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Home > Forum > Triathlon Forum > Training Through Periostitis (Shin Splint)?

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Training Through Periostitis (Shin Splint)?
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ericlambi
Mar 1, 12 15:38
Post #1 of 9 (5612 views)
I'm in marathon training and have developed some pain in my left tibia over the past few weeks (think it happened specifically when I did a long run in lightweight racing flats that I was considering for the race). I went to the ortho to rule out a stress fracture and an MRI showed periostitis, which I guess is just a fancy word for shin splint (but no stress fx/reaction!). The doctor recommended a lot of aleve and some calf strengthening exercises (putting ankle weights on my feet and lifting the foot up and down with the shin). He said I only needed to stop training if the pain became bad enough that I limped while walking.

With that in mind, I'm wondering if anyone has recommendations for managing or recovering from this through my training? A couple common recommendations from googling that don't seem too whacky are ice massage with a dixie cup and toe taps while standing. Anything else that you recommend? Will wearing compression sock/sleeve either when I'm running or resting or both help? What about PT/massage?

Thanks!

Eric
Dimond Bikes Superfan
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Re: Training Through Periostitis (Shin Splint)? [ericlambi] [ In reply to ]
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rroof
Mar 1, 12 15:47
Post #2 of 9 (5603 views)
Most marathon or experienced runners don't experience shin splints - more typical in "new" or returning runners. Which are you? Overworking the tibialis anterior is generally the cause, and rest, ice, compression sleeves (they do seem to help people say for reasons I'm not sure), running on softer surfaces, NOT overstriding/shortening cadence, etc. all help. You can run through them technically, especially with a neg MRI.
____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: Training Through Periostitis (Shin Splint)? [ericlambi] [ In reply to ]
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Dreadnought
Mar 1, 12 15:59
Post #3 of 9 (5598 views)
ericlambi wrote:
I'm in marathon training and have developed some pain in my left tibia over the past few weeks (think it happened specifically when I did a long run in lightweight racing flats that I was considering for the race). I went to the ortho to rule out a stress fracture and an MRI showed periostitis, which I guess is just a fancy word for shin splint (but no stress fx/reaction!). The doctor recommended a lot of aleve and some calf strengthening exercises (putting ankle weights on my feet and lifting the foot up and down with the shin). He said I only needed to stop training if the pain became bad enough that I limped while walking.

With that in mind, I'm wondering if anyone has recommendations for managing or recovering from this through my training? A couple common recommendations from googling that don't seem too whacky are ice massage with a dixie cup and toe taps while standing. Anything else that you recommend? Will wearing compression sock/sleeve either when I'm running or resting or both help? What about PT/massage?

Thanks!

Eric

The term "shinsplint" is actually term used to describe various different causess of pain in the lower leg. These can include tibial stress fracture, anterior compartment syndrome, and tendinitis (possibly with associated periostitis).

I personally don't see how strengthening the calves would help. That might actually cause more muscular imbalances. It would be of greater benefit to strengthen the tibialis anterior ( the muscle which dorsiflexes the foot and antagonizes the action of the calves) to reduce muscular imbalance.
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Re: Training Through Periostitis (Shin Splint)? [rroof] [ In reply to ]
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ericlambi
Mar 1, 12 17:17
Post #4 of 9 (5588 views)
rroof wrote:
Most marathon or experienced runners don't experience shin splints - more typical in "new" or returning runners. Which are you? Overworking the tibialis anterior is generally the cause, and rest, ice, compression sleeves (they do seem to help people say for reasons I'm not sure), running on softer surfaces, NOT overstriding/shortening cadence, etc. all help. You can run through them technically, especially with a neg MRI.

I am an experienced runner, and never had this problem before. It started right after a long run on pavement in some 5oz racing flats. With hindsight, I acknowledge it was dumb to do this. I just want to manage it as best as possible between now and Boston.
Dimond Bikes Superfan
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Re: Training Through Periostitis (Shin Splint)? [Dreadnought] [ In reply to ]
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ericlambi
Mar 1, 12 17:19
Post #5 of 9 (5587 views)
Dreadnought wrote:

The term "shinsplint" is actually term used to describe various different causess of pain in the lower leg. These can include tibial stress fracture, anterior compartment syndrome, and tendinitis (possibly with associated periostitis).

I personally don't see how strengthening the calves would help. That might actually cause more muscular imbalances. It would be of greater benefit to strengthen the tibialis anterior ( the muscle which dorsiflexes the foot and antagonizes the action of the calves) to reduce muscular imbalance.

I was wrong to say calf strengthening. The exercise he recommended is sitting down with your feet dangling and putting ankle weights on your feet, then flexing the foot up-and-down.
Dimond Bikes Superfan
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Re: Training Through Periostitis (Shin Splint)? [ericlambi] [ In reply to ]
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rroof
Mar 1, 12 17:35
Post #6 of 9 (5584 views)
ericlambi wrote:
rroof wrote:
Most marathon or experienced runners don't experience shin splints - more typical in "new" or returning runners. Which are you? Overworking the tibialis anterior is generally the cause, and rest, ice, compression sleeves (they do seem to help people say for reasons I'm not sure), running on softer surfaces, NOT overstriding/shortening cadence, etc. all help. You can run through them technically, especially with a neg MRI.


I am an experienced runner, and never had this problem before. It started right after a long run on pavement in some 5oz racing flats. With hindsight, I acknowledge it was dumb to do this. I just want to manage it as best as possible between now and Boston.

Gotcha. Nothing wrong with a 5oz racing flat - just not for a long run if not used to it! I personally wouldn't run a marathon in them (especially Boston, which I've done 3 times), simply moving to something in the 7.5-8oz range makes a huge difference on the lower extremity for a marathon, especially the back half of Boston after you have been beat up/flying downhill until the girls at Wellsley.

In your case, since you apparently seem to know what caused them, had a hands on exam/MRI, you should be fine. Just put away the flats till after Boston for the shorter speedwork, 5/10Ks, etc. ;-) Best of luck if it is your first Boston!
____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: Training Through Periostitis (Shin Splint)? [ericlambi] [ In reply to ]
Quote | Reply
Dreadnought
Mar 1, 12 17:46
Post #7 of 9 (5579 views)
ericlambi wrote:
I was wrong to say calf strengthening. The exercise he recommended is sitting down with your feet dangling and putting ankle weights on your feet, then flexing the foot up-and-down.

OK, that's better. That would work the tibialis anterior.

Stronger tibialis anterior will stabilize the foot landing, and it also may reult in strengthening the associated bony structures.
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Re: Training Through Periostitis (Shin Splint)? [rroof] [ In reply to ]
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ericlambi
Mar 2, 12 6:07
Post #8 of 9 (5515 views)
rroof wrote:
In your case, since you apparently seem to know what caused them, had a hands on exam/MRI, you should be fine. Just put away the flats till after Boston for the shorter speedwork, 5/10Ks, etc. ;-) Best of luck if it is your first Boston!

Great, thank you! Do you think massage/PT will help at all?
Dimond Bikes Superfan
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Re: Training Through Periostitis (Shin Splint)? [ericlambi] [ In reply to ]
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rroof
Mar 2, 12 7:00
Post #9 of 9 (5509 views)
ericlambi wrote:
rroof wrote:
In your case, since you apparently seem to know what caused them, had a hands on exam/MRI, you should be fine. Just put away the flats till after Boston for the shorter speedwork, 5/10Ks, etc. ;-) Best of luck if it is your first Boston!


Great, thank you! Do you think massage/PT will help at all?

Won't hurt, but will mostly only be helpful if part of your contributing factory is a posterior gastroc/soleus (which can then cause "overworking" of the anterior tibial).
____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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