Amy and Ben

Goodbye 'Nasti, Helloooooooo Boulder

I'm sure by now everyone has heard our awesome news about Ben's TA award in Boulder! We are so looking forward to moving out west! It's CRAZY to think that we've been here in Cincinnati for nearly 10 years... can it be? We'll keep you posted as we know more information such as when we'll be moving and what I'll be doing, etc. We're working on it, but we're taking small bebe steps! No need for an anxiety attack.



My marathon training has been on hiatus. Most people close to me are aware of my running injury - the dreaded shin splints. This has been a huge disappointment for me not only because I have paid so much money for the training program and the marathon itself, but because I truly love running and am frustrated that I did this to myself. Shin splints occur from doing too much too soon. I pushed myself too far in January after taking the month of December off from running. Apparently I did not allow myself to adjust to the amount of running I was doing - and my body never healed.

Here is a description of my problem that you might find helpful. It sums it up better than I can with my own words! You can check this article out or simply continue reading.


Medial Shin Splints

The outmoded term medial shin splints has been replaced by the term medial tibial stress syndrome. Either term is fine, the pain is at the medial aspect of the leg, adjacent to the medial tibia. Tenderness is usually found between 3 and 12 centimeters above the tip of the medial malleolus at the posterio-medial aspect of the tibia. When the tibia is palpated (touched) the tenderness is not directly medial, but just behind the most medial portion of the tibia, in the mass of soft tissue that is there and at the bone itself. Periostitis sometimes occurs in this location. The sore, inflamed structures usually include the medial muscles and tendons here. Most frequently involved is the posterior tibial tendon and muscle, but the flexor digitorum longus and flexor hallucis longus may also be involved.

“...the tenderness is not directly medial, but just behind the most medial portion of the tibia..”


Stress fractures can also occur in this area. The definitive test for stress fracture is a bone scan, but false negatives can occur and it is possible that a false positive might occur also, because of the soft tissue and periosteal involvement in this injury. Clinically, physical examination can be used to differentiate between "medial shin splints" and stress fracture. With medial shin splints, (medial tibial stress syndrome, MTSS), the tenderness extends along a considerable vertical distance of the tibia. When a stress fracture is present, tenderness is usually noted that extends horizontally across the front of the tibia.

Risk Factors

The first risk factor is overtraining. Evaluate your schedule to determine what training errors you may have made. Mechanically, pronation is most likely to be the culprit. When the foot pronates the medial structures of the leg are stretched and put under stress, this increases the likelihood that they will become injured. Running on a canted surface, such as the side of a crowned road, can put the upper leg at risk to develop this problem, because the foot of the upper leg is functioning in a pronated position.

Self-Care

Decrease training immediately. Do not run if pain occurs during or following your run. Non-weight bearing exercise may be necessary. Swimming, biking, and pool running can all be used to maintain fitness.

While running on soft surfaces has been recommended for this problem, that is not likely to help a pure MTSS. The foot is more likely to pronate excessively on mushy grass or sand. Packed dirt is ideal, and avoidance of concrete is also helpful. In many cases shoes that are rated high for control of pronation may be helpful. Gentle posterior stretching exercises may help, but control of pronation is more directly related to the cause of this syndrome. Ice applications following running may offer some relief, but are not curative. If symptoms persist it is important to seek professional medical attention.

Office Medical Care

In office medical care will repeat some of the procedures that you have done. A thorough evaluation of your training schedule, racing schedule and shoes will be followed by a biomechanical evaluation.

Anti-inflammatory medication can be prescribed. The use of physical therapy modalities can also be helpful. I use electrical stimulation (HVGS) and ultrasound to treat this problem. I will also tape the foot to limit pronation and decrease the stress on the medial structures of the leg. Pronation, which is a major contributing factor to this syndrome, in the long run, may be approached with improved shoes, and over the counter or custom orthotics.

So far I have visited a podiatrist who did an X-Ray - no fracture was visable. He decided to tape up my foot - and if it helped, he would put me in some orthotics. The tape helped! So I purchased my orthotics and they helped... for one run. Then the pain became more severe. The doctor told me that since it wasn't a stress fracture, I could keep running. So I did. I'd take about 4 advil pre-run and barely make it through. Finally, after our Tuesday evening run last week, I could hardly walk! I seriously felt and looked like I was a million-year-old lady with a bad case of arthritis. Getting up out of my chair or the car and going down stairs was the worst! I took one step at a time and had to mentally prepare myself for the next one. Excruciating! I couldn't bear it anymore. So I spoke with my doctor and re referred me to a chiropractor. I wasn't sure how I felt about that... I've always been suspicious of this type of medicine... is that bad? But I called and made an appointment. I met with a doctor who specializes in ART (Active Release Technique) and she prescribed 3 treatments a week for a few weeks. After this week if I'm not doing much better, we'll do a bone scan to make sure I don't have a fracture. I realize it sounds like I've got a case of the "Poor Mes" - which in fact I did. Now I'm dealing with it by not allowing myself to get too mopey about it; instead I must learn from my mistakes and move on.

Meanwhile, Ben's been trying to teach me to swim! Oh man... can I ever swim!




Actually, that is a lie. I can't swim. I am a ridiculous swimmer. It's so hard (I am a Virgo after all... an EARTH sign)! I just can't figure out how to breathe and use my arms. We're working on it.... we're working on it! We especially enjoy relaxing in the whirl pool post-swim. I am also trying to figure out how to water run. I might need to get a video because I felt veeeeery awkward trying to figure it out by myself.

Hmm.. anything else to add to this super long post? Not at the moment. But I'm sure I'll think of something to post later!

I'm Audi 5000.
Laters!

posted by Amy @ 11:38 AM