Q+A: Am I doing too much too soon?
Our experts answer real-life questions
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
Discuss this story
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
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