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1214 Views 5 Replies Latest reply: Mar 1, 2012 2:49 PM by Damien Howell RSS
GeeRaCeR Rookie 5 posts since
Sep 30, 2011
Currently Being Moderated

Feb 16, 2012 12:21 AM

Is this shin splints or something else?!

Hi there,

I have pain on both legs below the knee on the medial side and sometimes lower down the shin. Where there is pain below the knee it also feels like a bruise to touch but there is no sign of bruising. sometimes it also often feels like a burning sensation down the shin

I was wondering if it is shin splints as I have read that when you have them the pain is lower down your leg and stops when you stop running/are further into a run whereas my pain is much higher up and is worst when standing followed closely by walking/running.  running makes it worse afterwards.

 

I am a 17 year old female. I am not a heel striker and run in the merrel pace glove.

I haven't incresed my training or changed surfaces/intensity so I have no idea what caused it.

I have also been icing, stretching, massaging and stregthening but nothing has really helped

If anyone has any ideas of what this is or why it happened and how to fix it it would be highly appreciated

  • Damien Howell Legend 308 posts since
    Feb 27, 2008
    Currently Being Moderated
    1. Feb 16, 2012 6:06 AM (in response to GeeRaCeR)
    Is this shin splints or something else?!

    If it is something else besides shin splints it could be a stress fracture.  A diagnostic image (radiograph and/or bone scan) is needed to rule out stress fracture.  The question remains why the shins are experiencing increased levesl of stress. Take a look at this short article Gait Analysis: Evaluation and Treatment of Shin Pain.  Also do a browser search for the term "rate of impact loading when running". 

    Damien Howell PT,DPT, OCS -#www.damienhowellpt.com

  • JamesJohnsonLMT Legend 1,128 posts since
    Aug 23, 2009
    Currently Being Moderated
    2. Feb 17, 2012 1:40 PM (in response to GeeRaCeR)
    Re: Is this shin splints or something else?!

    How long have you been running? How long in that kind of shoe, and on what surfaces?

     

    You said you haven't changed surfaces/intensity, hinting you may have been running a while, but the details are important. It might be time to change surface and/or intensity, maybe even the shoe. Ones like these haven't been out long and could be a clue.

     

    A Merrell Glove is not very forgiving of impact (and does not pretend to be), especially for a forefoot striker. The vibram soles are designed mainly to prevent lacerations. Even softer surfaces, if irregular, will require more muscular adjustments, possibly resulting in the kind of symptoms you describe.

     

    Bear in mind that pain is mapped in the mind, often to the wrong place. Examples are many, but I often use the pain in neck/arm that indicates a heart problem. Running without traditional cushioning means it must now be provided by your muscles, several of which could combine to produce a pain image. There can be strain to the muscular attachments on the periosteum (skin) of your bone, resulting in periostitis in areas bordering the involved muscles.

     

    If I were you, I would ice only in the case of obvious inflammation, because its primary value is to control the kind of swelling that impedes circulation. Heat may work better for you after the acute phase.

     

    I would not stretch, because any strains that already exist could be aggravated by straining the tissues further. This is doubly important when you don't actually know which tissues are in trouble. Massaging is a two-edged sword. Enough to stimulate local circulation and lymphatic flow can be helpful, but too much foam-rolling, etc. can irritate further. Same with strengthening exercises at this point, if the muscles are already strained.

     

    If I were to continue to try running, I would also change to a completely flat and predictable running surface, using a cushioned neutral trainer. Even soft grass can result in more strain, because the ideal muscular adjustment to each foot strike is not known until impact. This effect has been observed to increase hemolysis (blood cell breakdown), counterintuitively. It can be extrapolated that tissue breakdown may be concomitant.

     

    A number of years ago, I experienced great shin pains in my second year of competitive running, which I blamed on shin splints after a lot of racing and speedwork, combined with long bouts of marathon training. It was just too much, and I had to cut back. I did, and eventually the limping went away so I could resume serious running.

     

    Don't out-compete yourself. It's a lose-lose scenario. Take a break with more rest than stimuation to these painful areas, and allow time for some obvious damage to heal, before going out to test it again. While it may seem remote to the problem, work on loosening up your quads, hamstrings and rear calves, all of which are involved with focusing their stabilizing efforts on tissues below the knee.

     

    If you are doing yoga, remember that there is a long muscle (Sartorius) going from the outer hip to the inner knee, that is instrumental in achieving and maintaining the lotus position. The muscle has several bellies, concatenated into the longest muscular chain in the body. Each of these bellies can exhibit symptoms individually, including the one at the medial knee, which attaches to the inner Tibia. Stretching the leg back (extending the hip), can result in a pain reflex anywhere along this muscle's length. Standing tends to aggravate the Sartorius, while sitting relieves it when it slackens. Rapid hip flexion, adjusting to varied surfaces, or any quick movements involving the hip can also make it worse. The main symptom is a burning or tingling sensation under the skin, sometimes resulting from the muscle directly affecting nerves in the leg.

     

    Message was edited by: James Johnson LMT

  • JamesJohnsonLMT Legend 1,128 posts since
    Aug 23, 2009
    Currently Being Moderated
    4. Mar 1, 2012 12:01 PM (in response to GeeRaCeR)
    Re: Is this shin splints or something else?!

    The contrast baths are a good idea, and you might benefit from soaking in Epsom (magnesium sulfate) salts for the warm part. I'm not sure if stretches are advisable at this point, since something seems too tight to stretch and needs to be relaxed somehow. The salts might help with that.

     

    Running on grass, though, can actually increase muscular wear and tear by eliminating predictability. See the link above for hemolysis. Yoga, involving prolonged stretching, is best when there are not tightness problems. The advantage is in training the mind to control the stress, but you don't want to injure yourself further in the attempt. Better to start healthy and use yoga as a reinforcement, not as an enforcer.

     

    You could try gentle foam rolling of the quads to get the sartorius, using mild pressure from inner knee to outer hip along its path to test your theory. While the muscle is hard to effectively stretch, as it is almost always lax, running in general, particularly grass running, can crank it up as a hip flexor.

     

    Try alternating runs with the compression sleeve to observe the results. Too much compression can interfere with lymphatic flow, and should be avoided. Kinetic taping might be a better option...

     

     

  • Damien Howell Legend 308 posts since
    Feb 27, 2008
    Currently Being Moderated
    5. Mar 1, 2012 2:49 PM (in response to GeeRaCeR)
    Is this shin splints or something else?!

    Running on consecutive days is not a wise idea when recovering from an injury.  Take a look at this short article Consecutive Days.   Ice, heat, compression sleeves are treatments that have been used for shin pain.  Again I would encourage you to examine the manner in which you run as potentially a major factor in the development and allievation of your pain.  Take a llook at Powerful treatment for running injury.  Also read about Impact loading running.  Running on grass can help decrease the rate of impact loading. 

    Damien Howell PT, DPT, OCS

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