I'm posting here to ask for advice on getting rid of, or at least reducing, an injury that has been persistent and debilitating for 18 months now. I feel like I have tried everything at this point. To those who are kind enough to read the whole story and give me their opinion, whatever it may be, I am very grateful.
I am a 17 year old high school junior, female, 5'9" tall. Distance running is my favorite thing in the whole world.I started running (low volume) in seventh grade, 2-3 miles about 5 days a week. From the ages of 12 to 14 I was underweight and lost my period for 3 years. During this time my bone density was measured as slightly lower than normal but not highly concerning. As per doctor's instructions I was gradually gaining weight during that time. The summer before my freshman year I increased running to 4-5 miles 6 days a week on average. I entered freshman year weighing about 130 pounds (same height as now), not underweight but still no period that entire year. I was running 5ks mid to low 21's and running 35-45 mpw on average. I had a stress reaction in my heel in late fall and one in the other heel in the spring, neither were serious.
Over the summer, with the knowledge and advice of my coach. I gradually increased my mileage to a peak of 58-60 mpw (end of summer). Over the summer i gained some weight from being less obsessive about my diet, finally getting my period back, and was a little over 140 lbs in September. I had no injury issues and ran a huge PR first race out of sophomore year. Then I strained a glute and limped when I ran, and before long I was having shin pain, which at the time I thought was a compensation thing. It did not go away and got worse and worse, as I took advil before every run to be able to run without limping too much (it still hurt). By mid to late Oct I was only running hard workouts and races, trying to stay fit (I had been number 1-2 and was dropping down to 5th man) with less volume. It eventually got to the point I could barely walk but I kept racing and doing modified training, as well as crosstraining on the elliptical and bike, lifting weights, and doing a lot of calf stretching, ice every day. The pain was localized and excruciating to press on, but i have a very high pain tolerance, especially when running is involved! :)
After XC regionals i took a month off of running and saw an orthopedist, who told me i had a stress reaction and gave me the typical "ice-rest-you'll be fine" response. I was not fine. Around Christmastime I tried to slowly get back into running, 10 min every other day I think increasing 3 min every two runs, but within like a week it was coming back. I resigned myself to no hope of a real indoor season. I did two months of physical therapy, doing the exercises every day. More time off, more trying to come back conservatively, no success. I was gaining weight gradually due to a combination of normal female growth, recovering completely from my eating disorder, and a LOT of weight lifting (I could squat 160 lbs).
At the beginning of spring track I tried to run with the team, and had maybe one or two 2ish mile weeks before it really started getting bad again. Midspring my weight was probably around 150 to 155. Eventually I was forced by limping to go back to only running quality workouts and crosstraining otherwise. Mid April I had the worst workout of my life, physically could not make my legs do the running motion because the pain was so severe, despite still having been doing ice, advil, stretching, shin strengthening exercises.I had no choice but to stop running. I don't remember exactly when, but I went to a very good sports medicine doctor who gave me a new medicine (topical antiinflammatory) and had me do fast walks (13 min miles) to strengthen the tibia. He also recommended all the usual shin splint stuff. I got an MRI, but it took like a month before I got an appointment, and when I went in, my shins felt the best they had since the pain started....and the results said I had the highest grade of stress reaction before stress fracture. The doctor said I had probably had stress fractures when I was having the worst limping and constant pain during XC and because I trained through them they never finished healing. At my physical in June I weighed 159 pounds which was shocking and upsetting to me, but my bloodwork was perfect for the first time ever, and I was very strong. During the summer, I hoped to gradually start running, transitioning from race walking (which I did four to six miles most days, at first with an air cast to relieve impact) and crosstraining, but had little success. Over the course of the summer I gained about 5 lbs. I ran a full mile with no pain July 1st, tried to increase from there, had a little pain but not bad at all. Random hip flexor strain in early August lasted six weeks and prevented me from running much at XC camp with my team.
In early September my right foot suddenly hurt in the front after a time trial, persisted for 2 weeks, coach and trainer said I had a pinched tendon. I ran one race and had bad pain, but managed a decent time. Afterwards I couldn't even put weight on my foot, got an MRI, pretty serious metatarsal stress fracture. Keep in mind I had been very very conservative with buildup. I was also careful in recovery, boot, crutches, lots of swimming. Clean bill of health after 10 weeks. Started running with 400 meters at a time. No shin pain for like 2 weeks. By the time I was trying to run a mile or two at a time about four days a week pain started returning. At this point it was mid December.
Since, I have been able to keep pain managed, even running two miles a day for a week without significant worsening during January, but then it started getting a little worse. Now I just run track workouts twice a week, about 2 or 3 miles of 200-600 m repeats at race pace. The pain in one of my shins is becoming more localised and bothering me even when I walk occasionally. There is no limping or anything, and pain lessens during running but hits me like a wave as soon as I stop. I am concerned that it will develop into another stress fracture and I don't know what to do.
In brief, I have taken huge amounts of time off, done tons of flexibility and strength exercises, used various medicines and things like calf sleeves and aircasts, full body strength improvement, have addressed functional strength and biomechanical weaknesses with my coach, do not pronate, midfoot strike, high cushion shoes with orthotics, bone density is now in the low normal range, I eat mostly vegetables, fruit, chicken, fish, dairy, oats, sweet potatoes, nut butter, protein and clif bars, chocolate, sometimes bread and other grains. What the hell is wrong with me?!?!?!
Do you think it could be my weight causing too much impact? I am trying very hard to lose weigth, have been for moths, no results. I am getting bloodwork done to determine if thyroid issues that I have had in the past could be a cause.
Any other ideas?
If you read all of this thank you so much! I just love running more than anything and desperately want to train consistently.