'Growth Spurts'- are they really a running injury?

12 messages
18/11/2012 at 18:20

I've been struggling with shin splints since April and I'm 17. I'm 6ft 4 and I've been told by my physio (amongst issues with my biomechanics) that a lot of it could be caused by simply growing. I have tight calves and weak tibialis muscles due to my biomechanics but my Physio says they're all linked. I also have Osgood-Schlatters in my knees. I've got some orthotics on the way and I'm really hoping they're going to give me the relief I desperately need from all this. I have been very very careful with the injury but my body seems to do the opposite of what it should do. After 6 weeks of rest- my pain went away after 4 weeks and came back last week! Stretching the calves seems to aggravate the shin pain but I've been told I need to  stretch to sort out the problem. I also need to strengthen the weak calves and tibialis but this also brings a bit of pain back.

 It's not the typical shin splints where I get pain during the activity- I get pain after, earlier on it would linger and ease after a few days. When I was still able to cycle hard but not run earlier in the Summer, I would have no pain but was resting from running to let it settle down. Then the pain came on in the late Summer and lingered for 3 weeks despite stopping all cycling and running. Even when the physio gave me the all-clear to start gently running again on grass, I was able to for 2 weeks and then the pain returned. This time it took less time to ease off. 

The only thing I have done in this rest period is stretching the calfs and a few calf raises (as advised), some hip strengthening and hamstring stretching. Is it possible that my injury is simply growth? Has anybody else on here had any issues training whilst young due to similar things? I feel like I'm being let down by my own body and I can't understand what the hell is going on and I don't think anybody else knows either!

18/11/2012 at 22:09
Injuries are literally a pain for all sports people. I'm not a physio or medic in any way shape or form but I can offer you this positive nugget. At 15, Dai Green contracted Osgood Schlatter disease during a growth spurt which caused issues with his knees. Now look at him! Keep positive and listen to your physio as it sounds like he knows what he's on about.
19/11/2012 at 12:20

I've said this before, but Stephen Gerrard used to be out injured all the time as a young player - one thing after another... and the experts said at the time that it was down to his continued growth (late growth as well, if I remember right).  I'd say they've been proved right.  For an 'all action' player, I'd say he's not been particularly injury prone in adulthood.

19/11/2012 at 15:02

Thanks guys- my distress is more revolved around the fact that I don't know what's wrong with me and the fact my body can't even  handle swimming! My muscles are wasting, my fitness is melting away and some plans next year are now in jeapordy. I feel like I have no hope. I've always been tall but it is possible that I'm still growing?! I'm 18 in 6 months. I'm happy at my height now and would rather just stop so I can run!

19/11/2012 at 16:54

It could still be growing :-S But have you had a recent growth spurt??   Are you streching both tibalis posterior and anterior?   Either of these in spasm can give you the symptoms.  'Shin splints' is normally considered an overuse, 'impact injury' so cycling and swimming shouldn't aggrevate it.  I'd be worried if muscle strentghening exercises you're doing are bringing the pain back.  DOMS is ok - recurring same symtoms (again & again) is not.   Tells me you should be trying some other strengthening exercises.

19/11/2012 at 18:04

I have had a recent growth spurt I think yes. My gait seems to be changing all the time just walking around. I'm not stretching them- how do I do this? I was doing a thing against a wall where I did foot-raises which stretched the muscles on the front of my shin (the anterior?) but I stopped those a couple of months ago. Swimming hasn't aggravated it- but it hurt my hamstring. Cycling does however I was doing the strengthening exercises and stretching at the same time so it could have been them?

 

19/11/2012 at 19:22

Its possible that some muscles in your calf (Ant & Pos Tibialis in particular) are over-working and fatigued, because of changes in length and gait.  Calf raises could be just irratating them more.    It could have been just the exercises that aggravate the injury, not the cycling. 

Both muscle help control pronation of the foot, especially Tib Posterior.  You need to find out what your foot looks like when it pronates and supinates (loads & takes off), its possible joints in your foot are locked up, which maybe overworking the muscles (and creating extra stress on the shin bone).  Lack of mobility in the hips can compound this.

Not sure if youve done these already...  

Sitting on your heels is one way of streching Tib Anterior (if you're not very flexible in your ankles!).  

Tib. Posterior can be streched by doing a bent knee calf stretch on the edge of a step.  The outer edge of your foot (in trainers) needs to be on the step edge, bring your knee over your little toe (or as near as you can).  Then drop the inside arch of your foot over the step, while keeping your knee pointing towards your little toe.  You should feel a deep calf stretch.

Try to keep as relaxed as you can and make gravity do the work - thats the best way to stretch

Word of caution - Lack of progress means its possible it may not be muscular at all, but bone stress on the tibia -  micro-trauma on the shins.  A bone scan would be needed to confirm that.  Treatment is more rest i'm afraid... (and mobilisation of ankle and foot...)

Hope that helps.

19/11/2012 at 22:56

I've been told that they are likely to be weak/fatigued by my physio. I've got orthotics on the way- will they help me at all? I was told to stretch my piriformis which I have been doing everyday as well as a hip strengthening exercise called 'clams' or something like that. Is it safe to keep doing these? My gait only seemed to change when I started doing them again recently. I've heard of the heel sitting stretch before so I'll give it a go- for how long and how often?

 My physio did mention bone stress. Although it's not sore to squeeze the tibia anymore and it doesn't feel tender. What could be causing the bone stress? I've rested from any cycling/running now for 6 weeks- how much more will I need to eradicate it completely if it's a prolonged case? Is pool running ok?

 

20/11/2012 at 10:51

Orthotics could help relieve stress by supporting your arches, but i would only use them temporaily.  How long is gauged by how long you have the symptoms. 

I don't prescribe clams anymore.  Its not a functional exercise for runners!   If you're a syncronised swimmer there maybe a case for doing them;  but how often do you do that movement when running!!

Instead, I would do one leg squats, multidirectional lunges (start small, then get bigger) and low level plyometrics - bunny jumps/hops & skipping etc.   But only if no pain when doing it.  Same goes for pool running - great functional exercise with reduced impact - but only do it without pain.

There is no scientific proof as to the optimum time to do a stretch, only assumptions and interpretations.   Depending on the state of a muscle at anyone time it may need different times to release.    I generally say 45 - 60 secs, RELAX into the stretch to a degree that is not painful, but still pulling.   Do it little and often (4x a day), especially after exercise.

Bone stress is normally caused by too much repeated impact over a certain amount time.   I'd guess running with tight muscles & bad running technique in your case.

If the bone doesn't feel tender anymore you could go back to training - but you must ease yourself and your shins back into it.  Cycle/run short distances to start with and see if you get a reaction the day after.  The musculoskeletal system needs exercise and movement to repair and get stronger - but it needs it progressively, too much too soon will overload it, and you will be back to square one.  

Be thankful you are still in your teens!  If you were in your 40's you'd probably have to double the recovery time!

 

 

21/11/2012 at 01:02

Will orthotics not help to stop my tibialis muscles being overworked and weakened because that's what my physio told me?

I do find clams work my hip muscles a lot though- do the other exercises you suggest have the same effect?

Can stretching or calf raises affect bone stress at all? I did some toe raises against a wall this morning and have had a few stabs of pain in the upper area of the shin where the muscle is during the day.  

The bone does feel a bit tender occasionally and there is a little bony lump/hole in the centre of my shin about 3 inches up from the ankle but it's not tender to touch. It is however improving in general and I get pain less often- it seems proportional to whether I have stretched or strengthened or not. I will wait to see a Physio to assess me before trying to cycle gently again.

Thanks again for your advice, very very helpful!! 

21/11/2012 at 12:05

Yes, orthotics will help stop your tibialis getting overworked.  But I treat orthotics like crutches,  great to take pressure off injured tissue.   And if you were in your 60's i'd prob say keep them in, but as a teenager you should gradually wean yourself off them. 

Clams will definetly work the hip muscles, just not in a way that is really functional to running.  I'd also argue that they can overwork the piriformis (something you may not want to do).   I'd prescribe them to someone virtually bedridden, who needs strengthening to walk again, not to a 'relatively' heathy runner.  

Yes, those exercises work ALL hip muscles, especially the multi-directional lunges! 

I would wait til physio can assess shin as well.

No problem, hope it gets better soon.

 

01/02/2013 at 13:29

Visit http://www.osgood-schlatter-disease.com/ or https://www.facebook.com/osgoodschlattersdisease and they will help you out. The Strickland Protocol cures Osgood Schlatters and clinical trials data is there on the site. Jenny Strickland Was lead physio at the olympics and knows her stuff. You can ask her a question on the facebook link. Good luck and I hope you are pain free soon


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