Is it on one side, or both? Interesting problem, especially when altering shoe choice and orthotic intervention hasn’t helped. I usually don’t initially recommend a running gait change unless all other avenues are exhausted, but after 5 years this might be a direction needed to create change. Maybe Alison can pipe in with some recommendations. Strength training to stress the attachments of the posterior tibialis on the tibia would also be appropriate. Doing heel raise holds for 45 sec x5 is a good place to start. Then progress to greater load, then jump landings in a heel raise position.
Short version: for the last five years I’ve had issues with mild to moderate medial tibial pain, most likely a bone stress injury, whenever my running volume gets above about 3 hours/week at MAF pace. What can I do?
Have tried orthotics, various different shoe gear, and building up slowly. Cadence is at least 168spm and usually closer to 180, very much an “old man shuffle” gait. BW has fluctuated between 180 and 195 at 5’11”, heavy but not excessively so. No weird dietary restrictions, no history prior to this of tibial stress injury, extensive history of strength training. Work in wildland fire, interested in recreational backcountry travel, and that’s what’s currently determining my goals. I could keep going pretty much ad infinitum so let me know if there’s anything else you need to know to help.
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