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rottensquirrel has offered to answer medical questions. His day job is a surgeon so ask away.
 

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Just as an introduction, I am an orthopedic surgeon with experience in sports medicine. The more detailed your description of your problem the more I can probably help. If you prefer not to air your medical information on this thread you can e-mail a private message. I will do my best to respond in a timely fashion but I usually do not post on weekends.
 

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I have one!!!<br><br>
Diagnoised with stress fracture in my lower left tibia (via bone scan) back in late October. Stayed away from running, and kicking while swimming, and standing while bikeing for 9 weeks. Still can feel that "hot spot" and I have tried coming back very slowly. Should I get another bone scan? Are they often wrong and could it have been another issue?
 

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Most stress fractures should be healed within 3 months. Do you feel the pain all the time or only after exercise or does it only hurt when you touch it? Some sensitivity is to be expected even after the fracture is healed. Another bone scan at this stage will almost definitely be positive. Even if healed the fracture will continue to mature for a long time which will keep the scan positive. If you need definitive proof of healing a CT scan would be more effective. However bear in mind that a CT scan exposes you to a fair amount of radiation. Bone scans are very non-specific tests. They are only an indicator of bone activity. However combined with an x-ray and a history of significant training your positive scan was most likely due to a stress fx.
 

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I've had a nagging on-again/off-again pain in my lower left abdomen for over a year now. I seem to have gotten used to it and keep forgetting to friggin call the doctor about it but it's a real PITA and is holding me back workout wise.<br><br>
It's a burning sensation that seems to be aggravated by long runs or any kind of ab work. It feels deep inside the muscle but not anything intestinal like Crohn's or IBS. If I try to do any lower-ab work that involves leg lifting the pain is sharp so I have to modify yoga/pilates exercises to perform them. Crunches, however, do not hurt. Sometimes the pain seems to extend down into the groin, usually after a long run. Pressing on the area, which is kind of hard to find, doesn't cause any pain. I don't feel any bulge. I did notice it started after needing to lift some heavy furniture by myself one time.<br><br>
Could this be some kind of hernia anyway, like inguinal or femoral? Athletic pubalgia? (Can you tell I've been looking on wikipedia?) If not, what else could it be?<br><br>
And, yes ... I will go to the doctor. I am just curious what to expect <img alt="smile.gif" src="http://files.kickrunners.com/smilies/smile.gif">.<br><br>
Thanks!
 

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I don't feel pain all the time, usually just after exercise or on a few occassions for a whole 24 hours after exercise (like when I did a lot of kicking drills while swimming, which I have since stopped). How do you know how much pain is OK to continue training? I wouldn't even say it's painful per say, more like it's easy for me to pinpoint the spot. I have been calling it the "hot spot" if that makes sense.
 

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<span style="color:#000000;">Hey Rottensquirrel first off, thanks for offering your expert advice...</span><br><br><span style="color:#000000;">I had a constant pain starting in my right hip that went all the way down the outside of my leg to the top of my foot. I also had a pins and needles sensation in the foot. I was recently diagnosed with grade two spondyliothesis (L4,L5). I've had a series of epidural steroid injections which provided significant improvement. I can swim and bike without pain but I can't run without pain.</span><br><br><span style="color:#000000;">My question is about a surgical fix. If I get a fusion, will there generally be loss of mobility? Can people with that type of fusion return to Ironman distance training/racing? Will the fix be permanent? Would you recommend a surgical fix to a good friend or family member?</span><br><br><span style="color:#000000;">Thanks in advance for your reply.</span><br><br>
Stu
 

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thanks rottensquirrel for offering to help. I am good, I just wanted to say thanks! <img alt="biggrin.gif" src="http://files.kickrunners.com/smilies/biggrin.gif">
 

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thanks rottensquirrel!<br>
I have a quesiton about your answer from the questions thread (is that circular)? About what seems to be a chronic but now greater low serum sodium is that the same as hyponatremia which I thought was an acute condiiton? I suspected it was related to sports but agian my doctors seemed stumped one reccomend increasing sodium and one decreasing it. Since other than the test report i have no symptoms I may not ever find a real answer but i'm still stuck on finding the answer to my primary problems anyway! I do need a new physical in a few months so if there's anything I shoudl try to track down there I will.
 

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Dougie your symptoms could be the result of a"sports hernia". A sports hernia is a weak spot in the abdominal wall that can be symptomatic with situps or lifting. These can often be hard to diagnose but you should probably see a general surgeon rather than an orthopedic surgeon. You might also need to suggest this as a possible diagnosis during your visit.
 

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Kristine it is tough to give you precise advice. Relatively mild soreness on a scale 1-3 (10 being the worst) is probably tolerable. The key when returning to training is to go SLOW. Slower than you think you should. I'm talking about running a half mile on a treadmill very slow. Evaluate how you feel during the run and the following 24 hours. Increase very slowly in quarter or half mile increments until you can go 3-4 miles comfortably. The actual spot will give you some soreness especially to touch even after the fracture is healed.
 

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Actually, I do have a question, although who knows if it is your area<br><br>
When I run my left "shin" area will get progressively tighter until pain. If I stop at 5min and stretch it, in particular EHL (Extensor Hallicus Longus) along with calves, hammy, quads then I am usually good to go - whether it is a 30min or 3 hour run. Regardless of warmup (albeit starting with walking, speeding up, etc) or whatnot. The result is that most runs the first 20min are varying degrees of uncomfortable, after 20min tend to be good to go. If I don't stretch eventually the muscle shuts down (oh yeah and pain is intense) and I can't flex my ankle.<br><br>
In training, this isn't a big deal. I can cope. But in racing... therein lies my problem. This alone is adding 2-3min to any given run, which in a sprint is getting darn close to the difference between hardware and no hardware.<br><br>
232lb male, 36, HIM distance, 5th season. Orthorics always in use on run but this has always happened.<br><br>
p.s. I have huge calves and shins, in case that matters.<br><br>
any thoughts? I'd love to snag some Clydes hardware someday
 

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Stu tough question. Spondlo's above grade I can lead to nerve root irritation typically the L4 root. That is most likely the cause for your leg pain. The epidural relieves the inflammation and hence the pain. I assume you have had a MRI to confirm the nerve root involvement. I would usually try some PT for strengthening before recommending surgery. Increasing flexibilty and strength may help. Unfortunately higher level slips can progress with time so you should probably be followed every 2-3 years with an XR regardless of symptoms. If the symptoms persist and prevent you from being active a fusion can resolve the issue. If I were to have a fusion I would have an instrumented fusion (metal rods) because I think the success rate is higher. I do not think a fusion would preclude you from an Ironman but that is surgeon specific advice.
 

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Swimmerbee, hyponatremia simply refers to low serum sodium, it comes in varying severity. Severe, acute hyponatremia can lead to coma and death. In your case it is somewhat chronic and your body has been able to compensate. I don't think the answer is as simple as more or less sodium. You need to know the actual cause before treatment.<br>
The problem could be kidney related or related to your adrenal gland but there are many causes and it is not always easy to sort it out. Hyponatemia is a little outside my area of expertise. If you cannot get answers from your internist you might consider a nephrologist they would probably be the best at making the diagnosis.
 

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ooh, I get what PCSRonbo gets.<br><br>
I get it on the muscle thats on the outside of each shin and tightness in my achillies and ankles. It lasts until miles 4 to 5 regardless of temp, time, diet, shoes, or level of training. Stretching during a run does nothing to aleviate the tightness in my lower legs.<br><br>
I Always, have to go slow, Like 10:00m/m until this tightness goes away, which makes most of my race times waaaaaay slower than they should be. I am also about 230, I've run up to 30miles, and am training for Full IM. The Achillies feels normal only when I run barefoot, which is only when there isn't snow on the ground. The shins are tight no matter what.<br><br>
Know anything that might help?<br><br>
Thanks.
 

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Pcs unfortunately that sounds like simple muscle cramping. The fact that it improves after stretching make other diagnoses like exertional compartment syndrome or stress fx unlikely. My only advice is common sense which is warm-up prior to a race as though you were embarking on a training run, when the pain starts stretch and then hopefully you will be good to go. I assume you have decent cushion in your shoe. I have had similar symptoms in the past but they seem to have resolved as my legs got used to the pounding. It does not sound as though this has been your experience.
 

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Pcs/rambler you might also get evaluated for over/under pronation and try running on softer surfaces and see a therapist for muscle specific stretches. This issue is usually stress dependent so increasing mileage/training may be partially responsible. I don't know why running barefoot would help.
 

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Stu tough question. Spondlo's above grade I can lead to nerve root irritation typically the L4 root. That is most likely the cause for your leg pain. The epidural relieves the inflammation and hence the pain. I assume you have had a MRI to confirm the nerve root involvement. I would usually try some PT for strengthening before recommending surgery. Increasing flexibilty and strength may help. Unfortunately higher level slips can progress with time so you should probably be followed every 2-3 years with an XR regardless of symptoms. If the symptoms persist and prevent you from being active a fusion can resolve the issue. If I were to have a fusion I would have an instrumented fusion (metal rods) because I think the success rate is higher. I do not think a fusion would preclude you from an Ironman but that is surgeon specific advice.
 

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Thanks very much for your reply. I am going to make a LONG overdue appointment with my doctor. Luckily (though I chose him for this) he's a runner and triathlete and sports medicine is one of his things.<br><br>
Poor guy. I have a list of things for him!
 

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Rotten Squirrel, Just want to say thanks for doing this. I don't have any physical problems right now, but being a runner and getting some sort of injury every couple of years, I am sure I will have something in the future.
 
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