shin splints/ Anterior Tibialis tendonitis
The fastest way to ease the pain in your foot, besides what you are already doing, is to cut it off. I am no doc but I would guess your body is telling you to relax and let it heal. I know that healing is an athlete's personal hell, but sometimes it's necessary.
I had something similar to what you are describing. I found that while running seemed to be the cause, cycling aggravated it. While I didn't stop training, I did have to cut down a bit. I also started getting A.R.T. which in itself is absolute hell, but helped significantly! I have found that physio has never helped with anything for me.
Good luck and I feel your pain!!
I have shin splints in the the same location as you right now. I am starting to think that it is because of my pronation. When I stand verticle, my legs angle "out". Also, I don't know about you, but I am not yet a fluid runner, and my foot / ankle is usualy tense when running just before my heel strikes the ground, tense such that the tip of my foot is pointing UP. That may be causing overuse of the tendon, and cause the tendonitis... At the moment, I am using a roller pin over the whole shin area, and ice...not really sure why. Maybe try working with orthotics, stretching and warming up more. Wish ya luck. You could try running on a treadmill with shocks to absorb the impact and help to strengthen and heal that way...everyones different...
Do you have media tibial stress syndrome? Have you gotten a diagnosis? Do you pronate? The reason I ask is I used to get shin splints and then it got so bad last year that I was crippled at Disneyland and called a podiatrist that was recommended to me. I had tried the superfeet orthotics and they did not help much. I got fitted for the real orthotics and they have changed my life. The doctor checked my out and was amazed that I had not had major issues before as he said I was a posterchild for MTSS. I just ran a half marathon on asphalt, something I though I would never be able to do. With that being said, I still am supposed to do calf stretches 3x day. If you have a similar situation and pronate(in my case a ton), you may want to get professional help. Hope that helps you.
After every run, sit down on a bed or other surface where your feet can dangle. Then spell the alphabet by pointing your toes (move your foot as far as you can in every direction). This will help to resolve the imbalance between your calf and shin muscles, and generally helps to prevent shin splints. Once they have become serious, rest is a much better treatment but whenever I feel tightness in my shins I do the alphabet trick and it goes away within a day or two.
Also, a tip on icing: Take a small paper dixie cup and fill it near the brim with water, then freeze it. Once its solid, tear off the top lip of paper, and you have a little ice cyclinder that you can hold by the cup, and rub directly on your shins. It works much better than a bag of ice for pinpointing the painful areas.
These are all great advice. I am healing but not as fast as I would like to. I still have pain anterior part of my ankle. I have been all the exercises people have been telling me. I have not tried running yet because I still have discomfort when I walk. Should I try to run? Would running help me heal faster to break up all the scar tissue and knots in my muscle or should I wait until I am pain free from walking.
I also had a question about heating. Should I incorporate heating into my recovery or just stick with ice. Any help would be great. Again thank you everyone who has written!
Tri the Mango at http://trithemango.blogspot.com/
If you have discomfort when you walk, you will only aggrivate it by running. This is what got you into the problem you are in to begin with. You may also be aggrivating it by doing some of the exercises BEFORE they have healed, or by doing too much of them. If you strain the muscles on your shin too much, you can also get a stress fracture which will put you out much longer (I am on 5 months--get to run next week).
Heat should be used after the initial injury (usually 48-72 hours). Shin splints are a bit different as they are probably only "accute" after running. You could probably heat before to loosen the area up then ice after. This is in a case where they hurt after running, and not just walking around.
Finally go see a PT who can do a gait analysis and determine if you need orthotics. They can make a world of difference.
In the past I have struggled a lot with shin splints / mtss. I pronate a lot and I have other weird biomechanical issues. It took me 3 xc seasons of running myself into the ground and having 3 month recoveries before finally learning my lesson. I saw 8 different trainers/PT's/doctor's,etc and was told that I really should not be a runner by a couple of them. I had custom nice custom orthotics made (I don't use them anymore). etc etc everything that I was supposed to do. I actually run in neutral - light stability shoes because, by my own experimentation, my biomechanical issues are too complicated for shoes to correct and I run better just using what I have.
What it took to recover completely was to stop running until there was no pain at all, and then build up slowly with this rule of thumb: If you feel any effect from the previous run, don't run.
That means, if I accidentally ran too long or too hard one day, it might be 3 or 4 days before I could run again, but if I stayed within my limits, every other day was ok.
I haven't had shin splints for years now. I never run more than 4 days or 25 miles per week. I just had to accept my mileage limitations and learn to use my miles wisely. I'm a lot faster now than I was when I was running 6 days/week with high school / college xc teams.
One other thing to add that I learned in one of my many PT recoveries. Start with say a 5 min run (just as an example). If you have no pain, run 10 the next time and then 15 the time after that. If at 15 min you experience pain, then go back to the 10 min. This way you can gague what your limitations.
I actually run in neutral - light stability shoes because, by my own experimentation, my biomechanical issues are too complicated for shoes to correct and I run better just using what I have.
I have also just started with a neutral shoe this Spring. I'm hoping it does for me what you've experienced .
catwood wrote:I actually run in neutral - light stability shoes because, by my own experimentation, my biomechanical issues are too complicated for shoes to correct and I run better just using what I have.I have also just started with a neutral shoe this Spring. I'm hoping it does for me what you've experienced .
So just to clarify, what you are saying is that even though neutral shoes, or by definition a neutral runner does NOT under or over pronate, and you DO pronate, that you decided to just run in neutral because of the other bio-mechanical issues? I guess it makes sense given the number of variables in your running mechanics, I just wondered if you have identified the specific bio-mechanical conditions that support this or if you realized this through experimentation? I am in the same boat, trying to figure out my issues.
I've pretty much realized this through experimentation. The orthotics and motion control shoes that correct one problem seem to exasperate another. I've found that with a highly corrective shoe, when my foot leaves the ground at the back of the stride, it jerks pretty harshly back to the position it wants to be in putting a lot of strain on my soleus and anterior tibialis. With a neutral or light stability shoe, the jerk is much less pronounced. The neutral or light stability shoes that I use now are also a lot lighter and I think that that also seems to help. I am a pretty small person and having big heavy shoes just seems to stress my body more than a little less cushioning does.
Yes I pronate a lot - if you want a laundry list of biomechanical issues: heel and forefoot varus in both feet in varying degrees, if I stand on one leg and bend it my knees goes way inward, right leg is slightly bowlegged, right hip is set deeper and rotated, right leg is slightly shorter. When my old pt suggested an orthotic that came up around my ankles because nothing else was working, I decided that there had to be a better way to go.
My favorite shoes are Mizuno Elixer's which are a really lightweight mild stability shoe. I have a few other pairs of shoes that I rotate through (NB lightweight stability trainers and Brooks Axioms) but the Mizuno's are my favorites. I've been racing in Pearl Izumi Streak SL's but I'm looking around for something else because they give me blisters.
Crazy stuff! So I now understand that when you have issues that are permanent, your body has already fused bones and adjusted muscles around to compensate, and it would be foolish to attempt to correct the issues!
I did try mizunos once, but they got stolen. Come to think of it, they were really light, and I got them in seperate sizes for each foot, and included one thicker insole to compensate for my short leg. I didn' t have shin splints that summer...Looks like I am goingwith mizunos!
/end hijack...sorry.
I would disagree. What works for one person may not work for you. I have similiar issues,(including a leg length discrepancy of 1/2 an inch). At one point about 5 years ago I had 3 stress fractures in 1 1/2 years time along with low back, and hip problems. After being fitted for my orthotics and wearing them I have been virtually injury and pain free since. I certainly have not cut back on my training at all. This last one(injury) was really due to not taking any rest and ramping up too soon/fast after my IM in August. Since, I have been fitted for new orthotics which are lighter and more flexable making them more comfy. Materials have changed those 5 years and it was time for new ones (they may have also broken down over the years leading to this latest injury). Getting your body used to them takes time, ie; you have to wear them walking, then running a few miles etc. I wear them with either the Assic Kyano or the 2100 series.
Just my opinion, since it works for me :)
from my end, going to a neutral shoe is a way of taking a mini step towards something like a nike free or barefoot but not quite that extreme
i'm a big guy. i have high arches (but they don't collapse) and i thought i'd be more comfortable allowing my foot to do what it wants to do a little more "naturally"
Its about what works for you. Brit's route works for many people and since that's what the medical people recommend (even though $$), I do recommend you try that first. I definitely went my route counter to what all medical professionals told me (though some of them just told me to give up running). I am also a really small person (110 lbs), I have average arches which are really the only thing below my hips that I've never had any problems with, and I severely limit my running mileage. Its a solution, but its not perfect. I'm glad I really have no ambitions for IM or marathon or anything like that.
You must develop a good body awareness that will allow you to analyze why you are hurting and you pretty much have to swear off running while hurt. The rule of thumb that I use "never run if you feel any effect from a previous run" has been key to recovery for me. I officially swore off my orthotics a bit more than 2 years ago after 2 years of trying every medical professional in the Boston area. I've also just gradually tried lots of different shoes as they've worn out. This year, I was lucky enough to win 2 pairs of running shoes in races so I was able to try even more. The mizuno's are definitely the best for my feet and I can run 10 miles sockless without blisters in them, but they wear out more quickly than other brands.
Over the past 2 years, my mileage cap has definitely increased even though I don't actively push it. Its not something that I feel limits me any more. 2 years ago 15mpw was pushing it, but now I can do 20 no problem. That seems to be plenty for the Olympic distance triathlons that I like to do - my 5 and 10k split time have been dropping like crazy and I feel I can drop another 3-4 minutes off my 10k on my current mileage. You just can't waste the miles you have. This is the first year that I've been able to even fit long runs into my allowable mileage.
Yes, I agree with Catwood. I guess what I was saying is that what works for her, may not be the solution for you. I personally would recommend seeing a PT, or doctor first (as she did) before experimenting. Yes it will cost some money, but my orthotics were completely covered by insurance, as were all my PT sessions (with a co-pay of course). For me it made sense. I am also a bit more OCD and could not manage not running that way(not running when hurt), esp with IM and marathon training.
P.S
It is awesome that you have been able to have such "injury management". I applaud you in being able to do something I cannot :)
On a happy note I ran 3.5 miles yesterday pain free!!! WOOO HOOO gonna give it another try tomorrow. With any luck I will still be doing my HIM in June. Seems the cycling, swimming and Hot Yoga have kept me in decent shape!





I developed anterior Tibialis tendonitis 4 weeks ago from overtraining (running). I had this same injury last year from, again, overtraining. Last year it resolved after 2 weeks with ice and ibuprofen. This year it has been worse. I wake up every morning with the muscle painful and tight. I can feel the "rubbing" of the muscle when I dorsiflex my foot. I have been doing a lot of stretching along with the ice and ibuprofen. nothing takes the pain away fully. I have been going to PT and they put me on this stretching schedule. They also use some machine that contracts my muscle. The pain is still there!!!! I have been doing a lot of cycling (on the trainer) and swimming. Neither exercise hurts while in the motion but as soon as I try to walk the pain on the anterior part of my ankle and shin comes back. Anyone have any ideas of what I can do? I feel like the injury is not getting better. Anyone has experience with this injury. What worked for you? What did not work? Does anyone have a magic pill that I can take to heal me instantly? Any help, comments or feelings would be great. Thank you
-Mango
Tri the Mango at http://trithemango.blogspot.com/