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Shin injury not healing after a year (warning, long, rant)

post #1 of 5
Thread Starter 

I apologize in advance if this comes out as more of a rant than anything else but I'm starting to get really frustrated and worried that my skiing days are over. At least maybe I can help someone not make the same mistakes as me but if anyone has any advice for me, I'm happy to hear it. Warning, it’s a bit long.

 

Last year I moved to Whistler and took about a 6 month break from working, which was great. Unfortunately, as I went from a weekend warrior at a small hill to skiing long runs 8 hours a day, every day, my body got a bit of a shock I think. After about 35 days of skiing in a row, my shins were quite painful and getting worse every day. Of course, I kept skiing through the pain and a few days later, I had a very backseat landing off a small 5 foot drop which gave me immediate, excruciating pain in my right shin and I knew I was done as I could barely walk.

 

Of course, I didn't go see a doctor then, thinking I just needed some time off. After about a week, I could walk again but it still hurt a lot so I took a few more weeks off and it got better and better but still sore to the touch. Living in Whistler and not being able to ski is very difficult indeed. So what do I do? Start skiing again, on lots of painkillers this time... I quickly realized that I wasn't going to be able to keep this up because all I could ski without severe pain were very smooth groomers. The slightest uneven snow and I was in major pain.

 

Thinking that of course it had to be ill-fitting boots that was causing all this pain, I went and dropped $1,000 on new boots, custom footbeds etc at what is considered one of the best bootfitters in Whistler. Got great fitting boots, and after "healing" up a bit, I started skiing again but had the same problem. Went back to the bootfitter about 10 times and had several modifications made. Since I was having shin pain and I have very thin lower legs, a lot of work was done to try and fill up the space around my lower leg. Also got booster straps which are supposed to fix these things...

 

So not having any luck with the new boots, I finally decided to go see a doctor in Whistler. Thinking I had microfractures that weren't healing, I had Xrays and an MRI which showed nothing. Doctor told me to just RICE and wait it out. So that's when I stopped skiing for the rest of the season (this was in February, and very frustrating.)

 

About 4 months later, the pain was gone but so was the snow. About this time I got a job a 45 min drive away and started commuting daily. It didn't take long for the pain to come back in my right shin. I'd get a sore feeling at the end of each drive and sometimes just sitting around, I'd get very painful shooting pains in my shin. Obviously I wasn’t fully healed, even this much later, so I went back to the doctor. This time they had me do another scan using radioactive imaging which did show an area on my shin where blood was “collecting”, indicating it was trying to heal something in that area. I was told I had a bad case of shin splints and likely tears in the periosteum that still hadn’t healed.

 

Doctor recommended I go to physiotherapy, so I did. I was referred to a very good physiotherapist in Whistler that deal with these issues all the time and used to be a physiotherapist for the Canadian Olympic Ski team so I assume she knows what she’s doing. I was told that all I need to do is to strengthen my lower legs and stretch my hamstrings and this should take care of the problem. She showed me several exercises to work the muscles on the front of my shin (mainly the tibialis anterior.) I have been doing these exercises for about 8 months now and while I haven’t always kept up with them as well as I should, I haven’t been slacking off that bad.

 

It’s now a year later, I’ve moved down to Vancouver (2hrs from Whistler) and I don’t have pain after driving anymore or any shooting pains, even though my commute is now an hour long. However, the area on my right shin is still sometimes a bit sore to the touch when compared to my left shin. The worst part is, I can’t ski still… I’ve only tried about three times this season and if I even get the slightest backseat, I have shin pain for a week after that. While it’s not nearly as bad as it was, it’s enough to put me off from skiing for at least a week or so. This means I only usually manage one or two runs before I can’t do any more. I don’t think I ski much in the backseat but in normal skiing, you can’t really help from getting knocked back there once in a while due to a bump, uneven snow etc, so I don’t think this is something I can learn not to do.

 

After this many months, I don’t understand how it hasn’t healed yet. While I understand that the strengthening exercises physio told me to do are necessary if I want to avoid this issue again, I would’ve thought that even if I didn’t do any of the strengthening exercises, it would’ve healed anyway, given this much time. So what is going on? I’d like to point the finger at the fact that I’m driving an hour every day, using my shin muscles to press the gas pedal, and that it is preventing this injury from properly healing. However, I did ask physio about this back when I first went to see her and she didn’t think it would be a problem at all if I did the strengthening exercises.

 

I’m not sure what to do now and feel very frustrated that I might be missing another season. I suppose it would make sense to revisit physio but it being two hours away and her not working weekends, it’s kind of difficult. I’m hesitant to see another physiotherapist here in the city as I’m not sure they’d have much experience with this kind of injury.
Sorry for the long post but thanks for reading. Any suggestions, I’d be happy to hear them.

 

post #2 of 5

Sorry to hear about your troubles. It really sucks when you have a nagging injury like that. First, I am not a doctor, I am not a health professional, I am not even an exercise professional. That said, I try and take care of myself and have accumulated an undisciplined, eclectic collection of sports/health related knowledge. Take anything I say with a huge grain of salt.

 

It sounds like you have had a bunch of problems. First, over use of the muscles with insufficient rest caused inflammation, damage, and atrophy of the muscles. But, and this is key, your neurological system hasn't adjusted to that damage. Which means that your nervous system can still drive your muscles too hard, causing inflammation, pain, and possibly further damaging the muscle.

 

So, the advice I would give you is to do the strengthening exercises, starting with very very low intensity and lots of RICE in between. Imagine that you're starting with very very weak muscles in that one area. Anytime you have pain, back off and try a lower intensity with more rest. Second, eat lots of protein, you'll need it to rebuild the muscle tissue. Third, keep an accurate of a record as possible of all exercise, activity, pain, and diet. Actually, this last item should probably be first; you need to gain an understanding of what's been happening to your shin and why it hasn't recovered.

 

Welcome to Epic Ski, Jave, and I hope you start on the mend soon.

post #3 of 5
Thread Starter 
Quote:
Originally Posted by enkidu View Post

Sorry to hear about your troubles. It really sucks when you have a nagging injury like that. First, I am not a doctor, I am not a health professional, I am not even an exercise professional. That said, I try and take care of myself and have accumulated an undisciplined, eclectic collection of sports/health related knowledge. Take anything I say with a huge grain of salt.

 

It sounds like you have had a bunch of problems. First, over use of the muscles with insufficient rest caused inflammation, damage, and atrophy of the muscles. But, and this is key, your neurological system hasn't adjusted to that damage. Which means that your nervous system can still drive your muscles too hard, causing inflammation, pain, and possibly further damaging the muscle.

 

So, the advice I would give you is to do the strengthening exercises, starting with very very low intensity and lots of RICE in between. Imagine that you're starting with very very weak muscles in that one area. Anytime you have pain, back off and try a lower intensity with more rest. Second, eat lots of protein, you'll need it to rebuild the muscle tissue. Third, keep an accurate of a record as possible of all exercise, activity, pain, and diet. Actually, this last item should probably be first; you need to gain an understanding of what's been happening to your shin and why it hasn't recovered.

 

Welcome to Epic Ski, Jave, and I hope you start on the mend soon.



Thanks, I've been going at it quite intense at the gym but for some reason never get any pain from doing the exercises which is why I haven't thought about lowering the intensity but maybe I'll give that a try.

 

Maybe I'll just take up snowboarding instead :)

 

post #4 of 5

Shooting in the dark here, but you live in Canada? It's not too much there to get your R-factor checked if you have not already, especially if you find yourself experiencing other common symptoms of rheumatoid arthritis.

 

I was born on the Prairies and 100% is my only factory setting. Later on, I had similar pains you speak of develop in my shins and wrist/forearms in addition to a multitude of other disabling conditions. I tried to play though, but it came to the point where it wasn't physically possible. This pretty much ended my late bloomer college hockey career. Turns out I just had a severely high rheumatoid factor and my immune system was eating my body alive for at least 5 undiagnosed years. My mom 15 years.

 

Check that out, it can't hurt. The shin pain from driving is eerily similar to my own experiences, so I thought I would mention something. I have had skates on since I came out of my mom's hooha, but for me It got so bad I couldn't even stand in the locker room.

   

Good luck; I hope you find some relief.

post #5 of 5

Hmm, maybe the exercises aren't targeting the right movement/dynamic in the muscle/area? Hard to say. But would recommend you try different exercises and see what works and what doesn't.

 

Boarding might be an option, but my gut says your shin will still hurt :-/. All the best!

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