“If you want to run, run a mile. If you want to experience a different life, run a marathon.” — Emil Zatopek
Hubby Patrick is heading down the road to experiencing a different life as a distance runner. He signed up for a Fourth of July 10k, bought some running shoes, and started running. After a month, he was running six miles in an hour. But his shins were hurting. It got to the point where he couldn’t walk around the house, much less take a run. I found out that Patrick’s is a common story.
“A shin splint is really just a catch-all word to describe pain in the lower leg, below the knee,” explained Dr. Victor Runco, ultra-marathoner and owner of San Diego Running Institute (619-265-7374; sdri.net). “Shin splints is [a term] used to describe pain on the inside of the leg, the outside of the leg, or the front of the leg. The most common type is a condition named posterior tibialis tendonitis. When it is on the medial side, the inside of the leg, the actual muscle inflamed is called the posterior tibialis and it is usually a tendonitis. The tendon gets inflamed from repetitive use. The problem is it can progress to where the bone actually becomes inflamed: periostitis. Or the person can start off with a stress fracture that gets misdiagnosed as shin splints.”
Who is prone to getting this type of injury?
“You’ll see this injury in somebody who takes up running, a newbie. You see it a lot in military recruits. You don’t generally see shin splints in an experienced runner. It is as if you never worked out with weights and I sent you into the gym and said, ‘I am going to have you do 5000 of these curls. You would get tendonitis in your arm. People never really consider running the same way. But, let’s say you run a mile and your foot hits the ground about a 1000 times; that’s 1000 repetitions. Nobody in their right mind who has never done exercise before goes and does it 1000 times.”
Does foot structure play a part?
“It’s not necessarily only a flat foot that would be predisposed to it, but somebody with an extremely high arch as well. So, the closer you are to that sort of perfect-shaped foot, [the less prone you are to injuries].”
What symptoms should runners look for?
“The best thing to do is to listen to your body. If you are running and you are having pain when you run and the pain is getting worse, that’s a good sign to stop. When the next day you are limping, that’s a really good time to stop.... If you put your hand over a hot stove, you pull it away. You don’t ice your hand and do it again.”
Runco pointed out an exception to the pain rule. “If somebody says, ‘It hurts when I run, but as I run it sort of warms up and goes away,’ and they say it is fine after they run and the next day, that is usually somebody’s body adapting, and that is okay.”
When should they resume exercising?
“They should definitely take a step back; nothing should hurt, and they should start by following a program. They can find specialty sites online. The San Diego Running Institute has a running club through the YMCA, and they get a lot of runners who never ran at all, and within four or five months they take them to the Rock and Roll Marathon and they complete it. Because they follow a slow, steady progression. We like to refer to it as the 10 percent rule, meaning don’t increase your mileage by more than 10 percent in any given week.”
Do stretching and shoes play a part?
“Stretching will never prevent shin splints, but shoes can be important. Getting a proper-fitting shoe that is made for running is important. In San Diego we have three shoe stores that are well known: Road Runner Sports, San Diego Running Institute, and Movin Shoes. They each do measuring and testing to try to help the person be in the right shoe.”
What about bracing?
“You have heard of the sports-injury mnemonic RICE: rest, ice, compression, elevation. There is a lot of bracing out there for sports injuries that provide compression to the muscle. They can be helpful. I am hesitant to recommend it to somebody because it’s not really fixing the problem. You never want to rely on a brace.”
Patrick’s old friend Joe, a self-described “tub-of-goo-turned-marathon-runner,” sent my man race-day advice. “Keep in mind,” he warned, “you’ll be really amped on race day and will likely run at least a minute faster per mile than during training due to the adrenaline rush. There is strategy involved in a journey of 6.2 miles; you must run your own race. Don’t let the jackrabbits pull you into too fast of a pace the first half and thereby shoot your chances for a strong finish. It’s a delicate balance, but every runner dreads bonking and feeling like crap while crossing the finish line at more of a walk than run. The fastest times you’ll ever run is when you have negative splits: you run the second half faster than the first half. Once you scale up to a 10k level, it is easy to maintain and stay feeling great and injury-free. Getting there is the hard part. There is nothing like the rush after a good run. Watch out, it can be habit forming!”