I’m not a doctor, nor do I play one on TV. (If you don’t get that reference, you’re not a masters division runner.) But here we go again, back on the injury train, and back in that agonizing mode of deciding whether to play doctor or use a real one.
Some things are complex, others are simple. Some are simple but have complex bits. Others are complex but have simple bits. No question the human body is complex, but there are bits that are simpler than others. If your computer fails, it might be hard to figure out why. But if the failure is because the table it sat on collapsed, well, that’s pretty simple.
At what point is something simple enough that a reasonably educated and knowledgeable person can figure it out?
The facts are simple: two weeks ago, about five miles into my run, I had a sudden sharp pain near the bottom of my right shin. I didn’t scream or collapse or anything like that, but it wasn’t subtle. It faded within a tenth of a mile or so, but over the next few days it came back on every run, getting worse as the week wore on. So by week’s end, I decided to give it a rest.
After five days off, I jogged a mile. Not bad. So the next day, I jogged two miles. Not bad, either, just a little discomfort. One more day of rest, then Monday I went for a ‘real run’. A few miles out, it started in spades. And of course, by then, I was a few miles out. By the time I got back, well, crap, it hurt a lot. And it continued to do so for the rest of the day. And a lot the next day. So there’s clearly something going on. But what?
Now, here’s where it gets perplexing. Brains are complex. Hearts are complex. Feet are complex – and boy, don’t I know that from last year’s adventure. Joints and muscles are complex. But try to think of the simpler parts of your body, and the lower half of your shin, just a few inches above your foot, will be near, if not at the top of your simpleton index.
Fact is, there’s not much going on there. A pair of bones and a few tendons skirting by, and that’s about all (neglecting, of course, blood vessels, nerves, and subway lines). If you were in the tougher neighborhood around back, you’d be in Achilles territory, a trouble spot if ever there was one (which, thankfully, has not been an issue for me). If you were somewhat further north up the leg, you’re in shin splint zone. But down bottom around front? Really, it’s pretty dull. Not much action. Nobody writes academic studies about that locale.
So if it hurts there, you’ve basically got three options: the bones, the tendons, or something totally weird. At least so I think. Remember, I’m not a doctor. But remember, I’ve had a little experience dealing with the anatomy of the lower appendages after last fall and winter’s adventures.
Assuming that nothing from the alien category is going on, the question boils down to, is this a tendon or a bone problem? Tendon problems supposedly come on slowly with increasing irritation. So they say. But I of course know better, having had one suddenly snap last fall. Then again, that one had been irritated for months, and it did come on slowly. This case came on suddenly. That rules out a mis-located shin splint, too (or Medial Tibial Stress Syndrome, to be precise), and besides, I know them, this isn’t them. Yet the pain feels, well, tendon-y. Or does it?
The bone? Well, it’s not sticking out the side of my leg, so it would have to be something more subtle. Stress fractures do supposedly come on suddenly. Really, I read it on the Internet, it must be true. Sounds like we’ve got an ID, detective. But not so fast. Niece Kristin (of the Boilermaker fame), who’s about 90% of the way to being a physical therapist, which means she’s actively studying this stuff and probably knows it better than those just practicing it, notes that theory is quite debatable. So too, she reports, is the theory that they can be ferreted out with a tuning fork, which I tried last night with no results whatsoever (conveniently, since I play in the church band and hang out with musical types, said device was easily available). Yet, the pain feels, well, stress fracture-y. Or does it?
To be a doctor, or not to be? That is the question.
If I choose not to be the doctor, we play the game. Wait to see the real doctor, who will likely order a bone scan or MRI. Argue with the insurance company about paying for the test. Schedule, then wait for the test. Wait to see the doctor to discuss the results, which will be – guess what? tendon or bone. By which time, it’ll be halfway healed, and I’ll be out a lot of time, hassle, and some coin.
The kicker, of course, is that the recipe for either ailment is pretty much the same: rest, ice, ibuprofen, the usual suspects. Perhaps double down on the calcium supplements if it’s the bone (I already added some vitamin D to the mix just in case, it helps the absorption of the calcium). There’s no magic dust here. All that diagnosis, and it doesn’t change the outcome a whit. Heck, I coulda’ told you that.
I can be the doctor and life will be a lot easier.
But, what if I’m wrong? What if there is something weird going on here? A bit of anatomy I’ve neglected? A rare but terrible syndrome? After all, I’m no stranger to weird medical issues. And what if there is some definite action to be taken, without which it will never heal, I’ll slowly grow fat, lose my sanity, and live out my life watching the Home Shopping Network?
If I only knew…