Bilateral proximal tibiae pain

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Bilateral proximal tibiae pain

by K.B.
(PA)

I started running/marathons in 2008. I was a smoker, and was running a 3:50-4:00 marathon. I quit smoking June of 2010. As you can guess, my running got a major boost of speed after. In July 2010, I noticed the medial portion of both tibae, right above the half way mark, started to experience a lot of pain. Not so much while running, but after, and it doesn't go away. The area is very focalized, and very painful when palpating. I've taken weeks off, had MRI's, but no definitive diagnosis, and here it is, about to be 2012, and I still have it! My MRI's always say I have edema bilateral proximal 3rd tibiae with no fracture line, and my Dr. tells me I can still run. I've pushed through, and still run marathons, but I am so frustrated. I feel it's holding me back from improving my marathon times, because I have to limit my mileage so much. The most I've ever ran a week is 40 miles, and am usually closer to 25-35 miles a week. Do you have any idea what this pain could be? I've done the whole ice massage, and frankly, it causes the area to hurt more the next day. Please help! I feel like I may have to just quit running all together. I've had my gait checked, and I am a mid-foot striker.

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Bilateral proximal tibiae pain

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Jan 01, 2012
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Proximal Tibial Pain
by: Mitch - MTS

First off, congrats on making a huge step forward with regards to your fitness and health.

The tibial pain can be a difficult issue for a lot of runners, especially people who make rather large increases in their activity. It sounds like you are suffering from what we would refer to as a "stress reaction." This is a precursor to a stress fracture. Usually on MRI, this shows up as edema in the outer layer of the bone with no fracture line. If you continue to push your limits, it will continue to a fracture.

There is a good chance that this has become a chronic issue for you at this point after all of the training and mileage. It is almost always caused by a biomechanical issue. Where the issue is, I can't tell you without seeing you. My guess is that it originates at your foot and gets exaggerated by hip tightness and core weakness (I'm taking a stab in the dark, but this would be typical for a runner).

I would likely put you in some custom orthotics. It is a good thing that you are a midfoot runner, as that helps you with some shock absorption over a rearfoot runner.

You may be at the point that you need to shut things down (and/or crosstrain) until your pain goes completely away with daily life. Then, once you have fixed whatever biomechanical issue you have going on, you can start to ease back to running.

Most runners are weak in their core, hips, and back. They tend to be tight overall, but especially in their hips. Fixing those area will be a good place to start.

Also, take a look at your nutrition. Poor nutrition (typically not enough calories) will have a large impact on these types of injuries.

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Bilateral proximal tibiae pain

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Bilateral proximal tibiae pain