Wednesday, January 14, 2015

A full shin update

I realized in all the hustle and bustle of the end of the year, the holidays, being sick, being injured, etc, I never full explained what was going on with my shins and what I did/am doing to address them. So here's the nitty gritty for those that are interested and for my own memory.

As December progressed a few things were going on. I was logging some solid mileage at a good pace, with not many 'easy' days (or at least no easy enough). I was running on feel and many of the runs didn't feel too challenging, but mentally, I knew I needed to slow it down before trouble started. I decided to back off the miles a bit during the 3rd week, but it was probably too late.  During my run that Thursday, I felt a sharp pain in my shin. I figured I had misstepped and kept a careful eye on my gait (I was on the treadmill). Unfortunately it happened two more times. It was a very sharp, specific pain right in the tibia. Judging from the symptoms, I at minimum had shin splints, but potentially also their evil cousin the stress fracture. I freaked out and got off the treadmill, went home, iced my shins, and drank a beer for good measure.
Though it may seem drastic, my response was to shut it down completely and begin treating myself for shin splints (Note: it was the start of the holidays, so Doctor's appointments were hard to come by). I knew my legs would benefit from a break and any potential injury would require it.  Initially I had just planned to take a week off, let my legs rest, and then evaluate if I was really injured or just over trained.  Unfortunately with the addition of a bad head cold, that time off got extended. To be honest, I don't think I was ready to run after a week off anyway. I was still having a lot of tightness and periodic pain (not as bad as the initial pain). Though my pain was nothing that was keeping me from walking, it was enough that running a 10 miler was a bad idea. Additionally, I am on my feet a lot at work, so cold turkey on the exercise was the only way to ensure I was getting some rest.

Once the head cold subsided, I was actually rather nervous to run and decided to focus on strength and cross training both to help me get back into the swing of it after the head cold, but also because my legs just didn't feel ready to run. At some point I settled on a test run at 3 weeks at which point I would either start easing back into running or visit the friendly ortho for a bone scan. Here are the ways I kept myself busy during that time.
1. Switched to cross training. For three weeks I did nothing but the bike and the elliptical. I tried to maintain my normal workout schedule. It took me a few days to figure out how exactly to get the best elliptical workout (it was rather comical at the start) but my goal was to mimic my running motion to maintain my upper leg strength and cardio without the impact on the lower legs. On the bike I focused on my RPMs to get a good cardio workout and the elliptical I tried to keep the strides between 160-180 (similar to a running stride rate).

2. Upped my strength training. Regardless of the injury it's always important to think about the entire kinetic chain. Body parts don't move in isolation, it's a team activity. If one part is weaker and not doing it's job, the rest of the parts either pick up the slack or suffer. I focused on squats, lunges, hip work, and ab work. I also added in some single leg work (both strength and balance) because we are never really on two legs while running.

3. Increased recovery activities. I iced after big workouts, wore lots of compression to encourage my shin muscles to stay attached to the bones, stretched, rolled, focused on lower leg flexibility, and took extra calcium to help with bone strength. Anything I could do while resting was fair game.
4. Focused on flexibility. I broke out the yoga book and start to incorporate lower leg and foot flexibility items multiple times per week. I also did several simple exercises that can be done at your desk/in line at the grocery store/while cooking including tracing out each letter of the alphabet with your foot, balancing on one foot, toe scrunches with a towel, and calf raises.
While I don't think I'm out of the woods yet on this one, I've got a good game plan and feel confident at this point that my issues stem from soft tissue injury. I will continue on with all of these activities and slowly add in running as my body allows in order to make sure I don't progress to the dreaded stress fracture.  While taking three week off from running wasn't exactly a picnic (esp when I fun running field trips planned), I was proud of myself for recognizing the need for the time off and staying focused on healing things now to prevent longer and more challenging time off later.

Here are a few great resources

4 Exercises to prevent Shin splints from Runner's World
Ironstrength Workout from Runner's World
A Great explanation of Shin splints, stress fractures, and compartment syndrome

What do you do when you think something is 'off'? Are you a fan of rest?

22 comments:

  1. You handled it the right way. I try to run through a lot of twinges but shut it down as soon as things start to hurt. Keep us updated.

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    1. Thanks Richard. It's always a delicate balance.

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  2. I don't think shutting everything down was a drastic - I think it was smart. Ending up with a stress fracture right now would seriously mess up your marathon training. It seems like you handled this really well and I'm glad you're feeling better, just keep being hyper vigilant about how things feel and it seems like you'll be good! Thanks for sharing everything you did to treat the pain - this post is a great resource now for others.

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    1. Thanks Brenda. Now it's that tricky part of figuring out when I'm recovered enough. Slow and steady.

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  3. Shin Splints are no fun. So annoying really. Good job resting and cross training! I hope it's back to 100% soon!

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    1. Thanks Jen. I'd never had them before, so I didn't realize my tired muscles were something more than that until it got bad.

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  4. It sounds like you have a great plan to get over this! Better to be safe than sorry right?!

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    1. Exactly Courtney! Always easier to take a few weeks off now than a few months off later.

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  5. Sorry about your injury. You'll be back to regular training sooner than later by being smart.

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    1. Thanks Tina. Slowly easing back in.

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  6. I'm glad to hear you don't have a stress fracture! Getting one is a terrible fear of mine. Hopefully everything you did in your off period will help you bounce back in no time!

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    1. It's one of my fears too. I had just met someone the week before this happened that was in a boot for 8 weeks. Totaly made me nervous.

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  7. I am glad to read here that it was probably only a soft tissue problem, but those can be frustrating and take longer to heal than bones! On the other hand if you had a stress reaction, it might have been just the right amount of time to let it heal up!

    Hoping that you are on the track to full recovery. I think you were wise!

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    1. Very true Raina. I think it's trickier to know when they are 'all better'. Thanks!

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  8. This is my first visit to your site, so Hi! But before I remark on anything, I have to comment on the fact that your picture is from Piedmont Park, and you are living in one of my favorite places in all the world. (Born and raised :D)
    Now that this is over, I will return to business. I am, as everyone else is, happy for you that it is not a stress fracture, and that you can still work towards improvement. But as someone who has dealt with the soft tissue injuries of both humans and horses, sometimes, fractures and such are actually easier to deal with--soft tissue tends to continue to misbehave. I hope that the yoga and other interventions help!

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    1. Hi Susie! Yep, that is Piedmont. Atlanta is a fun (and hilly) place to run!
      I absolutely agree. Soft tissue injures linger longer and tend to be harder to judge in terms of being 'all better'. I am happy that is does allow me to still get modified workouts in. Fingers crossed that my shins continue to improve!

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  9. I could have wrote this post! except for the I took off part... it was around Christmas while I was sick that I realized my left shin still hurt even after rest and that my calf muscle was fine, it was actually a little spot that my doc said was my tibia last week. I have a bone scan Wednesday next week.
    You are on your way to being 100% real soon no matter what it is! It was good you just stopped.

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    1. It's funny how similar our injures are. Hopefully rest is making a difference for you!

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  10. Yikes! You definitely did the right thing. I tend to stop a run immediately if I feel a twinge that persists. Usually things are better in a day or two for most tweaks, so it stinks that your shin issues have stuck with you for so long. Did you switch your shoes or anything recently? Here's hoping it heals up soon!

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    1. I didn't switch shoes, but I did get another pair of the same shoe. They might have needed some breaking in. I also was running a lot of 'race pace' miles so perhaps my recovery wasn't sufficient.

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  11. have you tried a massage? my 3 go to's when something feels off: chiro, massage, and PT for tips and or/dry needling (all 3 at georgia sports chiro). i'm crazy like that. i think you handled it well, though. you listened! and are working on strength training to be safe which is always good! :)

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    1. I really should go in for a massage. It would be a good idea in general. The time off was a big help but now it's just getting back into the grove.

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