Posterior Shin Splints. Injury management/recovery?

Hi all

I'm a fairly inexperienced competitive runner. Went from doing  typically not much running in a week, to running distance road and track races fairly regularly over the last few months. I didn't feel pain only until the last couple of weeks after doing a 10 miler in 1:06 something, (won first junior image). I know I've got posterior shin splints and I know it's because of my over zealous approach. I've the proper shoes for an over-pronator. Just joined my local club too and I want to go on a proper training program. One of the guys who runs for the club told me he got them on and off when he was a novice and just to keep training and they will eventually go away. Is this good advice? All the stuff I've read tells me rest/ice etc. I can run on them if I have to, did a 5k on the track yesterday, but am pretty sore when I don't have the adrenaline flowing. Tried to run in my local park earlier and the pain was definitely enough to put paid to my run. Training through can't be good advice?

Recovery stories anyone? Is this typical for novice runners?  I'm pretty impatient to use my summer to build good fitness for cross country. Thanks for any advice/replies.

Comments

  • Hi,

    I wouldn't run through it, it might get worse doing this. How did you get a diagnosis of posterior shin splints? Shin splints isn't an accurate diagnosis, it's a bit like saying "runners knee" it can cover a few things. Exactly what the problem is will affect how you manage it.



    When people say posterior shin splints they usually mean either

    A) Tibialis posterior tendonopathy...or

    B) Stress reaction in the medial (inside part) of the tibia. Sometimes called Medial Tibial Stress Syndrome.



    Do you have any bony tenderness or pain on impact (e.g. If you hop)?



    Sorry for complex reply - need to know a bit more before I can advise you.



    For more info on this check out this blog;

    http://runningphysio.wordpress.com/shin-pain-part-one/



    Tom
  • Hi Tom thanks for taking the time to reply.

    I just looked through a few internet pages on the topic and diagnosed myself really. It is sore yeah when I hop on both shins on the inside. It is concentrated particularly in one area on both shins. I pressed with thumbs up the inside of my shin bone and in one area of about 2 inches in length on both legs it is quite tender but is only sore if I press on that area quite firmly. There is no bump like a stress fracture. Also it doesn't hurt when I'm sitting down. The area is about half way up each inner shin at the front where the calf muscle seems to join bone. Intense at start of run then used to subside but recently hasn't been subsiding. Classic shin splint symptom according to net. 

    Thanks for any advice. I know this has probably been discussed a ton of times already if I bothered to look throught the forums. Just want to know recovery times etc. 

    Conor

  • Hi Conor,



    What you describe sounds like it could be a bony stress reaction (which can be part of shin splints). In terms of healing it depends how severe it is and how quickly you heal. I would rest from running until it's settled and you can hop repeatedly pain free. This might take a couple of weeks or more, in the meantime maintain fitness with cross training - bike, swimming etc anything that is pain free. Ice usually helps and people often say compression socks help too. When your symptoms have settled and you can hop try a short run on the treadmill or grass and gradually build up distance but stop if it hurts. Gradually return to your normal running with plenty of rest days inbetween initially.



    If it is a bony stress reaction and you just keep running it may progress to a stress fracture. Obviously it's impossible to diagnose anything 100% without assessing you properly. If you have bony tenderness and pain with impact I would get it properly checked out. See your GP or a Physio that has experience with runners.



    Hope that helps



    Tom
  • Actually I just read your blog there. In fact it says everything.  I suppose I should get checked out for stress fractures?   I will never use the term shin splints again! Very comprehensive look at shin problems. Thanks. 

  • By the way I will post the recovery process etc. when it's healed. I guess I won't be running through it image

    Once again thanks for the advice Tom. Was looking for a better idea of what was going on.  Better get used to the bike lol. 

  • I've had what I thought was posterior shin splints, had thought this was what I had for just over a year and read up on what to do and so on. Turns out it was a stress fracture all along but meanwhile I had gained a bit of an understanding about shin splints.

     

    I had decided that it was impossible to stop all exercise, not just the psychological side and fear of weight gain but also because I do not own a car or a bike or have a taxi service. I have to walk alot day to day even just to get the train or bus and quite frequently throughout the day. Resting was not an option.

     

    So I worked out that shin splints are aggrivated by the muscles being inflammed and also by impact. Running causes an impact as you can imagine, its probably the worst type of exercise you can do.

     

    Walking also used to hurt me but as I say, I had a SF and not SS so it may well be different. What I did fine was that wearing trainers rather then smart shoes or flat sandals (or ballet pumps or anything else which isn't made from a wedge of soft rubber) would hurt, so switching to trainers could help as well.

     

    Pill wise I used to take ibuprofen, I'd read this helped because it reduced the inflammation and this itself also worsened the SS as it would further inflame the muscle which would in turn pull away from the bone and so cause further problems.

     

    I also used to wear a compression sleeve. This did help (so also helps SF and not just SS). I got mine from Runners World for about £10, called 'Vulcan' or something like that its blue and made with velcro straps and they also make them for ankles and knees and so on but only some branches sell them. I do think it was worth it though as it worked far better then any of the white stretchy bandage type support wraps you can buy elsewhere.

     

    I also found sports massage helped. Don't ask me why, I don't know! I have theories about it increasing the circulation and I do think that good circulation is key as it carries away any damaged cells and helps replenish with new working cells to speeds up recovery. I also think it helped by releasing some tension I'd built in my calves and quads and losening things up which possibly meant I was using those muscles properly as oppose to pushing more stress onto the already damaged areas which possibly had become damaged party due to repetative and undue tension.

  • Thanks for the info! Been resting the last week and it's still sore. Must just have patience I suppose. Did you find even walking would impair recovery? I feel I will have to take a couple of days where I won't even walk at all only to and from the couch. 

    Can't afford a sports massage but I found a self massage technique on the internet for the calf muscle  http://www.youtube.com/watch?v=IDvHxir7bXM

    I find it really helps it. It's not sore when walking after it. Comes back though.

  • kaffeegkaffeeg ✭✭✭
    I agree with the advice above. Don't run until it's healed.

    When I got 'shin splints', I was training for my marathon. Ignored it, and it got worse. I managed to keep on with my training by doing deep water running (as recommended by one of the Olympic gb physio's). It allowed me to carry on 'running' but without putting any stress on my legs. It really helped me. So, if you want to carry on training - I recommend it.



    As to your friend who says they get 'shin splints' every now and then. No one needs to. You need to work out why you got any injury and solve that problem. If you don't sort out the route cause, you will get it again.



    Good luck!
  • Hi All

    I'm in a lot of pain today, caused by a measly 5k parkrun on Saturday (when I say measly, I mean the distance, not parkrun!)  I often get pain on the outside of my lower legs (not on the shine bone) and it always feels muscular.  The pain seems to be coupled with tenderness on the end of the leg where it joins the foot; pointing my toes really hurts.  My concern today is that it still hurts to walk (it's knocking me a bit sick, if truth be known). Usually, the pain only occurs when running.  I can't believe that such a short run could provoke this.  A HM didn't cause this much pain!  Was the lack of a stretch afterwards to blame?  Also, I do seem to get pins and needles in my toes now and again during a run.  Are they related?

    I am an excessive over-pronator, and I use footbalance insoles.  Would investing in some higher quality orthotics solve this?

    Any advice would be greatly appreciated

    Jo

  • kaffeegkaffeeg ✭✭✭
    The pins and needles could be related. I got my 'shin splints' which built up over time,a nd I just ignored all the warning signs. I got a numb/tingling feeling in my toes and up my shins when wearing new trainers. And then achy-ness on the shins. This all happened over a two week period. Then a 13 mile slow run. Then, two days later a 10k race. And then pain like you describe. I think, like me, you're pain is not the result of the 5k, but something else.



    Why do you have insoles? I hear mixed reviews about them. Maybe you need different shoes?



    I don't wear my trainers that I got my injury in. Even though they were pricey and new, I think they (along with not stretching and over training) were the cause of injury.



    Rest. Ice. Rest and ice some more. The pain will go, but son't run whilst it's sore.



    Good luck. It'll get better!
  • Thanks for that.  To be honest, I'm at a bit of a loss now as far as shoes are concerned.  I got the footbalance insoles to combat the over-pronation, but they're obviously not making a blind bit of difference.  What's the point in all these expensive trainers (currently Asics stability shoe, circa £100, plus £40 insoles), if I get the pain regardless?  Or are they actually making things worse?  Should I just go neutral (or barefoot image )

    I think you're right about the 5K not being the actual cause: it's so out of proportion to the distance.  I've never had this much pain before, and almost never when not actually running.

    I'll take your advice - rest and ice. 

    Thanks a lot.

  • Hey all I said I'd update when I was returning to running. Rested for exactly 6 weeks and felt perfect. No pain when hopping on one foot for a good 2 weeks and walking was fine. Ran up the stairs at home couple days in a row and didn't hurt so I decided to go running. I've done 2 miles for 3 days at an easy pace on a grass field with 2 day's rest inbetween each run. Planning on 6 mpw for the next 3 weeks easy and then increasing by 10% for the following 3 weeks, and so on until I get to a good level of mileage. I will back off if I feel any hints of pain. No pain so far. Keeping the fingers crossed it won't return. Not running on roads for the forseeable future. Next race I aim to do will be xc so running in a field is good training anyway I suppose. Bit wary of road running atm. Did a couple of bike races and lots of swimming so I am still very fit. I'm going to give my legs a chance this time around. 

  • Hi Conor,

    Glad you're back on track, your plan for returning gradually sounds good.

    Good luck with it

    Tom
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