Last Tuesday, I got on my bike to try and go for a spin. I wasn't really in pain doing it, but decided 30' was enough, and when I got off, my right ankle was really killing me. So I decided I should go to the doctor to get checked out, knowing it would be primary care, refer to ortho and see where we go from there.
I didn't tell my PCP exactly what I was doing when I experienced the acute onset shin splints/ankle pain/whatever it was, just that I was running. Describing my symptoms in detail (acute pain, unable to walk without limp, redness over tibia) where I stressed I might have a tibia stress fracture, it was easy enough to get the ortho refer.
I went to the ortho on Wednesday, had the obligatory x-ray, which showed nothing, and got an order for a bone scan. The ortho I saw is really good--he pegged me right away for a competitive type, said he figured that if I'd never had a stress fracture up until now that my bones were probably in pretty good shape, but he recommended supplemental calcium/Vitamin D, which I am now taking. He told me to take this not because he thinks my bones are troublesome, but because he knows I want to stay competitive for many years. I told him I'd already tried swimming and it caused no pain, so he sent me off saying "if it doesn't hurt, it's OK to do." He said he guessed I probably have a stress fracture.
Note that on Monday when I tried to swim, it hurt to push off the wall because my quads were still so messed up that THEY hurt, not my shin/ankle. But on Wednesday I swam pretty much business as usual and it felt good, and I had no issues extending my foot, kicking was fine, pushing off the wall was fine. I scheduled my bone scan for Thursday afternoon.
I decided not to try biking again for awhile just because my legs are probably beat up from the 35 mile run anyway, and my legs could use a full week of rest. I did lift on Tuesday, but nothing to do with my legs. Upper body feels great, actually.
The bone scan was kind of fun, because I could see my bones on the screen as the gamma camera was taking the pictures. The picture above is me! I'm glad they did a full scan, because any issues with my bones will show up. The front of my ankle hurt that day, but I wasn't sure if it was because of driving and the position of my right foot, or all the walking to/from my car at the hospital (I went once at 3PM for the radioactive injection then back at 5:30 for the pictures). I won't know the final results until I see the ortho again on Wednesday.
Meanwhile, I went ahead and researched aquajogging, in case I am relegated to that for a number of weeks. I found a pretty good program that would keep me run fit, although it would be boring as all hell. But if I have to do it, I will.
Since I am very familiar with minor aches and pains occurring over my musculature and trying to diagnose the cause, or at least the causal muscle, so I can do whatever body work and stretching to fix myself, on Friday I began in earnest to see if I could hunt down what is going on. A tibial stress fracture has the same symptoms as shin splits (or as it's now called medial tibial stress syndrome), and there are other lower leg muscles that can generate pain where I was experiencing it. Other than in the actual race, I am not having pain over the tibia itself anymore, but it seems to be lateral on the lower shin and then right across the top of the ankle, which is where a number of lower leg muscle tendons come in to control the foot.
My suspect muscles are tibialis anterior and the peroneals. Whether or not I have a stress fracture, these guys are pretty pissed off right now, so I've been doing trigger point work on them and also icing my upper shin, because no matter what happens, they need to be restored back to health. Oh, and I worked on my quads all week and while they aren't 100%, I am good up and down stairs and normal quad stretches. So that's good!
Yesterday morning I decided I try and go for a really short walk (.5 mile) to see how walking feels. I was fine for about 1/4 mile and then the ankle was not very happy. Good to know! I then raked my back yard again, which in retrospect may not have been a good idea to be on my feet like that, but at least it was soft ground, and at least I could use my right leg to tamp down the leaves in the yard bags! I get so excited for little things that I am able to do!
I headed to the Y for a short swim, but thought just for the hell of it, I'd try out the elliptical. Good news! I was able to use it with zero pain! I only stayed on it for 10', though, because I just don't want to push things this week. Still, I was happy, and optimistic that at least I could do this rather than aquajogging, and even if I don't have a stress fracture, 2 weeks of elliptical will be good for me to ease back into running.
I ended up swimming 2,000 yards yesterday, and I must be getting into swimming, because if lap time hadn't run out I would have swum more. When I got home, I made my (should be) world famous tuna salad that should last me a week's worth of lunches, prepped a roast chicken and answered the doorbell for what turned out to be far less trick-or-treaters than I'd expected. Which means I have a bunch of leftover candy, and I am just as weak as anyone, so I will put it out of sight where it will come in handy once I'm able to ramp up my training hours again.
Today I thought I'd try and extend the elliptical a little more, so I did 20', and was absolutely fine. I swam 1500 just because I am not doing anything else. And yet I'm a little tired. I think that I am probably more tired than I think and needed some rest this week anyway.
So what's my plan? Normal swimming, substitute elliptical for running this week, try biking again on Tuesday (fingers crossed!), see the ortho on Wednesday and go from there. Even if I do have a stress fracture, if I can get back on the bike, then effectively I will not need to adjust my training all that much except maybe weight bearing strength exercises. But I will ask about those as well, because there are so many different things that I do that for someone to say "off your legs" would be ridiculous. I will, however, honor my body, and its need for rest, and am prepared for this coming week to be a little lighter than normal. If biking doesn't pan out, I'll do a little extra swimming. Hey, why not, right?
