As an athletic trainer at The Orthopedic Institute of New Jersey, I see many overuse injuries. Running to train for competitive events can lead to the development of these. Some of the most common running related overuse injuries are of the shin and outside of the thigh.
One of the most common injuries in runners are “shin splits.” Shin splits is the layman’s term for a painful condition that develops most commonly on the front, inner portion of the shin bone. This condition does not necessarily describe one specific injury but is more an umbrella term for a series of common injuries that can occur singularly, or together. Most commonly, shin splints refer to the micro-tearing of the muscle tissue that allows you to raise the front of your foot up, like if you wanted to put all of your weight on your heels. These muscle tissues attach to the inside of your shin and especially when training and running downhill, these muscles must be more active to control your foot from “slapping” the ground. Over time, without strengthening or with overuse, the muscle tissues begin to “tear” from the bone which creates micro-traumas that cause inflammation. This can cause dysfunction and pain when running and/or walking.
In my experience, Shin splits cannot always be completely prevented but they can be managed. The first step in caring for this condition is to ice as much as you can. At least for 20 minutes every 2 hours. This will control the inflammation along with the use of over the counter anti-inflammatories. Just be sure to take the counter anti-inflammatories as directed on the bottle or as directed by a doctor. My favorite exercise to do for shin splints is “heel walks.” This is just as it sounds. I have athletes stand, lift their forefoot off the ground and walk with all the weight on their heels. Proper footwear is also important. A supportive shoe gives the right cushioning which is translated up your lower leg. Also modify the routes you train on by trying to avoid hills and where possible run on softer, level ground.
Iliotibial band syndrome is another common occurrence in the running athlete. The illiotibial band is located on the outer most part of your thigh. It runs from the hip to the shin and attaches to the knee where it assists in stabilizing that joint. Pain is most commonly felt on the outside aspect of the knee. This occurs from either inflammation or tightness of the IT band. IT band syndrome is caused from repetitive leg turning in during running which can result from worn-shoes, running downhill or from running in one direction around a track too much or just running too many miles in general. The turning in of the leg cause the band to rub against the bones on the outside of the knee which causes irritation. IT band syndrome is more common in women due to their hips being at different angles than men.
When an athlete comes in complaining with symptoms of IT band syndrome, I tell them to cut back on their mileage for a few days since this will decrease the friction occurring at the knee. A proper warm up to lengthen the band is also important, such as walking for at least a quarter mile. Again, a proper pair of shoes is important. Running on flat, even ground will decrease undo stress to one leg. The side of the road is often tapered to allow for water/rain to drain off.
Foam rolling is also great for this. Foam rolling is where you lay on a roll made of foam or other material that may or may not give a little in an effort to loosen up tiny “knots” in muscles. This allows the muscles to be their natural healthy length, thus decreasing the friction on the band at the knee. Foam rollers are available at most sports and fitness stores and come in a variety of materials. Many fitness centers and gyms also have these readily available. You can seek instruction on how to use them by staff there. Cross training, like swimming will reduce the friction while still allowing you to maintain your cardiovascular level.
If pain continues to worsen or if you are unsure of what is causing your pain seek the advice of a sports medicine professional. At The Orthopedic Institute of New Jersey we will be glad to provide further guidance as to what you can do or if you may require further care under the supervision of a physician.
-John Meyer, ATC
The Orthopedic Institute of New Jersey