With the approach of the cooler weather we see the start of the running festivals. There seems to be more running events now than at any other time and with a more focused approach to health many people are using the events to give themselves a goal to get fit.
For most seasoned runners there is an awareness of how much load their bodies can endure and a subsequent adjustment in workload depending on their symptoms. For the relative new runner there are some conditions to be aware of and one of the more common conditions that I encounter is Shin Splints.
Shin Splints or the more correct term of Medial Tibial Stress Syndrome (MTSS) is a condition where the runner sustains pain on the inside or medial side of the shin bone. It occurs frequently at the start of a training schedule where the muscles on the inside of the shin are placed under increased stress and have not had a chance to condition to the rigors of running. The muscle at the heart of the syndrome is Tibialis Posterior. Its role is to support the arch during stance, controlling the pronation of the foot. It also helps stiffen the foot during toe off to give a strong, efficient base through which to deliver power from the calf. Weakness of the Tibialis Posterior muscle, excessive pronation and incorrect footwear prescription and training methods all contribute to the propagation of MTSS. Once the condition sets in rest and ice are good methods to control the inflammation and pain. Then incorrect foot postures, training techniques and shoe types can be addressed, followed by a gradual return to sport.
Another condition that is similar in symptoms to MTSS is stress fracture of the tibia. Often the symptoms are difficult to distinguish as both have medial shin pain that is present with activity. MTSS tends to be a little more diffuse in its pain presentation where stress fractures generally have a point which is significantly more tender than the rest of the bone. There may be associated swelling with the fracture and usually pain gets worse with activity, often resulting in night pain. Shin splints, while being painful tends to plateau in intensity with activity and pain at rest is absent.
The mechanisms for stress fracture are similar to that of MTSS in that training errors and excess pronation are common contributors to increasing torsional stress through the bone which eventually results in failure. Stress fracture rehabilitation includes rest which may require a period of non weight bearing, protective weight bearing in a CAM boot and footwear modification. Most fractures are sufficiently healed by the 12 week mark for a return to activity but pain is a good guide.
So if you’re planning on engaging in one of the upcoming running events I suggest that you visit one of the specialist foot wear stores to match the shoes to your feet. Most of the stores will have sufficiently qualified staff to assess your foot type and provide a conducive foot wear solution to reduce the chances of injury. If you are experiencing any of the above symptoms a quick assessment with a health professional should be enough to set you back on the right course.