From trails back to pavement = recipe for disaster ??

[paraganek]

A little BG:

I have been running BF since June last year.

I started on pavement and slowly worked up my mileage with no major issues (just the usual blisters, tight calves, occasional ankle swelling in the first couple of months).
Back in November my mileage was around 25 miles a week. My long runs on weekends were just 10 milers. No injuries, good form and felt great.

In mid December I switched to trail running which was even more rewarding to me. I was running trails exclusively for 3 weeks doing about 15 miles a week.
Then I decided to try back on pavement. One day I ran my usual 6 mile route on concrete and something did not feel right. No pain but my lower legs felt really tired after the run which never happened to me before.
And this is the time where I think I made a huge mistake. I did not take the usual day off and ran 4 mile trail run the next day.

At the end of those 4 miles I get this weird pinching localized pain on my fibula right above the ankle.




I stop immediately and just walk back to the car. The next day the pain is still there, a little swelling. Applying R.I.C.E.
I do not run the next five days, I can walk just fine but the sore spot is still there, sensitive to touch.
I start worrying about a stress fracture on my fibula and go to see my doctor. I get both x-rays and a bone scan done. The doc says it does not look like a stress fracture (BIG relieve) but more like a shin splint. He tells me to run just 1 mile tomorrow and slowly get back to my previous mileage.
It has been 10 days without running since the injury happened. The spot is still sensitive when touched but no real pain so I decide to run that one mile. The pain is back almost immediately.

I am basically back where I was 10 days ago, the same burning pain, I am not able to run anymore, walking with a limp and stairs quite hurt. It just does not seem to be going away.

I know shin splints usually happen on tibia but the burning pain I am having is just on fibula right above my ankle.

I believe it is not a stress fracture based on the bone scan results. The doc says if there is a stress fracture x-ray does not show much but on the bone scan they should definitely see an increased blood flow in that area (the bone is repairing itself) and there was nothing like that on my slides.

My plan is R.I.C.E. for a couple more days to see if things are going to improve.
Any other suggestions what to do ? Has anyone had any issues in that spot ? Any ideas how long it might take to heal up ?


Thank you for any help.

 

[Barefoot TJ]

Sorry your important thread

Sorry your important thread was interrupted, Para. Hopefully some people will chime in soon to help you.

 

[Barefoot Mary]

Gosh, I just posted on the

Gosh, I just posted on the forum almost this exact same question. I have soreness in the same place, but not nearly as bad as yours.

Hope you feel better!

& Hope someone has an answer to the side-shin-splint...

 

[Barefoot Mary]

OH NO!!!Here's me sending

OH NO!!!

Here's me sending healing vibes your way ((((((~~~~~~~~~~~~~~~))))))))

Or, maybe my cat just stepped on the keyboard...

 

[Barefoot Dama]

That really does not sound

That really does not sound good at all.

My husband had the same symptoms and it turned out to be a SF on the fibula. I am sorry it's not getting better.

Can your Dr order a MRI?

 

[Barefoot TJ]

It sounds like something is

It sounds like something is cracked in there. Perhaps the bone scan didn't do its job the first time around. I would ask for an MRI. Good luck, Para. I don't believe you will be like this forever, so keep hope.

 

[paraganek]

Thanks everyone.I am not

Thanks everyone.

I am not losing hope.

Two weeks ago I was thinking "OK, I am going to take just a week off and than keep training for my end of February half-marathon",

than a week ago I was more like "OK, maybe two more weeks off and I will switch to running just 5k at that race"

and now "I will do whatever it takes to fix this up and I don't care about training or racing, I will be the happiest man on the planet if I can run just 1 mile in a week"

I would like to get the MRI done and my doctor can order it but it's going to cost me a lot (around $2000 out of my pocket even with my insurance) so the decision was made to wait those two more weeks hoping it is going to improve.

 

[JosephTree]

Dat zucks bigtime!  Any

Dat zucks bigtime! Any thoughts about what actually did the damage? It seems to me that a simple transition back to pavement wouldn't be enough in itself to hurt you.

 

[Humboldt-explorer]

This is a interesting

This is a interesting thread. A few things stuck out in mind mind of your original comments. Do you consider ankle swelling to be a normal part of barefoot running even in transition ? It sounds like you experienced this more then once. Do you feel this is normal ? I'm troubled that after your first doctor visit you were advised to run 1 mile to feel out the injury. I feel this was really bad medical advice. Is this a new doctor for you ? I'm curious what is your age, gender ? Are you getting a sufficient intake of calcium ? Have you had any other bone issues in past ? Just trying to collect a bit more info on your situation if you don't mind.......



I don't think expensive tests are going to give you considerable more info. I'd take many weeks off with no running at all. Then reevaluate the situation based on how you feel. Though you should really try to get to the root of what caused this. That is a interesting spot for a injury. Which is why I had those few questions above.......I think you really need to change the way you think on getting back at running. You sound like your wanting to rush the healing process which may cause re-injury. I am just saying don't set a date in your head when to start running again. Let your body dictate when it is appropriate for you to start running again. I would just slow things down, and really give the body time to heal and figure out what caused this to begin with. Sorry for lack of paragraphs. Hitting enter on keyboard does not seem to give me paragraph breaks....

 

[Neil_D]

I just wonder if many of us

I just wonder if many of us try to transition too, wanting to do too many miles too quickly.

I've been running barefoot for around 15 months and only recently have covered a distance of 16km (10miles).

It is interesting the description you use of feeling a 'tiredness' in the leg rather than something suddenly giving way. Maybe this is an indication of a stressing of the bone. If so I would imagine it will take quite a while to recover at least until you can rub the front of the shin without any feeling of pain.

If I don't practice my Pose drills at least once a month I get sloppy, so, every months I go back to the basics, do the drills and see if they feel good or not.

As I run on the beach and road there is a big difference between the impact you make. If I start on the road it takes me about 1km to get to feel the correct landing. I always start with the small stride and this gradually lengthens when I get the right feeling. Sometimes I just can't get it right, even now, so I just maintain a short stride all the way.

Sounds like for now you are going to have to rest for a while, maybe ultrasound will help with the healing.

Good luck anyway and remember patience is a virtue.



Neil

 

[Humboldt-explorer]

My concern is that he has had

My concern is that he has had swollen ankles in the past. This should not happen with proper form. Secondly I'm not so sure they needed a doctor, but if they wanted one to comfort them more so be it. It does not seem the doctor did anything to help nor would I expect him for this type of injury. I think the OP needs to figure out for themselevs that they were doing too many miles. June to now is not very long for this type of new activity. So hopefully they will evaluate their mileage, and back off to rid future TMTS issues. I think the injury was under estimated, and ran on it again way too quickly. I think in this case they really need to go easy on that area of injury, and give it plenty of time to heal. Just forget about running for now until your healed. Then I think it would be worth looking at your form, and reduce your mileage to something more modest. Every body will adapt differently, and it can be really important to just listen to the body. The great thing about injuries is they are learning expereinces if you pay attention to what is happening. It would be a waste of money on even more tests. Just get proper rest, and stop the activity that caused it for now. I'm certainly no doctor. Of course each person should do whatever is most comfortable for them. If that means more tests to please their needs then that is what they should do. I really don't think trails back to pavement had anything to do with it.

 

[Barefoot Gentile]

I run 100% on concrete

I run 100% on concrete barefoot for almost two years now, I experienced the same sensation last summer. I think you have peroneal tendonitis, it stayed with me for awhile but eventually went away. Because of the hard surfaces you are experiancing more stress.

I started doing balancing exercises which helped the healing and strengthening process. I am sure you have good form but imagine you have to put your foot in peg, nice and straight when you foot plant.





Okay I just re-read the post where the doctor noticed some swelling on your ankle and a bump, that I didn't get. Worse case scenario it can be a stress fracture, but I could be wrong. Hope you feel better soon.

 

[paraganek]

JosephTree wrote:Any thoughts

Any thoughts about what actually did the damage? It seems to me that a simple transition back to pavement wouldn't be enough in itself to hurt you.

I am still puzzled by what actually caused it. In my last month of running I was not increasing my mileage and my speed was the same. I was just comfortably doing 15-20 trail miles a week running every other day and felt great and relaxed. (My running form video)

It probably was not the transition back to pavement. The only thing I can think of is not taking my usual one day off between runs.

Do you consider ankle swelling to be a normal part of barefoot running even in transition ? It sounds like you experienced this more then once. Do you feel this is normal ?

No I don't think it is normal. But I have had some issues with that in the past.

As long as I can remember (from my twenties) my right ankle has been always clicking when walking. Step-click, step-click. It was not causing me any problems and I got used to it.

Some 3 years ago (still in shoes) I started jogging, doing 1-2 miles in the morning. My right ankle always got a little swollen but I did not mind because there was never any pain or discomfort and it always went away in a day. I only lasted 2 months anyway and than quit running for a while.

In June last year I started BFR. Taking it really slowly. Right ankle - the swelling is back. Again, no pain, no discomfort, just clicking. And it's gone in a day. My wife convinces me to see a podiatrist just to "make sure". I get x-rays done and the doctor tells me I have a Partial Tarsal Coalition (condition in which 2 bones in the hind-foot are partially joined) in my both ankles. He is a BFR advocate so he encourages me to keep running barefoot with the idea the natural way of running will make things stronger and eventually fix the fused bones.

And it worked. In the following 5 months my ankles got stronger and there was no swelling anymore. Just the clicking. Than this weird pain on my right fibula happens one day, it's not going away and when I run on it ( ) the right ankle starts swelling again. (To add to the whole mystery, my left ankle also diagnosed with the tarsal coalition has always been fine and with no clicking)

I think you really need to change the way you think on getting back at running. You sound like your wanting to rush the healing process which may cause re-injury. I am just saying don't set a date in your head when to start running again.

I agree. That's what I am thinking now too. Whatever it is it must eventually heal up sooner or later so I will just wait until there is no pain. Right now it seems to be better when walking on a level ground (no pain, just stiffness) but it still hurts quite a lot walking down stairs/hill.

 

[stomper]

Sorry to hear about your

Sorry to hear about your situation, paraganek. I'm not sure what is happening, or whether it has anything to do with the difference between trails and pavement.

However, I can second the idea that the surfaces are rather different, and that running needs to be adjusted accordingly. Late last summer after doing almost all trails I decided to switch to pavement to train for a race and was surprised how banged up a 6 mile run left me feeling. I think trails give your body a much more variable workout. Whereas pavement, it's just the same motion over and over again. I ended up having to shorten my stride and increase my cadence yet again before I got comfortable.

Which is not to say that could have been a solution for you. But pavement definitely is less forgiving.

Sante.

 

[ajb422]

I have had lingering ankle

I have had lingering ankle issues for months now. Nothing approaching what you have but it sounds like a much less severe version. I've had it from my lower ankle region up to where your picture showed. I do find that pavement makes it significantly worse. I still come back less banged up from pavement now that I'm bf/minamalist than when I used to do it in shoes, but it isn't the same as the paths and trails. I've pretty much sworn off all my routes that have more than about 5 miles of concrete because its just not worth it. In shoes it was my hips, no shoes it my ankles. Maybe some day I'll be able to build up my pavement mileage but for now I'm sticking to

 

[nature runner]

   I have had the same

I have had the same problems in my left ankle as described in your picture for months, without the swelling. It doesn't seem to be as bad as long as I stick to trails though.

 

[paraganek]

stomper wrote:Late last

Late last summer after doing almost all trails I decided to switch to pavement to train for a race and was surprised how banged up a 6 mile run left me feeling. I think trails give your body a much more variable workout. Whereas pavement, it's just the same motion over and over again.

Interesting. That's exactly how I felt, really banged up after a 6 mile run on pavement. I think when I am able to run again I will start on trails and stick with it for a while.

 

[Humboldt-explorer]

I think that trails are more

I think that trails are more healthy. You get away from the car emissions. Your out in nature more. The trails tend to be a better workout with more diversity under your foot, etc. Personally I'd say stick with the trails.

I've been told I'm very spoiled cause I'm a BF beach runner. I'm in a rural area. So were not talking jersey shore, or some other crowded beach. It's a rural beach. That is my prime running environment now for the above reasons. I really dislike street running a lot. I intend to take up trail running soon. I like running on university outdoor track sometimes. Mostly to promote the bare feet......

 

[EricsLearning]

I love trail running even

I love trail running even though I'm in vibrams most of the time but I will say that running on concrete or asphault is a more realistic race simulation. Trails allow me to relax different muscle groups at different times while still running. I run both right now with my normal weekday workouts on the road and my long weekend runs on a few trails at a local statepark. My only issue with the trails is the park service feels the need to put down gravel in spots to help drainage... OUCH.

 

[swoggis]

Sorry to hear that your

Sorry to hear that your injury did not improve. I'm in Week 5 of my six weeks of no-running recovery from my fibular stress fracture. I'd say, if you have any pain when you push on the spot after your two weeks off, get the MRI. My doc is considering another MRI for me after next week because I ran on through this injury for 4 months before finding out what it really was and he wants to be really sure it's gone before clearing me to run again. Things stopped hurting two weeks ago, but that doesn't mean the bone is actually healed. If you keep going out for runs as soon as the pain subsides, and it really is a fracture, you may end up with a much longer uncertainty/recovery period like me.