lower leg pain

Just looking for some advice on an injury i have picked up.

Its a really strange pain that starts low down on the front of my right shin, at that point it feels like bone pain but it moves around the outside of my calf rising almost to my knee, feeling more like ligament or muscle pain.  Its not sore all the time, but at certain points in the day.

when i begin running i am very concious and almost limp for the first few hundred yards but i soon ease into it and can run in pain for about two miles, after that the pain eases off almost completely and i have completed runs of up to 10 miles, but when i stop thats when it hits and i will be in pain again for the next few days.  i have had about 4 days of not running now, but will go for a 10k tonight to see how it feels.

has anyone else experienced pain like this before? and what is the advice on dealing with it?

id be keen to get some feedback,

cheers.

hmm - tricky.

The one thing you say that I note is 'feels like bone pain'.....COULD suggest stress fracture, but the fact that it moves and eases off suggests contrary to this. 

Where is the pain post run?

Does it hurt when hopping barefoot on the leg in question??

If it is lower leg, there really isnt much there other than muscle or bone. 

http://runningtimes.com/Article.aspx?ArticleID=12894&PageNum=&CategoryID=

thanks for the response.

thats how i can best describe it but its actually really hard to put my finger on, it sort of all over the front and side of my lower leg, hopping on one leg sends a 'shock' right up through the centre.  i have no idea how i could get it treated as i couldnt describe it any better to a physio!

 i had considered a stress fracture but i think that would be a lot more painful when i run.  i read an article on achilles tendoonitis, i wouldnt rule that out or it could be a combination of both.  6 weeks rest is out of the question for me, i would put on about 2 stone in that time if i didnt run so i am looking for any other advice and keep that as a last resort!

WHy would you think a SF be more painful?

I ran 30 miles on one.

They come on gradually, and get worse.

It isnt my place to offer a diagnosis. An x-ray wouldnt help - an MRI might (although it didnt in my case). THat is of course assuming it is a SF......which it may not be.

Achilles tendonitis....any 'creaking' sensation in the achilles area when you flex your foot?

If it is a SF, expect 3 months minimum not running....not 6 weeks. 

http://www.best-leg-exercises.com/images/calf-muscles1.jpg

there isnt much in the lower leg.....

Im not saying it is LP - just that it COULD be....I agree with the pain subsiding. MIne didnt increase, or subside, not did it hurt after the run....so it isnt always so simple.

I am saying that you need to consider it - along with other possible options that a trained medical professional will be able to consider and evaluate - not just one bloke (i.e. me) on the internet!

Hi LP,

I would suggest there are three reasons (at least) to suspect it's not an SF.

1) SF pain is typically very focal - you can literally point with a finger to the site of the pain - this is especially true of a tibial SF which is about the most common type.

2) SF pain almost always stops when you stop running, though there may be local tenderness or even bad pain, when pressure is applied over the point of injury.

3) SF pain does not typically ease off as you run further - it will either stay constant or get worse.

NIckL is absolutely right to suggest than an x-ray will be of little help - it is highly unusual for a stress fracture to appear on x-ray, and usually when they do it is during the healing phase when new bone is being laid down. MRI's have a much better record on this level but  your GP will be reluctant to do this as they are expensive and your symptoms are not classic SF by any stretch.

There are a few more things in the lower leg than muscle and bone (thank god - or you wouldn't be able to walk, let alone run)  - there are ligaments which attach bone to bone, tendons which attach muscle to bone (like your achilles) and there are stacks of nerves, blood vessels,  - oh and you've got specialised facia that compartmentalize various muscle groups, particularly in your calf. 

In your first post you said the pain starts in the lower area of your right shin and then gradually moves around the ouside of your calf and up to to your knee (presumably during a  run) . In a following post you said it was all over the front and side of your lower leg (presumably after a run). You also say it's not sore all the time (presumably at rest) but that the pain comes and goes. 

Some questions ...

Other than the lower front shin, which side of your leg is the pain on - outside or inside or is it actually in the calf at the back ?

How spread out is the pain ?

Try applying pressure working all the way along the shin muscles from the bottom near your foot to the top just under your knee checking both the soft tissue on the outer side of your shin and the inner side of your shin - identify which areas are most tender and the extent of this. Is there tenderness in your calf or the back of your knee ? Nip your achilles firmly but not too hard between your thumb and forefinger along it's length - any tenderness ?

Does the pain only move about during a run ?

Does it come on when walking ? when sitting down ?  when lying down ? one, two or all of them ?

Is it a dull ache, does it throb, do you get any tingling or numbness ?

Did anything change prior to the onset of the pain ? (e.g. new trainers, increased mileage, started speed work, new running socks, shoe inserts ) 

Any help with these questions might throw further light on your issue.

Regards, Groz

Last Place,

Throughly warm up before you start a run making sure you concentrate on the leg stretches/exercise the most and always START SLOWLY for a run

Do this and you will be sorted, it works.

wow, thanks for the responses guys, especially groz for such a detailed response.

i agree, i think we can rule out a stress fracture, i have done a little research of my own and the symptoms do not sound the same.

sorry to groz for being so ambiguous and what appears to be some conflicting posts, its very hard to describe the pain.  i ran 10k at the end of last week and it was just a constant stabbing pain through (from the outside) of my calf muscle, behind the shin bone.  this was a prticularly tough run due to the pain.  i completed it but havent ran since, I think i may go with a couple of weeks rest to see if it eases off.

And yes, in answer to your question groz, i did suddenly increase my mileage and i know this is probably to blame.  I have ran a couple of marathons but spent the last 6-8 months running 10ks with my long runs only being about 8.5 miles.  I then entered a half marathon and did it with no extra training, i set a pb on the day but have carried this pain ever since (about 4 weeks now).  I have had ITB trouble in the past and am fully aware of the dangers of sudden mileage increases so i can admit that was foolish of me.

However the damage is done and I need to sort it.  i started running 3 years ago and lost 4 stone in weight, since then i run every second day and am worried about how much weight i am likely to put on during a prolonged period of rest due to injury.  Like you other guys say, i will concejntrate on massages and stretching while not running and hopefully in a few weeks i'll be back on the roads again.