What is this perpetual bruise-like pain on my shin?
January 26, 2013 6:52 PM   Subscribe

This is an issue that I've been aware of for years, but have never investigated it with a doctor because it usually only hurts when I put pressure in one particular spot. (Hey, doc, it hurts when I do this...) The spot is 3-5 inches above my ankle, along the very edge of my shin bone on the inside of my left leg. It's very tender, hurts quite a bit if that one spot is knocked or if I push on it. There's no bruise visible on the skin.

I'm a relatively healthy male: 30 years old, 5'8", 150 pounds. Mostly sedentary. I lift weights or jog sporadically. I just started Couch to 5K (again) and stopped after three weeks, which is when the pain/bruising flared up last time, about a year ago. There are all sorts of symptoms, enough for me to be sure that I have really crappy feet/calves but beyond that I have no idea what's going on; which issues are connected or what.

Pretty much any time I jog, I notice that the bruise comes back. This time:

--First week of running: not really any pain while running and the bruised feeling, like I said, only bother me if it comes into contact with something.

--Second week: calves became incredibly tight while running.

--Third week: calves and arches were tight and burned intensely and my heels hurt too. All pain subsided immediately after finishing the run.

Other info:

--I've been running on asphalt streets in my neighborhood, up and downhill, which I know isn't great. (But my wife has been doing it with me -- she has never run in her life, thought she would absolutely HATE it, and has been doing great with no pain whatsoever -- so I think it's mostly me and not the running environment.)

--I have pretty flat feet and have been using green Superfeet inserts in a pair of Asics Duomax running shoes. Which actually made my arches hurt like the dickens on the last run I did.

--My feet start to ache quite a bit in the arch and heel when I'm standing for long periods of time. I noticed that I tend to roll my feet a lot while standing and stand on the outside edge of the foot.

So, I guess I have a few questions (YANAD, YANMD):

A) what is this most likely to be? (shin splints? a bone bruise? a tear in the muscle?) Is the bruise likely related to the other pains while running?
B) what are the best options -- I don't have health insurance at the moment -- for me to get this looked at (should I go pay out of pocket to see a sports doctor? a gym trainer? a physical therapist? I have no clue.)
C) If I had to try to fix this myself without a costly professional diagnosis, what exercises could I be doing to rehabilitate and not further strain the weak parts of my feet/calves? Should I realize the obvious truth that I should never run ever or am I just doing it wrong?

Thanks MetaFilter!
posted by Trespassers William to Health & Fitness (16 answers total) 2 users marked this as a favorite
I'm not a pro runner nor an expert in sports medicine, but I think you are conflating two different issues. The spot of tenderness that you call "the bruise" that has bothered you for years regardless of your activity level is one thing, the pains and tightness that you get in your calves and your feet when you start trying a running program are another thing. The two are not likely to be related. The calf and foot issues you get with running are likely to be something you can correct.

You can probably go get tips on why your running is causing you pain for free by going to a fancy runners' store and having them watch and analyze your running on a treadmill. Running with poor form, wrong shoes, etc can cause pain for many people - this doesn't mean you have "crappy legs" or "bad feet", it just means you need some advice on how to do this without hurting yourself. As for the tender spot, ask your doctor about it once you get your health insurance back.
I am not your doctor and this is not medical advice.
posted by treehorn+bunny at 7:10 PM on January 26, 2013 [1 favorite]

Best answer: This sounds exactly like shin splints -- especially given that you "jog sporadically".

When you are running a lot, I always considered shin splints a good sign that you should change your shoes. Not to some new "type" of shoes, but that they had "expired" and that it was time for a fresh pair. The old rule of thumb was like 250 miles or three months or something.

When I used to get them pretty badly, I would ice them after runs. I would often find that they were the worst not long after beginning a run but then be ok after a long time into the run.

Trying to work out and run more regularly was always the best way for that type of "nagging" injury.
posted by This_Will_Be_Good at 7:11 PM on January 26, 2013 [1 favorite]

Oh, and for the calves -- when I tried to start running with more minimalist shoes after running for quite some time in normal running shoes, I suffered tightness and cramps in my calves like I had never experienced before. In any event, the use of a foam roller or lacrosse ball to knead out the tight muscles is incredibly helpful (and something I wish I had done years ago for tight muscles).

It sounds like a bit of a contradiction, but it seems like you need to both not overdo it and do things more regularly. Easing into a workout program is key so you don't overdo it initially, but keeping it up once you do start is what seems to really help prevent a lot of these sorts of injuries from happening as well.

Check out the Mobility WOD site for lots of good tips for loosening up and working on calves, ankles and feet.
posted by This_Will_Be_Good at 7:17 PM on January 26, 2013

Best answer: I totally agree it's two different issues. You might want to just get an Xray. The kind of pain you describe from the one sensitive spot - localized, only bothers you with pressure, but hurts like hell if it's directly hit - could be from calcifications - bonelike chips that result from old bruises. i have a few from an injury from when I was a child, in my ankle, and they hurt like hell when impacted. I've sometimes had them throb a little when starting a new or changed exercise routine...I think it's to do with what's going on in the surrounding muscles, or the fact that they're moving around more than usual. I've been advised they can be removed with outpatient surgery, but I've elected not to do anything about them because they aren't threatening anything.

The other stuff? Beginning running. Stretch and do isometrics!
posted by Miko at 7:28 PM on January 26, 2013 [1 favorite]

could be from calcifications - bonelike chips that result from old bruises

Or something much more serious. See a doctor.
posted by rr at 7:37 PM on January 26, 2013

Best answer: Barefoot shoes will eliminate a lot of it. When I say this post, it brought back terrible memories. I had the same problem. One small spot on my shin would throb like crazy when I began working out or running. I almost never kept up with running because of it. Ice and rest just didn't work.

Began jumping rope to sort of 'condition' it and then start running. No go. So, I bought a pair of Merrells (Barefoot, minimalist shoes) based on a bunch of things I read on shin splints. Wore them as I worked out, mostly jumping rope. After about two weeks, I couldn't feel the pain anymore. Began running, no problems. Could not believe it.
posted by MMALR at 8:14 PM on January 26, 2013 [1 favorite]

Best answer: I don't know about the weird shin spot, but some discomfort when you're first starting to run is pretty normal. Note that I am not a doctor, or anything remotely like a running expert (ha). You're using muscles all through your legs and feet like you never have before, and they will feel it for sure.

My rule of thumb in the 9 months or so I've been running is to ignore mild discomfort that happens while I run, just slow down or take a stretch break if I need it. If it hurts when I walk the next day, I stop running until it doesn't hurt and pick up running again a little easier once I feel 100% again. This has gotten me through a few bouts of shin splint like pain when I upped my mileage too quickly or switched surfaces. YMMV and definitely go to a fancy running store and see what they say about your firm and your shoes.
posted by MadamM at 8:37 PM on January 26, 2013

Best answer: You have shin splints. (I think? I am also not a doctor!) You sound like you've look this up before - and it seems you have several key factors that lead to shin splints: your erratic jogging schedule and your flat feet; both of these issues put extra pressure on your feet. I ran cross country in high school for several years and my shin splints never went away, so nowadays (several years later) I exercise and stretch them regularly to avoid excess pain. I used to go to physical therapy, until the therapist told me that it wasn't doing much for me, after several months of declining progress.

So my advice to you: stretch them. There's two good exercises my physical therapist taught me. Try walking with your toes up in the air. (you'll feel stupid doing this one) Also tap your foot with your heel on the floor repeatedly and quickly. Look up shin splint exercises. My coach prescribed ice on my shins after exercise, which supposedly helps with the shin healing process but that never really worked for me. YMMV. Also try exercise that doesn't give you the leg pain, namely swimming (which I only recently learned how to do! great way of not dealing with shin pain) and biking (also good).

Your shoes could also be an issue. My running coach claimed we had to replace our shoes every four months, because old shoes do not absorb shock as well. Also, your shoes might not be well-suited to your feet. Go talk to a local store that specializes in athletic shoes - they could probably examine your feet, maybe have you do some tests to advise you what sort of shoes are best and how you can adjust your exercise regime. Try to get more than one opinion if you can.

And you've had this for years?? I personally think you should look into physical therapy. Or at the very least, learn more about the problem. I've had shin splints for years and have only learned to live with them. You might be in a similar situation.

As for the burning calves/arches, that might be just discomfort from the jogging. Much more noticeable if you don't do it regularly - your body isn't used to it.
posted by myntu at 9:47 PM on January 26, 2013

Compartment syndrome aka shin splints. Get to a doctor, especially if you want to keep running, and get his or her ok first since this condition can be dangerous. In the meantime ice it whenever it hurts.
posted by windykites at 10:29 PM on January 26, 2013

I think you also have plantar fasciitis- makes sense with the flat footedness and other symptoms you describe.
posted by windykites at 10:30 PM on January 26, 2013

"Compartment syndrome aka shin splints"

These are different problems with related symptoms. I had compartment syndrome, eventually getting surgery.
posted by jacalata at 3:08 AM on January 27, 2013

It's important to note that the "bruise' sensation has been going on for years. I agree that there are probably shin splints - that's totally common for beginning runners, and isometrics helps - but it's not the cause of the pain on pressure. I do agree about seeing a doctor, who will probably want to do an X-ray, which is why I said that: but calcifications are one very common reason it can happen, especially on shins where, over the course of life, there have been many impacts and bumps that can result in them. It could be something much more serious (though it's scary not to at least suggest what you would think could cause that), but the first stop is just to point it out to a doc.
posted by Miko at 6:14 AM on January 27, 2013

Best answer: One thought on the smartfeet. If you have truly flat feet (ie, no arch at all) the black ones might be better for you. My husband has completely flat (born that way) feet and the black ones are the only ones that help, anything else causes pain from it trying to make an arch out of a foot that has no arch at all.
posted by SuzySmith at 9:34 AM on January 27, 2013

"Periostitis and compartment syndromes... as well as tibialis posterior tendinitis and tibial stress fracturs are sometimes grouped under the lay term "shin splints", a non-specific phrase that describes pain along the medial border of the tibia with exercise." Rattray, Clinical Massage Therapy, 2005

Sorry if that's not the appropriate way to do a citation, I fully cannot remember, but shin splints is undoubtedly a term for compartment syndrome.
posted by windykites at 11:24 AM on January 27, 2013

However, it's totally possible that the OP has one of those other conditions; compartment syndrome was my instinct based on the description but I'm not a doctor and none of this is a diagnosis.
posted by windykites at 11:26 AM on January 27, 2013

So, I almost answered this question yesterday because your description of the pain and its location sounds kind of like what I was recently diagnosed with, posterior tibial tendinitis. (Random acute pain in the inner mid-calf + tight calves.)

But, here's the thing: I suffered with the tendon issue for years (although it recently got more serious, prompting the doctor visit). I described the pain to a certified personal trainer and a general practitioner, plus I've taken college anatomy and I'm interested in health stuff, so I spent a bunch of time looking at textbook photos of cadaver ankles and drawings of tendons. Until I went to see an orthopedist, none of us knew what it was. Everyone, including the GP, was wrong. The orthopedist diagnosed it immediately, confirmed by an MRI.

I think it's worth calling a sports medicine/orthopedic practice and figuring out who can work with you for a reasonable price for out-of-pocket visit. (But god, you do not want an MRI. They cost roughly a million-billion dollars.)
posted by purpleclover at 7:48 PM on January 27, 2013

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