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View Full Version : Shin splints, stress fractures, plantar fasciaitis, orthotics, Oh My.


Daniel Holcomb
09-11-2010, 06:10 AM
TL;DR Version: Please help a non-athletic-background feral crossfitter develop strength and flexibility in his feet and legs so that he can get rid of chronic shin and arch pain and run far and fast enough to get into police academy. Also, twice this summer, when my shin pain spiked in the shin that I stress fractured, I developed a half-dollar sized bruise right at the most painful spot, on the inside of the shin where you can feel the bone, two thirds of the way up from the ankle towards the knee, that took a week to go away, and was not the result of banging my shin on anything.

Long Version:

So I was raised a nonathletic homeschooled bookworm. I did some pretty extensive hiking in the last two years of college, and walked everywhere as I was not a car owner. I never had foot or leg pain issues, even though I bought cheapo shoes and wore them until they fell apart.

Fastforward to 2.5 years ago, at the age of 24, I began training to go to Officer's Candidate School. I ran in hand-me-down running shoes, on pavement, and developed classic shin splints. I kept running in new shoes, on pavement, and they didn't improve.

I went and saw a local physical therapist (I live in the country, far away from civilization, and the quality of medical care is not the highest) and he recommended expensive custom orthotics along with physical therapy, and told me that I had to stop wearing sandals or barefooting and rest a lot.

I did this for three months and developed severe arch pain and spent most of my time sitting at a desk or lying on the couch, when I wasn't walking rounds at work (I am a campus security guard). I wore boots and orthotics all the time. My physical therapist had left town and I had run out of money anyway. I talked to my doctor and found another physical therapist an hour away. A bone scan indicated that I had stress fractured my right shin, and my physical therapist told me the custom orthotics were way too aggressive, and prescribed cheaper GoodFeet plastic/foam archsupports. She taped my feet up twice a week with Kinesio Tape, which is pretty cool stuff, we did exercises to strengthen my calves and loosen my arch ligaments and build stability in the legs.

Now we're at last August, when I started running again, and promptly had a relapse of the pain in my shins, right where I had previously stress fractured, and I still had recurrent pain in my arches. I went to an orthopedic surgeon, got a third physical therapist, who stepped me down to soft arch supports from the sporting goods store. The pain in my arches decreased.

Sensing a pattern, I worked down to no supports in the shoes, and had a lot of success with Brooks Adrenaline shoes. By April of this year, I was beginning to run again, through a lot of pain. I saw some improvement, but every three to five weeks, I would have a lot of shin pain that would force me to take a week or two off of running.

Two weeks ago, I was running five to six miles a week, with steady, low pain in my right shin. Then the pain started increasing again, and I've been down to one or two stiff, sore, unhappy miles a week and lots of residual pain during the day.

Part of this may be attributable to doing fewer of the prescribed therapeutic-type exercises (calf raises, careful stretching of the lower back, hamstrings, calves, and arches) due to time constraints: if I have the time to run, I'd rather pack that into my day than stretching.

Part of this may be me just running too far, too fast, too much. I have no idea what a sensible running progression or build is. This summer I have been attempting to run M-W-F, 1-2 miles at a go, taking Friday off on weeks if pain seems to be increasing. I started at quarter/half mile days, and built up to 1, 2, and sometimes 3 mile days. Sometimes, I could pack a lot of mileage into a week without seeing an increase in pain...sometimes I could run a mile or two with no significant pain, just aches and tightness...and sometimes I would from the first quarter-mile.

I also have no way to gauge what is "good pain to push through" and what is "bad pain to stop exercising" and my physical therapists have all been very vague when answering this question. Either they tell me no pain at all (which ends with me on the couch whenever I'm not at work, which increases my pain because my muscles get all tightened up).

I bought a pair of Nike Free Running shoes and a pair of Vibram Five Fingers. I love the feel of walking/running in both, but they cause my left arch to really start to hurt after anything over 2 miles, and usage more than twice a week, and my right shin began getting more painful. However, my legs have responded well in the past to going for a barefoot mile or so walk, with a weighted backpack, once a week.

I find that box jumps can be painful in the shins, especially when I jump down instead of stepping down. On weak weeks, I get spikes of pain in the right shin, on strong weeks, just some aches and weakness in the left arch and maybe one or two reps with pain in the shin before they warm up. Double unders a couple of weeks ago felt amazing, and I followed them up with a run that felt amazing, but completely destroyed my calves and the next few times I attempted to run I cut short after a mile because of the increasing right shin pain.

Things that have recently worked: I have noticed that my arch pain increases if I spend a lot of time resting them by sitting down. Standing up after sitting down was the most painful part of the day. So I solved this problem by never sitting down, even at the desk at work. It was exhausting, and definitely worked my lower back, but it did produce an overall decrease in pain.

Since I haven't been running this week anyway, I decided to test the hypothesis by spend as much time as possible on my feet, and replacing the running with long, speedy walks straight uphill in running shoes, and long slow treks barefoot in the woods and the mighty Genessee river. I've put in nine miles this week, on top of an increase in walking around campus at work, and my pain this week (and the non-traumatic bruise on my shin) have decreased. So I'm chalking that up as a success, and something I will continue.

Does anyone have any info into how bad the non-traumatic bruising is, what it might be indicative of? Anyone have advice for building barefoot strength, or a detailed explanation of the "proper" foot placement and stride, keeping in mind that jogging up stairs and uphill, or running on my forefoot, seems to aggravate the shin and arch pain?

What's a sensible amount of mileage/mileage increase for running post injury?

Thanks!

Jason Wallis
09-11-2010, 09:12 AM
http://www.board.crossfit.com/showthread.php?t=60991

Katherine Derbyshire
09-11-2010, 03:00 PM
Part of this may be attributable to doing fewer of the prescribed therapeutic-type exercises (calf raises, careful stretching of the lower back, hamstrings, calves, and arches) due to time constraints: if I have the time to run, I'd rather pack that into my day than stretching.

I'll let others comment on the rest, but this is a poor decision. Weakness and poor mobility are almost certainly part of the problem. Even if they weren't before, they are now after all that rest and all those weird orthotic attempts. Stretching and walking -- barefoot on trails, not on pavement -- should be enormously helpful in terms of building up basic foot and leg strength.

On the pain issue, I'd be very conservative. You clearly have some serious weaknesses and some inadequately healed injuries. This is NOT the time to prove how tough you are. If running hurts, and especially if it hurts more as you get warmed up, STOP. Which doesn't mean sit on the couch, it just means stop doing the specific thing that hurts.

Katherine

Steven Low
09-11-2010, 06:02 PM
Here ya go... read the whole thing (all 5 pages) wfs and start working on corrections

http://www.eatmoveimprove.com/2009/11/shoes-sitting-and-lower-body-dysfunctions/

Daniel Holcomb
09-17-2010, 08:18 PM
Folks,

I had the last four days off work. Now that I'm back, it's good to see that I have lots of good reading, and I'm defininitely going to attempt to do it without sitting down :)

Thank you all, I'll post more later.

Dan

Steven Low
09-18-2010, 06:36 AM
Cool. Keep us updated.