to the bone might enhance sensitivity to pressure along the adjoining Tibial bone surface. Similar pains can occur on the Fibular side that feel, for all the world, like a broken bone. Some rear calf muscles will produce pain in the vicinity of the Achilles tendon that feels like tendinitis.


    If scans continue  to show nothing major, it may not be the usual muscle problem, but a new one. Yes, muscle problems frequently feel like they are deep within bone. The perception of pain is a mental construct that approximates a  3D image of what's actually wrong. It isn't perfect information, but useful in that it gets people (most people) off their feet. That's what  "listen to your body" is all about. It may not be accurate, it may be teenage histrionics, but it (usually) works.


    So, my advice is to take a real break, so to speak, get off your feet, and keep probing for specific symptoms, locations, and actions that will help your doctor form a better diagnosis. If the tests still come up empty, your body may just have become very convincing when it comes to warning you of overtraining, which in this case would probably be a healthy adaptation.


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