On Monday I went back to the sports podiatrist in Palo Alto (remember? Runner? Boston qualifier? Duathlete? Podiatrist to the Stars? That's the one).
Something I'm learning about doctors is that they always have really high expectations for your body. Typically I will go to have a thing treated, then go back a few weeks later for a follow up; they're like, "So how's it doing?" and I'm like, "Oh, pretty good, it seems to be a little better," or "Oh, great, I'm not incapacitated by pain anymore." Then the doctor will examine whatever it is with a disapproving look and say something like, "This should really be much better by now." This always makes me feel kind of anxious because I feel like s/he is insinuating that I haven't been trying hard enough to make my body heal itself.
So it was with the podiatrist. I've been faithfully doing my TheraBand exercises 4-5 days per week, and although my shin splints are definitely still there, I haven't had any utterly miserable days since my last visit. I assumed this was some kind of progress. Then he started pressing around on my medial tibias until I cried uncle. That was when he got the disapproving look.
Since I've had the shin splints for years, they don't go away with less mileage, and a few weeks of strength exercises hasn't gotten rid of them, he said that the next steps were to try fully custom orthotics and try running in air casts for a while. Sometimes, he said, people are just too biomechanically messed up for their bodies to be able to deal with something like this on their own. (Okay, maybe he didn't put it exactly like that.)
Maybe this doesn't sound like a big huge deal, but it kind of feels like one. I have always been kind of biased against braces and orthotics and such except in the case of serious injuries; everyone I've talked to about it and everything I've read (that's credible) says that the net effect of things like that is to weaken the small stabilizer muscles in the feet & lower legs. (This is where I can hear the minimalist shoe people starting to yell about the evils of modern shoes. Believe me, don't think I haven't thought about trying the creepy toe shoes on the off chance that it makes a difference, but it's not something I can start working on with a marathon in 10 weeks.) Also, the idea of running with all sorts of little pieces of medical technology strapped to my legs and feet makes me feel a little like the Bionic Woman or something, and that's an icky feeling. Like my body, in and of itself, has been officially deemed Not Sufficient.
Sigh. To be honest, it's kind of a moot point right now. The air casts aren't covered by insurance, and the cheapest I've been able to find them for is about $40 each, so $80ish in all. The orthotics are mostly covered; I'd pay 20% of somewhere between $350-400, so $70-80, plus whatever they'd charge me for the fitting. The fact of the matter, though, is that cost of the marathon and hotel room is probably more than I really should've spent on something I didn't actually need, and I certainly don't have a spare $200+ sitting around to spend on medical bills. (I've already spent $50 on the two visits alone.)
On the other hand, there is a part of me that's sufficiently terrified of having paid for this race and then not being able to run it because the shin splints suddenly went rogue on me that I'm still seriously tempted to just eat the cost of one or the other. These days I get a little panicky any time I feel a sharp pain anywhere in my shins and start hyperventilating about the possibility of ending up with a stress fracture. So maybe it'd be worth it, just for the peace of mind.