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Q+A: Am I doing too much too soon?

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Posted: 16 August 2004
by Richard Braver

Q I’ve been a runner for several years, but have recently found that soon after I start running, my calves tighten, my shins hurt and my feet get numb. I’ve tried wearing different shoes and tying my shoelaces looser, but nothing has worked. What can I do?

A It’s possible this is a simple case of doing too much too soon. However, your particular combination of tight calves, shin pain and numbness indicates that your complaint may be exertional compartment syndrome (ECS). Often affecting more seasoned runners, ECS is treatable, but it is important that it is properly diagnosed.

ECS happens when lower-leg muscles swell with blood and fluid during exercise. This causes the muscle covering (or fascia) to tighten, and puts pressure on nerves within the muscle compartments. Symptoms can range from a dull ache to sharp pain, but runners typically feel tightness, numbness or weakness in the foot or leg, which normally improves soon after you stop running.

I suggest you see a sports injury specialist to rule out other problems and to confirm the ECS diagnosis. The doctor may order X-rays or a bone scan to check for stress fractures. But the definitive test for ECS involves a procedure that checks pressure in the muscle compartment both before and after you run.

Conservative remedies include stretching, orthotics, new running shoes, soft-tissue massage and physiotherapy. Advanced cases are treated by making a surgical slit through the fascia, which relieves the pressure (and thus the pain and numbness). However, this is rarely necessary, and recovery from this procedure can take up to six weeks.

Richard Braver, podiatrist


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I'm not a seasoned runner, and sadly I can't seem to get past 30 secs run, 90 secs walk stage. Whenever I run more than 30 secs, my shins start to hurt. My shoes are fine, I don't think I have any injuries that may be affecting me either. Has anyone got any suggestions? I was trying to start slowly (for weight loss reasons) and now I'm just getting frustrated.
Posted: 26/02/2007 10:17

Hi Phil - from lurking on the forum generally I have picked up some advice which I had to apply to myself a couple of weeks ago as I, too, had very painful shins.

1) Did you have a gait analysis done in a proper running shop? It could be your shoes, even if you don't think so.

2) Don't go out again until your shin is totally back to normal - if you go out when it's still sore (as I did) it just gets worse.

3) How long have you been running for? If you haven't exercised for a while, it might just be that it will take longer than expected to move onto run 60 secs walk 90 or whatever.

Hope this helps, and your shin gets better soon.

cj
Posted: 26/02/2007 10:34

Shin pain can have several different causes, wrong shoes being one. It can also be caused by various muscle weaknesses, and this is not unlikely in someone who is new to exercise. Ask me how I know...

Even though the symptoms may be mild it may be worth a trip to a physio who can help you figure out the cause and solution.
Posted: 26/02/2007 11:14

Phil, I started running in January and got a sore right knee after 4 weeks running in a pair of Pumas that were lurking in my cupboard. I was up to about 1min/1min. I had to stop for about 10 days, then bought a pair of shoes from a running shop and now I'm fine (touch wood), I think - I've run about four times since.
Posted: 26/02/2007 11:23

Phil, it sounds like you're developing what is commonly referred to as shinsplints. It's very common in new runners where you're not used to exercising those particular muscles and tendons. As already advised, I would get your gait analysed at a running shop (preferably with video analysis if possible) and make sure that you're in the correct shoes for your gait. It's not good enough to simply be in 'new' running shoes, there are all different kinds for how you run and this will affect the way your foot falls and the impact stresses on the shin area.

Also, another good thing to remember is if it is painful then you need to stop running until it's completely better and restart at a slower pace and lower distance. Shinsplints in new runners is often caused by increasing mileage, pace and distance too quickly. Slow and sure is the key to starting properly until your muscles are used to running. Don't give up on it. It will come right.

Final thing... whilst it is painful make sure you're doing the RICE thing. Rest, ice, compression and elevation. Hope things improve soon. Take two weeks out and restart again and see how you go.


Posted: 26/02/2007 11:32

Thanks for the advice (thought it was shinsplints). When I have the time, I'll go and get a gait analysis. Around here (Hull) I don't know where that would be though. ..

I think the thing that frustrates me the most is that my parents (yes, I still listen to them) and other friends just seem to think that you can start running at the click of your fingers. I may not be the paragon of fitness that my other siblings are, but I'm certainly not unfit.



Posted: 26/02/2007 11:50

Well doen phil for persevering with it . If I were you I'd walk for longer , get out to a brisk 30 minute walk before trying any running , it'll build the shins before you do any running. If the 30 mins leaves you out of breath wait till it is a doddle then you'll know you've done enough.

Make sure after walking you stretch the muscles in the calf and thighs so they'll be ready next time.
Posted: 26/02/2007 11:54

Phil, have a look online and see whether there is a Runners Need or Sweatshop near you. Usually both stores do decent gait analysis and I'd recommend either of them. As for what your parents and siblings think, at least you're getting off your backside and doing something. The rewards for it will come, it just takes a little time though. Stick with it and you'll see an improvement in no time.
Posted: 26/02/2007 11:55

I walk to work every day (20 mins brisk) and that feels fine. What pace would you suggest I start off at? I know I should be asking e.g. an instructor at the gym, but they're all hopeless - the only answer I get is 'start off slow', great answer, but how slow?!
Posted: 26/02/2007 11:58

Good advice from Mike there. Try looking at one of the RW beginner schedules and then adapting it to your own needs. Also, whilst you're resting the shins, think about maybe swimming or cycling in the meantime. It will still improve your fitness but reduce the stresses on the shin area.
Posted: 26/02/2007 11:58

Cycling I love - I'd take that over swimming every day
Posted: 26/02/2007 11:59

Cycling is your sport then until things improve. As for pace. I started at a gentle slow jog. The usual recommendation is so that you can actually hold a conversation (bit difficult if running alone). I normally count (in my head) and if I'm struggling keeping up, I'm going too fast. Then do the walk/run thing. Also, don't be tempted to skip bits of the schedule for walk/run and don't move on to the next part of the schedule unless it feels relatively easy.
Posted: 26/02/2007 12:04

Found a running shop in town - phoned up the owner who sounded really jolly and will go in and have a chat. Will let you know what he says.
Posted: 26/02/2007 12:23

Jolly good, that sounds like you're on the road to making a start with it. Let us know how you are doing.

:o)

Good luck!
Posted: 26/02/2007 12:35

Ok... think I need to check my glasses - hadn't seen that the cushioning on my soles had completely disappeared! Took them into the shop and the guy said 'I've seen worse'.
Posted: 26/02/2007 17:23

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