Pain in outside of lower leg - repost from wrong forum.

[Judo Chop!]

I got flamed for asking about this in techtalk (I guess for thinking I was talking about boot tech?? ) so I'll ask again here.

I've been getting pain along the outer sides of my lower legs around the area of my boot top. Both legs, and with various different boots.
I can't tell if it's bruising (although it doesn't hurt to press on it) or a muscle thing. One reply suggested it might be the peroneus longus muscle. I've had it last season and this season most days, and just sorta deal with the pain but I'm worried I'm doing damage. I guess I would describe it as feeling similar to shin bang yet on the sides, not shin. It gets worse after a few days in a row. It lasts for days after skiing; but lately I haven't gone too many days between skiing
I actually feel it more the more-forward/less-backseat I get. However I also think it is worst when skiing my Renegades (which like a more upright stance) than my other skis (which are each wider or narrower).

I've tried a bunch of different remedies myself - booster straps seem to help a bit, but not a solution. I always struggle with heel hold, and it does seem to get a bit better whenever I do something to improve heel hold (mostly adding foam / new boots). I've also played with cuff alignment.
I don't have footbeds because my liners don't leave much spare volume, although that is the next thing to try to figure out.

FWIW> I naturally supinate, not pronate.

Yes, I have done searches and not found anything really satisfactory, although some good small tips to help with the symptoms, but not much about the root cause.
Is this common? Causes? Solutions? Am i doing any long-term damage?
I've tried bootfitters - who else can I see about it?
thanks mags.

[Orthoski]

This one's going to be tough to answer on a forum. The peroneal muscles are on the outside of our leg (both longus and brevis) and the work to bring our ankle outwards (i.e., evert). You mentioned that you naturally supinate - meaning you have high arches? Sometimes people with high arches might have a bow-legged (varus) alignment in their ankles, which makes the peroneal muscles have to work harder to keep your ankle from going inwards. This would go along with your statement that your symptoms are better when you maximize your heel hold. If this is indeed the case, a footbed with a lateral post (something to prop up the outside of your foot) can help align your ankle into a more neutral alignment and take some of the stress off the peroneal muscles.

Again, this is a tough question to answer on a forum. Consider seeing an orthopedic surgeon that specializes in foot and ankle, because he/she can put an exam with your story. Best of luck!

[Judo Chop!]

awesome. thanks for the specific feedback.
I was thinking along those lines with the footbed type (although, no I have normal arches. And my ankle barely rolls inwards even if I try - outwards) . Tried getting in to get a footbed today but took too long so went skiing instead.

Also have an appointment with a podiatrist. But also have a friend who is a very good ortho, so I'll chat with him too.

[kookjong-san]

I also have this problem.

I've found the cause to be the force exerted on the outside edge of the uphill ski in a turn.

Looking along the ski from the rear, consider that pushing up on either edge of the ski will tend to lever the corresponding side of the boot shaft inwards against the lower leg.

Now, the force needed to prevent this motion is applied by the bottom of the foot. The inside muscle chains of my feet seem strong and up to the task, able to hold an edge reliably without allowing the boot to lever against my leg. Thus the downhill ski presents no pain.

The outsides of my feet seem dramatically weaker, allowing the offending motion to occur with force applied to the outside edge of the ski, as to the outside edge of the uphill ski in a turn. The motion becomes increasingly pronounced as fatigue sets in.

The damage is compounded as the muscle being impacted is the very same one needed to prevent the motion in the first place, causing the whole thing to snowball.

This issue is exacerbated by wider skis which provide a longer and therefore more powerful lever to drive the boot shaft inwards. Stiff skis will also intensify the motion.

Add to the mix boots with exceptional lateral power transmission and the recipe is complete. Let simmer for 30 days back to back and you're on the exit ramp to Gimpsville.

For me it's Volkl Katanas with Dalbello KR2's.

I think the solution is to strengthen the weak peroneal muscles and consider more forgiving equipment (narrower skis, perhaps without two sheets of metal, maybe different boots?) in the meantime, while using ice and advil to prevent inflammation as well as sufficient rest.

I don't personally believe that going to a boot fitter and spending hundreds of dollars on custom footbeds and shell modifications is necessarily the answer, (although these measures may certainly be necessary to prevent myriad other issues). The motion described above will still occur. I think it is primarily a matter of strength and conditioning.

This is only a theory and I am nothing even close to resembling an expert in this area. I'm just trying to use a bit of common sense. I'd be very grateful for input from the community! The pain is pretty bad and is keeping me from skiing for the time being.

[creaky fossil]

if it's not boot cuff alignment, then it's possibly a not uncommon pain found when your turning method involves you trying to torque your skis, more common on wider skis or when moving to a new ski that's a good bit wider than your old one. when you torque at the feet rather than angulate at the knee (better) or decouple at the hip socket (best) you'll strain those muscles along the outside of the shin. a shin splint sort of pain. probably most noticeable if you are skiing chopped up stuff, gets more noticeable the heavier/stickier the snow. a supple ankle is better than a tight ankle. active eversion overuse?

[jma233]

I had something similar when I started skiing wider boards inbounds. This is what eliminated the problem for me.

http://www.tognar.com/the-eliminator...-tongues-pair/

I just stick them under my socks and don't worry about permanent installation. They drive your heels into the back of your boot where they belong. I have skinny 'bird heels' and skinny ankles.

I always suspected the pain was from my peroneals working overtime in a boot that was a little sloppy.

[ShaneSchmutz]

Just out of curiosity. For the people having this type of pain; do you have Intuition Liners? I recently started having this pain after switching to Intuition Liners. Yes or no?

Shane

[kookjong-san]

Hey Shane,

Yes, I am using Intuition ID Pro Wrap liners in my Dalbello KR2's. This liner is seriously stiff and the inner edge of the wrap runs along the part of the leg which is in pain. So yes, I believe the liners are at least part of the problem. I didn't even get mine thermo-molded. I think I will do that and see if it helps. I may also switch to a softer, higher-volume Intuition liner, perhaps the traditional type instead of the wrap (although I do like the added support and warmth of the wrap).

[ShaneSchmutz]

Kookjong,

The more research I do on this pain the more that I think it's the Intuition Pro Wrap liners that are causing the problems. I've had mine heat molded and they are very comfortable (minus this excruciating and debilitating pain). Unfortunately, I think the answer may be to move away from the wraps. I think they provide too much support everywhere else and cause the area we are discussing (the muscles there) to get overworked.

Shane

[ShaneSchmutz]

Or, could it be that the edge of the inner wrap of the Intuition liners are where the pressure point is? If so, any way to fix this assuming you've already had them heat molded and that inner wrap is already pressed down and shaped thin?

Shane

[Gepeto]

if it's not boot cuff alignment, then it's possibly a not uncommon pain found when your turning method involves you trying to torque your skis, more common on wider skis or when moving to a new ski that's a good bit wider than your old one. when you torque at the feet rather than angulate at the knee (better) or decouple at the hip socket (best) you'll strain those muscles along the outside of the shin. a shin splint sort of pain. probably most noticeable if you are skiing chopped up stuff, gets more noticeable the heavier/stickier the snow. a supple ankle is better than a tight ankle. active eversion overuse?

JC, I would test this assessment of your problem first and it is the easiest to eliminate depending how engrained your current technique is.

Manipulating the ski with your foot/ankle is a definite no no. Any void in your boot will promote this tendency too.

An easy test to determine if you have this tendency is to head to a groomer and initiate, hold and exit turns while wiggling your toes. If you’re able to wiggle your toes freely without any noticeable deficiency in your arc, then see the other comments.
If not (freely wiggling), take the turn apart. Wiggle on entry only; wiggle in the apex only; wiggle on extension/exit only.

This process will help narrow down the negative input and get you on the right track.

Getting a solid foundation under your foot will be a way of accelerating your learning curve away from this bad habit (if you have it of course). See a podorist for real custom orthoses. They won’t be cheap, but you will have them for years.

The molded footbeds off the ski shop shelf thrown into the boot oven have come a long way. They are not, by any stretch of the imagination, a healthy anatomical foundation for your unique foot.

[Toddball]

Bumping an old thread; going through this right now.

Did any of the afflicted ever find a solution? I like kookjong-san's theory that pain on the outside of the lower leg is caused by smashing through firm variable snow on skis that are too wide, but it also makes sense that manipulating the ski with the ankle (especially the movement of turning a ski towards the outside) could overwork the peroneus muscles. Certainly those muscles feel sore when I try to roll my ankle inward/lift outside of foot.

I don't think I've ever had a problem with this in consistent snow conditions, but I end up with really bad pain trying to ski sticky, inbounds, heel-slid Cascade Concrete. Boots and skis that cause this include Kryptons, MTN Labs, Hojis and Jeffrey 122s. Only solution so far has been ibuprofen and tele (on Garmont Syner-Gs and 97mm Karhus).

[auvgeek]

I found a solution for my issue, which was tendonitis of my peroneal muscles where they attach to the fibula. Tried all different types of boots, liners, orthotics/footbeds, etc. Finally found relief as per usual with tendonitis: isometric and progressive concentric/eccentric loading of the tendon via eversion exercises with a theraband.

Tendonitis gets worse with intense compression, so it's much worse for me in a ski boot.

[rod9301]

Shock wave therapy, 5 sessions

Sent from my Moto G (5) Plus using TGR Forums mobile app

[splat]

Rubbing the fibula does wonders for this, relaxing the soft tissue that is pushing it out of line.

[Toddball]

I found a solution for my issue, which was tendonitis of my peroneal muscles where they attach to the fibula. Tried all different types of boots, liners, orthotics/footbeds, etc. Finally found relief as per usual with tendonitis: isometric and progressive concentric/eccentric loading of the tendon via eversion exercises with a theraband.

Tendonitis gets worse with intense compression, so it's much worse for me in a ski boot.

Hardly ever done theraband work but I'll give it a shot. Thanks!

Shock wave therapy, 5 sessions

Sent from my Moto G (5) Plus using TGR Forums mobile app

Not sure what shock wave therapy is, sounds like the kind of thing I was doing to injure myself in the first place.

Rubbing the fibula does wonders for this, relaxing the soft tissue that is pushing it out of line.

I had my most excruciating foam roller session ever trying to work this area, but I do think its helping. Thanks!

[rod9301]

Hardly ever done theraband work but I'll give it a shot. Thanks!



Not sure what shock wave therapy is, sounds like the kind of thing I was doing to injure myself in the first place.



I had my most excruciating foam roller session ever trying to work this area, but I do think its helping. Thanks!

Google it, it's used widely in Europe, I had it three times, shoulder, Achilles and elbow, healed every time

Sent from my Moto G (5) Plus using TGR Forums mobile app

[auvgeek]

I haven't tried shock wave therapy -- though I'll look for a provider who offers it near me, but my experience with tissue work (massage, foam rolling, ultrasound, graston, etc) is that it can absolutely help the affected tissue and reduce acute pain, but there's a high probability of recurrence unless you fix the underlying cause -- usually lack of strength and/or poor biomechanics. If it's an acute injury caught early, then tissue work without strengthening might work just fine.

[rod9301]

Well, yeah, once you cure the tendinitis you need to strengthen up, stretch etc.

Sent from my Moto G (5) Plus using TGR Forums mobile app

[revolutionrock]

I have a similar problem only in my left leg.

Last season I went to a physiotherapist he suspected the peroneus longus muscle. Was apparently weaker in my left leg and got a few exercises but didn't help or to little training, hurts this season to...

Pain only occurs when I'm in a ski boot. And if rise up from a squatting position.

If I push a finger between the calf and peroneus it hurts "AF" if I've been skiing for about two days in a row.


https://www.tetongravity.com/forums/...n-in-lower-leg

[Toddball]

Bump, maybe the wrong thread. Had a weird crash on Saturday that has resulted in a similar, but probably different, issue. Managed to catch a tip on some avy chunder on a shitty runout (Source Lake to Alpental lot 4, for WA denizens), which spun me around 180 degrees, at which point I speared the tail of my right ski into another ice ball and stopped the ski dead. Fell very abruptly onto my back, although my pack and helmet did a great job of cushioning the fall. The ski that got hung up did not release, and I instantly had a lot of pain in my lower leg. I could ski out in a fair amount of pain, but was able to drive home without much issue.

Yesterday (1 day from crash) and today, I can walk around and even jump up and down on the ball of my foot, but if I flex my ankle forward and try to weight the ball of my foot I get really intense pain in my lower leg. It seems like it's generally on the outside (lateral?) side of my leg, and I guess on the back (posterior?), like maybe my soleus muscle or something.

I think the pain has improved significantly every day, and I can work from home so I don't have to walk around too much. Never had much swelling.

My questions are:
(1) What is my injury? Any chance of bone fracture (e.g. fibula)? I can bear full body weight on my right leg if I weight my heel, or on the ball of my foot if my ankle is not flexed forward.
(2) Besides RICE, what should I do for rehab? Stretching + rolling okay, or counterproductive? Ibuprofen good or no?
(3) How stupid would it be to go tele skiing (or alpine skiing) tomorrow night, for which I have already purchased a ticket? Planning on bringing a reasonable amount of Ibuprofen if needed.

[Ottime]

^^^^you might want to consult a professional doctor instead of some random dudes on the Internet.

If something is torn, skiing is not going to help. Neither is a pain blocker.

[Toddball]

^^^^you might want to consult a professional doctor instead of some random dudes on the Internet.

If something is torn, skiing is not going to help. Neither is a pain blocker.

I thought everyone here had a medical degree?

Yeah I guess I'll do that. Just curious if anyone has had symptoms like this before from this kind of crash.

[Ottime]

Yeah. I get it. Sounds like you tore something to me with the 180 spin to abrupt stop. But I only play doctor when I’ve had a few too many drinks.

[t-the-east]

I thought everyone here had a dental degree?.

FIFY