Recovery and Prevention Advice for this Lower Leg Use Injury???

[Ethan A.]

Sincerely appreciate your advice. Please scroll down to next post…

[Ethan A.]

Appreciate any advice from the BPL recovery brain trust. Fortunately haven’t been sidelined often by injury, and when I have, I’ve been good about icing, stretching and PT exercises on my own. Notice I didn’t say rest – that’s the hard part – like most here I love moving outside on my feet.

Not resting enough was my bad this time too, and I’m trying to isolate what would be best to speed recovery and prevent this going forward. Note I’ve always had slightly less mobility in my L ankle – my L foot flexes back toward me a bit less than my right, my L foot flexes a little less to the outside than my R and my L calf tends to be a bit tighter than my R.

For strength exercise I do body weight and band exercises and for aerobic hiking, jogging, trail running and climbing stairs. A few months ago I started yoga 40 min/day about 5x/week as part of body weight exercises – mostly warrior poses, tree poses and planks front, sides and back. I was jogging throughout this time on and off but also doing a lot of desk time. The yoga felt great. However after some time the warrior poses with my L leg to the back with L foot twisted out, and tree poses balancing on one leg seemed to be giving me L anterior shin splints (Tibialis Anterior or outside shin muscle). L leg only. I iced and stopped yoga for a few days and it would come back when after the yoga again, probably because I never gave it enough rest.

In the middle of this a few weeks ago I dove to the ground in a kneeling position during a game and landed a bit hard on the outside bottom of my left knee. Didn’t feel I injured my knee itself, but afterward whenever kneeling and putting weight on my knees (which I do during a shin stretch) I’d feel a sharp pain under and to the left of my L knee between the top of the Tibia and side/bottom of the Fibula. This has been getting better every day but still feeling after a few weeks.

2 days ago, after yoga in the AM and a jog that evening, my lower L leg rebelled. In addition to the L anterior shin splints, I felt some tightness in my L calf, so sat on the floor and rolled my L calf top to bottom over a lacrosse ball and stretched calf and hamstring by pulling on my foot with a belt. 30 min later started to get 1) pain in my lower L calf and upper Achilles Tendon; 2) pain in the strip of muscle/tendon on the outside of my L ankle above the ankle running up the lower leg, and 3) some tenderness and pain in the outer top of my L foot below the ankle bone (where your foot attaches to your ankle).

I know I’ve got to rest the lower leg. I’ve been icing both the L lower outer shin and lower calf/upper Achilles 20 min at a time every few hours with a neoprene wrap that holds the ice pack. I haven’t taken any NSAIDS. Once things calm down, I think I need to:
-Cut yoga to every other day
-Strengthen the shin muscles (for example, walking on heels)
-Stretch the L IT band by rolling over a roller between hip and knee
-Strengthen and stretch calves
-Up running time slowly

Sincerely appreciate any suggestions for speeding healing and prevent this from coming back.

[Paul Wagner]

First of all, it’s a really poor idea to get medical advice from people on the internet. Just sayin’.

My experience with shin splints is that they are more likely to be cause by jogging than by yoga. You may have felt the pain during yoga, but if you have shin splints, cut the jogging immediately. Rest is indicated.

And you may discover that rest is really the best solution. You may also discover that as you get older, things hurt more and take longer to heal. They do for everyone else, so I doubt you are going to be much different.

The usual remedies apply; rest, ice, compression and elevation.

Find a good book.

[MJ H]

I agree with Paul about the internet, the jogging, and the getting older so you need more time to heal. I have not the slightest idea about yoga, unless you count the Wii Fit. If you fell to the ground hard enough to bruise your bone, your knee will take more than a few weeks to heal (but still heal fine). Your body might be putting more stress elsewhere to protect that knee in the mean time.

Though bone heals slower than skin or muscle, it heals much faster than tendons. The Achilles tendon is a murderous bastard that deserves its place in legend as a fatal weakness. It responds to rough treatment by causing heel spurs, which are unfortunately not something named by somebody with a fanciful imagination. Treat it like it’s a kidnapper with a gun pointed at your ability to move easily. I have come to deeply regret not taking a long enough break from jogging when my tendons told me I needed to stop.

[Terry Sparks]

The sooner you start your period of rest, the sooner you will be back on the trail. Without personally seeing how you walk and run, I can only suggest that you look at your mechanics of walking and running, including both legs. It’s possible you are compensating with your left leg and putting stress on it, causing some of the problem. I ran marathons for over 10 years and never heard of anyone with medial tibial stress syndrome (shin splints) affecting one leg only.  With all the other problems you describe affecting your left leg only, Achellies, knee, ankle and calf, it seems plausible you are compensating for something originating in your lower back, hips or right leg.  Finding the cause and correcting that will get you back up and going again, it seems you are treating the symptoms.

[Ethan A.]

I am resting it now and icing regularly and feeling better. Walking briskly in comfy shoes but not jogging. Also checking it out with an orthopedist.

@Paul, thank you, you’re right on all counts. However, while I agree the internet shouldn’t be your only source, your active friends and the internet are important sources of information. I have a fit cousin in his mid-60’s who says, “He who multiplies doctors multiplies troubles.” There’s truth in this especially in a system that doesn’t reward prevention but does reward sending people for many unnecessary tests.

I have a bio background and some experience in healthcare and medical R&D as well as being point person for family members when they were hospitalized. If not for some folks on BPL including Roger Caffin, as well as runner friends and some good info on the web, I would have continued to follow the absolutely damaging advice of 2 terrible podiatrists. I eventually listened to myself and experienced walker friends and literally through their crap in the garbage (unnecessary metatarsal pad and orthotics) and just bought good shoes with more forefoot room, lower drop (4mm) and good padding. Cured.

How bad can they mess you up? After returning from a Point Reyes GGG 23 miles hiking on a metatarsal pad that wrecked my foot, I found out the podiatrist who insisted I needed it gave me one sized for a size 16 foot because she thought I was a “big guy” (she was about 4 ft 8 in., I’m 6 ft tall 175 lbs, size 11 foot). Also found out she had 2 weeks experience. In my first meeting with her and the other bad podiatrist, I brought my trail and running shoes and told them I thought I needed a wider forefoot. I was right – while they thought there was no need to see my shoes. I found out the second podiatrist had a mountain of complaints including from many employees who saw him from his own medical establishment. Both working at prime SF Bay Area hospitals and clinics. Both terrible.

[Ethan A.]

You’re also right about the jogging. I traced back the start of this to one day running fast 15 minutes in hard dress shoes (Ecco but no cushion) carrying a heavy bag catching a train. Didn’t stop jogging after and the tree poses exacerbated things.

[Ethan A.]

@MJ H, thank you for the advice, realizing that and taking it seriously. My Mueller ice/heat pack (I’ll post it later) is a real help. Lets you ice or heat almost any body part while working at a desk or moving around. So fantastic my wife and I each have one.

@Terry, the main things I could be compensating for are slightly less mobility in my Left ankle and slightly tighter left hip (a reason why I love Yoga – really opens up your hip).

In the first 6 months of airborne training (and after), while many of us had shin splints at one time or another and usually in both legs, I had friends who had them in one leg or worse in one leg. Got over them. I had them slightly worse in my left leg, again probably the biomechanics of my left ankle and hip.

The knee issue is directly the result of a fall onto rock-hard ground just below the knee on the outside side. Not super hard but hard enough to still feel 3 weeks later.

I find it takes good docs/PT’s who are active hikers and runners themselves to focus on prevention. I hope I find someone good. I’m working overseas for about another two months and far from good people I know back home.

[Author]

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