The most likely injury for beginner runners is: SHIN SPLINTS
- painful shins, also called Medial tibial stress
syndrome...which is simply an inflammation along the inner
side of the shinbone.
A stress fracture pain is likely to be a continuous pain and
restricted to one spot. Do not run.
If you have a more diffuse pain or tenderness in the lower
third of the leg on the inside, or along the entire shin,
and if stretching
eases the pain, a fracture is less likely.
Run on soft surfaces if the pain is not severe and read on.
With shin splints, pain is felt on extending the toes and
weight bearing. It hurts if you press the area with your
finger. Physiologically, it’s an inflammation of the
tendons OR muscle in this area. Pain gradually gets worse as
you run, though for some types it eases when you’re well
warmed up, but resumes at the end of exercise. Other types
ease shortly after stopping.
* Running with the weight too far forward;
* Striking the ground with the first third of the foot;
* Shoes too tight around the toes;
* Inflexible shoes;
* Weak arches may be present;
* Tight calf muscles stress the shin structures;
* Calf muscles too much stronger than the shin muscle...
* Which, tighten and pull on the shin muscles;
* Beginner runners are very susceptible;
* Overtraining is its trademark; especially:
* Increasing mileage too quickly;
* Running on hard surfaces;
* Too much speedwork, too early, on hard surfaces.
- Flexible foreshoe—Wear a combination or slip lasted
design in preference to heavy or stiff shoes. Replace shoes
every 300 to 400 miles. Use a heel lift to reduce jarring,
along with arch supports or padding if necessary. Don’t
make a sudden increase in training or run too fast too soon.
Balance your training. Run fewer miles and do them on softer
surfaces. Include pool running and other cross training.
Concrete is six times harsher to your shin tissues than
asphalt. Asphalt is three or more times harsher than packed
dirt trails. Grass and muddy trails are still softer, and
significantly decrease your risk of shin splints. Bring back
road mileage a mile or two at a time as you ease back to
full training. Use orthotics or anti-pronation shoes.
Stretch before running, and again after warming up. Made a
training mistake and hurt your shins? Ice them, take some
NSAIDs and don’t do it again!
Shins always hurt after a track session? Do your speedwork
on dirt, grass, sand, up hills, on a treadmill, or pool
running. Also, correct any training errors. Do an
appropriate amount of speedwork and run at a reasonable
pace. Gradually work up to 10 percent of your weekly mileage
in one session, and run no faster than 5K pace until you can
do that 10 percent without severe aches and pains.
Do not forget your warmdown...perhaps the most under rated
part of a training session. Running for two to three miles
may sound gruesome if you’ve just done 20 times 400 meters
at 5K pace. It is gruesome if you were not in good enough
shape to run those intervals with a bit to spare! Easy
running brings in blood with its nutrients and speeds the
extraction of waste products from fast running. Add a
quarter mile of walking at the end and you’ll also
decrease your post exercise blood pooling which adds to
muscle inflammation. Hose your legs with cold water, put
your feet up for 20 minutes while you rehydrate and cool
down, then take your shower and stretch.
The shin muscle works against the large calf muscles, is the
last muscle to warm up and the first to cool down. With this
in mind, do an exercise to build them up. While sitting in a
chair, draw large circles with your big toe, and then write
the alphabet with your big toe. After a few weeks, add the
paint pot exercise (sit on a table, hang a weight from your
toes and pull your toes up i.e., flex your ankles for sets
of 12). Or hook an elastic belt or similar item around your
toes and push against it ten times, then pull it toward you
10 times. Reduce your mileage to get over the shin splints.
The shin muscles are the last to warm up. Wearing long thick
socks will help to avoid the chill when not running, making
it easier to warm up the muscle before you do run.
Pain on the outside of the shin? Walk with your toes pointed
in for one minute a day.
Pain on the inside? Walk with toes pointed out for one
minute. Build up toward five minutes.
Then practice walking on your toes and on your heels with
toes pointed in and out.
- use ice and NSAIDs for the initial swelling. Then
flexibility work: Stretch pre and post exercise. Lie on your
back with one foot in the air. Place a towel around the sole
of your foot, and pull with your left hand to bring the toes
down and to the left, which will stretch the muscles on the
right. Hold for 30 seconds and repeat to the right and with
the other leg.
Also, massage gently down the muscle to your pain tolerance,
and then back off by 10 percent to avoid damage. Use ice
alternating with moist heat...then put the muscle through
its full range of motion. Use NSAIDs.
This malady usually relates to
the anterior compartment of the lower leg, which is on the
outer part of the leg, the area in front of the fibula.
The inner part of the lower leg is dominated by the tibia
bone. The compartment set up by these bones is surrounded
by a tough sheath containing muscles, nerves and blood
Compartment syndrome is a muscle pain due to the muscles
growing faster than the sheath surrounding them. It
includes one form of shin splints, though it also affects
the other smallish muscles of the lower leg. Your shin
muscle will feel tight, numb (if nerves are involved) and
you may have a sensation of pressure due to excess fluid
or muscle development. The pain is on the outside of the
leg, and unlike true shin splints, the pain comes on
during exercise and lasts well beyond the finish of your
session. Diagnosis is with a pressure check, though your
specialist will usually rule out shin splints and stress
Some muscles grow so much that they constrict the blood
flow into the sheath...resulting in necrosis (a medical
emergency) of the muscle. The nerves in the sheath can
also be pressured.
Massage, ice and anti-inflammatories can help, but several
months off of running may be required. Surgery (fasciotomy)
may be required if the pains return, releasing pressure
and allowing the muscle more room to expand. First though,
reduce mileage to allow your muscles and the sheath
surrounding them to adapt.
Like shin splints, compartment syndrome is attracted to
people who make sudden mileage increases or suddenly
introduce speed running. Stretch regularly and do weight
training using light weights for many repeats to decrease
Other muscle problems
Dialogue, 280 pages, by David Holt RN. Training for
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These and other MUSCLE
PROBLEMS are usually treated with RICE.
Prevent or protect your muscles from more damage with
Rest, Ice, Compression and Elevation.
A slightly strained muscle often responds well to running
fewer miles at a slower pace than which you normally
When you injure yourself, and it is you who does the
injuring, blood vessels at the injury site expand. The
extra fluid or edema causes pain. Do not mask this pain
with Tylenol. Blood is needed to bring in repair materials
but too much inflammation constricts blood flow, and can
interfere with healing: combat the swelling with ice. Use
ice for 15 minutes each hour for two days.
Ice decreases inflammation, preventing many sore spots
becoming injuries. Hosing your legs with cold water after
a run has the same effect--it can ease significant
fatigue, plus it’ll bring your body temperature down.
You can use real ice to cool the inflamed area or use
frozen peas or other vegetables or use gel packs,
including Velcro wine chillers which can be fastened to
your legs. Within minutes of taking off the ice pack,
blood will rush to your injured area and bring in
nutrients to help with healing.
Because heat brings in more blood and fluid, use warmth
only after all the swelling has subsided.
A compression bandage takes skill to apply. A lightly
wrapped ace bandage is usually more effective. Don’t
allow either of them to restrict circulation to your toes.
Elevating the achy limb for an hour or two at a time helps
to decrease inflammation also, but your main partner is
ice or ice substitutes.
Still hurting after multiple ice applications and
elevation? Take an appropriate dose of NSAIDs to reduce
the inflammatory response.
Heavy exercise raises the level of free radicals, which
can make your muscles sore. Finnish researchers have shown
that taking 2,000 milligrams of vitamin C before, during
and after a 10K race speeds recovery. Vitamin E works too.
Use this combination for 5 or 6 key sessions per month to
avoid the side effects from too much vitamin intake.
As a rule, muscle strains at the back of the legs are from
running too fast, or overstriding. You will need to rest
and you need to slow down.
Cutting out speedwork for a few days of active rest, and
putting your muscles through a comfortable range of motion
will bring nutrients to the muscle and stimulate repair.
You will also maintain fitness. Massage can increase
circulation, bringing nutrients and oxygen to cramping or
damaged muscles to speed healing or at least make the ache
more comfortable for you. Massage can reduce pain and
stress levels, but try not to use it to enable you to get
straight out to the track again and restrain the original
torn muscle. The American Massage Therapy Association is
Muscle tears are graded from first-degree strains with
little muscle damage and no restriction in range of
motion; to second-degree with more damage and swelling; to
third-degree with complete rupture of the muscle unit and
severely limited movement. Generally, the more it hurts,
the greater is the area of muscle tissue strained. A third
degree strain will often need to be seen by an injury
specialist, to help you overcome the pain and potential
for lasting damage if not properly and patiently rehabbed.
The major muscle tear will require you to stop running;
minor tears, if not hurting when you run, will heal with
active rest. But:
* Run 30 seconds per mile slower than usual;
* Avoid long runs...do two sevens instead of a 14;
* Avoid hills...you tend to run too fast down them.
* No speed running.
* Don’t overstride.
The combination of easy running and RICE for the acute
phase of about two days, then stretching and massage
later, and an anti-inflammatory if appropriate, should
help your muscle recuperate.
Practice good running form before you do speedwork again.
Wear appropriate shoes. If you use lightweight racers for
speed sessions, do copious stretching of the calf and
Achilles to prepare them for the lower heel. Ease into the
fast running after your warmup, stretching, drills and
striders. Do fewer reps for the first couple of sessions
fracture of the shin bone (the tibia)
stress fracture pain is likely to be a continuous pain and
restricted to one spot. Do not run.
If you feel pain when you put pressure on the shin...rest.
Stress or hairline fractures don’t show up on x-ray until
healing is well under way, but they can be confirmed quite
early by a bone scan. The dilemma--a fracture requires six
to eight weeks’ non-impact exercise to heal. Use
non-running exercise to maintain muscle tone until you’ve
confirmed if you have a fracture. Pool running, elliptical
training and cycling are the best exercise options.
common runners injuries:
Runners Knee Injuries
Common foot injuries & cures
Why do runners get stress fractures?
Retuning to running after stress fracture
or other major injury
Stretching before running or only after?
Thanks David Holt for
the permission to reprint this article
Text copyright © 2000 by David Holt - www.runningbook.com