This winter - of all times - I decided to try again. I started slowly and actually used the 5K Runner app on my iPhone. I tried a few apps, but this one gives you audible cues even when your screen is locked, which many others didn't do. However, after the few few days, my shins were on fire again and I had to take an entire week off. I started up again, and ran through the pain, but knew something wasn't right.
It wasn't your typical shin pain. It was actually the insides of my shins on both legs. It hurt for 24+ hours after running, and flared back up whenever I did the cardio days of Jillian Michaels Body Revolution.
So I called up my old orthopedic surgeon who performed my knee surgery back in 2005, and he agreed to see me even though he is semi-retired and no longer operates. The first thing he did was order X-rays of my legs. Fortunately, no stress fractures. However, he said it was definitely shin splints and recommended 600mg of ibuprofen three times a day and physical therapy. Well, remember kids, I am prone to ulcers. I had one as recently as spring 2011 and had to stop taking all NSAIDs for six months. When I forgot and took them for my severe thyroid eye disease pain, my stomach burned for a week - hello again, ulcer! So, I decided I won't be taking 1,800mg of ibuprofen every day. I instead take 400mg when I really need it after running.
I did agree to physical therapy, even though that seemed a little silly for some shin splints. Boy, was I wrong.
I went to my first appointment Monday night, dressed like I was going to the gym. I am no stranger to PT, but it has been about eight years since I last went, and that was for knee surgery rehab. Shin splint PT is a whole other beast. I know all about deep tissue "massage" and how unpleasant it is, but I was not aware of the Graston technique until last night. Let's just call it torture, shall we?
Backing up, the physical therapist first asked me about my symptoms. She looked at my arches and gait, and determined that I have low arches and am nearly flat-footed. She recommended I get orthotics for my running shoes and cross trainers, and interestingly enough, it is the same orthotic I was planning on buying anyway. She told me she was going to do the deep tissue massage, and I knew that wasn't going to be fun. But then she brought over these metal tools that reminded me of the mixing blade on my stand mixer and a barber's blade, and I was suddenly very afraid. She explained these Graston tools help break up scar tissue and increase blood flow. She also explained that one's shins should be smooth under the skin. For as long as I can remember, mine have been bumpy. But since I was a competitive cheerleader and never a runner, I never realized how damaged my shins actually were. I laid there biting my sleeve and practicing lamaze breathing while she worked on each shin for several minutes. The pain was unreal, but as soon as she finished, she had me stand. I felt immediate relief - a feeling I haven't had in months.
She also told me that the cause of my shin splints is twofold: weak lower legs (calves, ankles) and my low arches. The orthotics will help my arches while stretching and strengthening my calves will help my lower legs. My ankles are permanently shot from spraining both multiple times, breaking the right once, and tearing all the ligaments in the left once. They basically flop in ways any joint should not. So we have to focus on strengthening my calves, which used to be my favorite muscle to show off. I remember going to a dance my junior year and having my date and all his friends ask me to show my calves. I could rise up on my toes and this huge muscle would shoot out my otherwise skinny legs. It was impressive and intimating, but now my calves are just fat. So fat I can't wear boots higher than my ankles, and that bums me out. So hopefully these new stretches combined with my diet and exercise will help my shins and my ability to wear cute boots!
After the torture and stretching, she iced me down for about 15 minutes. That felt OK, but my ankles really started to hurt from being at a 90-degree angle when they normally relax at about 170 degrees (gross, I know). Picture a gymnast's feet during her routine - her ankles are about 180 degrees. Now picture her standing on the medal podium - her ankles are at 90 degrees. My ankles naturally fall to 170 degrees or so on their own because they are so damaged, and probably trained from years of pointing my toes. So when they are forced to 90 degrees, they fight back. They still hurt now.
Before I left PT, she asked, "If I tell you to stop running, will you listen to me?" I agreed, but insisted on being allowed to continue my other workouts which include two cardio-only days and four days of either just strength or strength and cardio (depending on my mood and schedule). She OK'd this.
I went to the orthotics store on Tuesday to buy what I thought was going to be support for my low arches. However, I had a foot assessment done and I don't have low arches at all! I have medium-to-high arches! I thought so! The assessment showed that I put almost all of my weight in the balls of my feet, which stresses the fascia and thus causes shin pain. After walking around the store with the orthotics in my shoes, I forked over $70 only to later find out the same orthotics are available online for $50. Annoying.
My workout Tuesday was far less painful. It was a strength day, but my feet felt really good, and my shins were less sore than usual.
I went to physical therapy right after work on Wednesday. I had a different therapist, but we started with 15 minutes of heat, Graston (which hurt much worse than it did Monday, and also much worse on my right shin than the left), massage, and stretching. It took all of 35 minutes, which was nice. I got home and did my cardio workout. By "did" I mean "attempted." My feet were hating the orthotics. Tuesday involved very little jumping or running, but Wednesday was ALL jumping, running in place, and a few boxing moves. The program is only 24 minutes but it took me almost 40 because I had to keep stopping. My shins were sore but my feet were actually breaking inside my shoes - or so I thought. The orthotics have metatarsal support and my feet simply aren't used to that yet, so they revolted. Ow. I made sure to ice my fascia as well as my shins afterward, but I was limping by bedtime.
Fortunately, I woke up feeling fine. It's just an adjustment period. I'm about to head to the campus fitness center (free for employees) to do my C25K training on the treadmill since I promised not to run on pavement. If it hurts my shins, I will stop and switch to the bike or elliptical. And then when I get home, it's a strength day, so hopefully my feet and shins can recover.
I'm not a runner...yet. But I have big hopes of running a 5K this spring, so I'm doing what I've got to do to get there.
