Severe shin splints?

[JLager]

Sorry if this is a bit long but I want to get as much
info in as possible.

I believe I have fairly severe shin splints from skiing,
now to the point where I can't walk without it hurting. Here's the history on what happened:

1. Started skiing this season in November 2010. I live in a ski town so I ski almost every day.

2. After a few weeks of skiing, I noticed my shins were a bit sore in the spots indicated in this image I found:
shin_pain.jpg.
Although my pain seems to go a bit further down as well but it's on the front/inside of each leg.

3. They would feel fine the next day so I didn't think much of it and just kept skiing but of course each day they started to hurt sooner in the day to the point where they were already a bit sore when I started skiing for the day which is where I probably should've stopped and done something but kept skiing anyway since it wasn't that painful.

4. After about 2 months from my ski season starting, I was almost limping home every day but since they felt so much better the next day I still kept skiing but they were getting really bad. Then finally I was jumping off a small drop and landed with my weight fairly far back so that my ankles were in what I guess would be called a plantar flexed position. This is when I had a very sharp, burning/shooting pain in my right shin. I'm just guessing but I think I was probably trying to dorsiflex to pull myself up right as a reflex and this tore
something in my shin.

5. After that I knew I was done skiing for a while as I could barely walk. I saw a doctor and had xrays to rule out a fracture and she said to just rest and ice which I did. I didn't do any skiing, running or much physical activity for a month and a half after that at which point my shins felt pretty normal and I couldn't really feel any pain while pushing on the area which previously hurt.

6. I had a two day course I was taking which involved climbing and skiing and that I couldn't cancel and since I was feeling good at this time I decided to ski for the two days after which I was a bit sore on my right shin (left shin was and is completely fine now) but nothing bad like before so I figured if I just rest a couple more weeks I should be fine.

So now, two weeks later... I'm not fine. I can't walk 5 mins without it starting to feel very tense and sore and even though the pain is not severe, it doesn't get any better from day to day like it did in the beginning my ski season. I even went on crutches for 5 days to completely take all weight off my right leg and it did get better to the point I had no pain but as soon as I took a 5 minute very easy walk, the pain came right back.

This is getting extremely frustrating and I've never had anything take this long to heal, even though I've had much more severe injuries. I know this was probably mainly my fault for not properly working out my lower legs and stretching properly.

Any recommendations? Should I go back on crutches for even longer or could it make things worse by not using the leg at all?

Again, sorry for the long post. I'm just getting a bit desperate here!

Thanks!

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[Emanuele]

Hello JLager,

Have you experienced any "funny" sensation on your right shin? Pins and needle? Numbness? Any paleness?

[JLager]

Hello JLager,

Have you experienced any "funny" sensation on your right shin? Pins and needle? Numbness? Any paleness?

Thanks for the reply!

I keep getting a very sharp pain, seemingly randomly. Sometimes while walking and sometimes while just sitting and not really moving my leg. It feels like it suddenly gets very tight and almost like someone is pinching me there very hard. I can't make it happen by moving my foot/leg in a certain way... it just happens.

No pins and needles feeling and no paleness. Also no numbness on the shin but since you mentioned it, and I don't know if this is related or not but the left side of my right foot has been somewhat numb for almost 4 months now. It's not completely numb as I can still feel pain if I pinch it etc but it feels like it's not my foot when I touch it, if you know what I mean.

I brought this up to the doctor when I first went there and she said it's likely a pinched nerve somewhere around that area and that it would likely go away over time but it hasn't (although I've gotten so used to it I don't really notice it now.)

The reason I didn't mention that is because that numbness started a lot earlier than my shin pain getting bad so I didn't connect the two and I still don't know if they're related or not. Just thought I'd mention it anyway.

Another thing to mention is that I noticed my shin pain gets worse when heated. For example, it starts to hurt if I'm in the shower for too long and when I come out, the area is fairly red and there's a weird small skin bump in the painful area that appears. It goes away when my leg cools down again though.

I thinking of going back to the doctor but she might just refer me to Physio which she did the first time and I can't afford any Physio at this time.

[Emanuele]

Have you noticed any discolouration or loss of hair in your leg? Where exactly this kind of numbness is located? If you press the nailbed of you big toe can you feel the pressure? Does this numbness affect the plantar surface of your foot, the inner aspect or the neck of your foot? can you put your big toe up? Can you dorsiflex your foot? Have you ever experienced kind of foot drop or maybe sometime happened that you have stumbled?

Pain and fine touch runs on 2 separate pathways and that can explain why you could feel pain but still having a funny feeling on soft touch.

[JLager]

Have you noticed any discolouration or loss of hair in your leg? Where exactly this kind of numbness is located? If you press the nailbed of you big toe can you feel the pressure? Does this numbness affect the plantar surface of your foot, the inner aspect or the neck of your foot? can you put your big toe up? Can you dorsiflex your foot? Have you ever experienced kind of foot drop or maybe sometime happened that you have stumbled?

Pain and fine touch runs on 2 separate pathways and that can explain why you could feel pain but still having a funny feeling on soft touch.

No discoloration or loss of hair. I've circled the area that's numb in the picture below:

footnumb.jpg

I can move my foot completely normally, big toe, dorsiflex etc. I can't think of anything that would've caused this such as stumbling etc. The only thing I've been doing is skiing a lot and since my shin pain is very close to this numbness (starts kind of just above the circled area, on my shin) I thought that maybe they were related but I don't know.

If you don't think they're related, I'm not too concerned about the numbness since it's not impacting anything. What I really need to understand and fix is my shin pain.

[Emanuele]

Hello JLager,

The 2 events, (numbness and shin splints) could be related, but please, consider always that a "virtual assessment" from internet is often sterile in meaning and all the "diagnosis" you can get from websites need to be taken with a pinch of salt.

Said that, I would suggest you to carry on your R.E.S.T. management which seemed to give you good result and basically solve the problem at the very beginning.

If symtoms relieve, then I do suggest you to gently return to such physical activity, adding sessions of gentle stretching of both posterior and anterior compartment of your legs, bearing in mind that Ski boots are not very helpful for your problem as if unproperly buckled (too tight) they can precipitate your problem.

Another consult with a GP/Senior Physio/Osteopath is suggested as I said above, virtual anamnesis, diagnosis and prognosis could be fallacious

All the best

Emanuele