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

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