On August 7, 2010 I broke my foot playing soccer. This was a fifth metatarsal fracture to the Left foot. I undertook some strict self care and got back to the point where I was released to run. Even with this release and visualizing the healing on x-ray personally, I had some fear of returning to running. Whether justified or not, I know better and still had that trepidation.
Why Would I Be Scared?
- Fear of Reinjury: Although injury is always a risk, after a truly healed fracture, the chance of reinjury is usually less, not more. Threrefore it is important to discuss this with your physician and get cleared to return to running. I cleared myself to run, conservatively, and should have no fear of reinjury.
- Does My Foot Still Hurt? After any injury, there is some residual stiffness and process of getting back to normal. At times I have thought that my foot may still hurt, but in reality it had no pain with pressure or pushing on it. Was this a valid fear? If it is truly healed it shouldn't be an issue.
- I Am Heavier Than I Ever Have Been: As a runner, I have kept my weight under control by running. When unable to run, and not changing my eating habits, I have gained weight and that (of course) makes it harder to run. Although this is a valid concern, if you are careful with return to running this problem can fix itself.
Overcoming My Fear
1. Remove Possible Excuses: The easiest way to justify not running (when afraid or otherwise) is to not be prepared to run. As cold weather is in full swing here in Utah, I ensured I had sufficient winter running wear to allow me to run when the time came. This included a good quality pair of running shoes and possibly a traction device if ice could be a problem.
2. Set A Date A Time To Start: In truthfullness, do any of us have time to run? Life will use any time we have for other purposes. Some purposes are valuable, and others are just time fillers. We always have time, however, to do what we want to do. Therefore, set a date and time to start running and don't let anything stop you. You schedule other things in your life and keep them. By making this strict appointment, you do the hardest part of running again, starting.
3. Don't Over Do It: It is irrelevant what distance and speed you were running before, you are starting over. Start slow and run relaxed. You should start with a shorter distance and slower speed and work back into what you were doing. My rule of thumb (for me) is to run until I am not hating it anymore and then turn around a run home. If you always hate running, that may not be a good rule, but for me it was just about one mile out so I started with two miles. I usually love to run once I am running again.
4. Run Baby Run: The only true way to overcome this fear is to run. After the first run, you will have much less fear and can work on the routine to get back to normal.
Remember the reasons you are running and get back to the routine that you were in before you stopped. If we can help you get back to running, let us know.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
Showing posts with label running. Show all posts
Showing posts with label running. Show all posts
Tuesday, December 7, 2010
Saturday, March 13, 2010
Barefoot Running, What's The Truth?
Barefoot running is not new, in fact it has been around since the beginning of mankind. Often man had to run to find food, or keep from being food. This reasoning is often the justification for barefoot running. They will often even quote "studies" that prove running shoes are bad, or barefoot running is good.
But what is the truth about barefoot running? Here is a good discussion that was brought to my attention: http://www.prolaborthotics.com/Blog/tabid/90/EntryID/132/Default.aspx
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
But what is the truth about barefoot running? Here is a good discussion that was brought to my attention: http://www.prolaborthotics.com/Blog/tabid/90/EntryID/132/Default.aspx
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
Friday, September 25, 2009
The Truth About Leg Length Differences In Running...
As I stated in a seperate blog, the development process causes each half of the body to develop independently, including foot size and leg length. As a runner, it is imperative that you understand these differences and adjust your equipment and training to accomodate the differences.
1. Based on which foot is larger, you should fit your shoes to minimize injuries from loss of toenails, to ingrown toenails, to blisters and even stress fractures.
2. Leg length difference can be a bigger issue:
-If the leg length difference is only minor, you will often not notice any difference and can continue to run without difficulty. No training adjustments will be required.
- For a significant difference, the following training modifications should be considered:
A heel lift or orthotic (with heel lift integrated) should be considered to allow modification of length to make the legs function closer to the same. This minor modification of equipment will preclude major changes in training.
If you typically run on a treadmill, the heel lift/orthotic are imperative, because there is no training adjustment that can be done to fix the additional stress on the bones, ligaments and tendons or aggressive pronation of the shorter leg that will occur irrespective of the shoe utilized.
If you typically run on a road, modify your running such that the longer leg is on the downside of the road. For example if your left leg is longer, running against traffic is good. The opposite is the case for a longer right leg. This is because most roads are canted to allow runoff during rain storms to the sides of the road.
So before you get more expensive shoes, run long distances or get injured from poor functioning of your feet from a simple leg length difference, make the necessary adjustments to improve your running gait pattern. Your body will thank you.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
1. Based on which foot is larger, you should fit your shoes to minimize injuries from loss of toenails, to ingrown toenails, to blisters and even stress fractures.
2. Leg length difference can be a bigger issue:
-If the leg length difference is only minor, you will often not notice any difference and can continue to run without difficulty. No training adjustments will be required.
- For a significant difference, the following training modifications should be considered:
A heel lift or orthotic (with heel lift integrated) should be considered to allow modification of length to make the legs function closer to the same. This minor modification of equipment will preclude major changes in training.
If you typically run on a treadmill, the heel lift/orthotic are imperative, because there is no training adjustment that can be done to fix the additional stress on the bones, ligaments and tendons or aggressive pronation of the shorter leg that will occur irrespective of the shoe utilized.
If you typically run on a road, modify your running such that the longer leg is on the downside of the road. For example if your left leg is longer, running against traffic is good. The opposite is the case for a longer right leg. This is because most roads are canted to allow runoff during rain storms to the sides of the road.
So before you get more expensive shoes, run long distances or get injured from poor functioning of your feet from a simple leg length difference, make the necessary adjustments to improve your running gait pattern. Your body will thank you.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
Tuesday, May 12, 2009
Proper Running Technique For Hills
I was talking on Sunday with a runner who is training for the Wasatch Back Relay and has been running without difficulty for months. Recently she has been runnning hills and is trying a new hill running technique taught at the local Rec Center and has started having leg pain (shin splints). The cause of this new pain is improper running of hills, as this instructor told the runner to turn their upper body sideways and push up the hill (after they start getting tired) with almost a side step running technique. Whether you lead with your right shoulder or left shoulder, the technique is biomechanically unsound and caused her current overuse injury. I will therefore give my recommendations for hill running:
1. Hill running should always be a part of training, as the running of hills improves your mental attitude (you believe you can) and increases conditioning. Many studies have shown improved performance in races from running hills as part of your training.
2. Run up hills utilizing the same energy as on flat ground. Instead of "attacking" hills, I recommend running at the same energy expenditure, meaning slightly slower with shorter steps. This will allow you to reach the top of a hill without being short of breath and permit you to return to your pre-hill speed (often passing many runners that overexerted on the hill).
3. Use proper running technique. As you run, arms should swing at your side toward the front and back. Never allow arms to swing across the body as this reduces efficiency of running and interferes with proper swing of the legs. Legs should move straight forward (not to the side, not crossing).
4. Arm swing should be shorter and lower. By less aggressive arm swing, you are keeping the legs closer to the ground allowing better propulsion up the hill.
5. Set mental goals as you move up the hill. A majority of hill running is mental (as is most running) and setting short goals helps keep you moving up the hill. Don't allow the hill height to win by thinking your not moving very fast. I don't like to stop and walk when running, therefore I break hills into little sections and countdown the sections as I complete a long or difficult hill.
Uphill running can be a great addition to any running, and can provide you with an edge when racing. Run smart and keep running...
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
1. Hill running should always be a part of training, as the running of hills improves your mental attitude (you believe you can) and increases conditioning. Many studies have shown improved performance in races from running hills as part of your training.
2. Run up hills utilizing the same energy as on flat ground. Instead of "attacking" hills, I recommend running at the same energy expenditure, meaning slightly slower with shorter steps. This will allow you to reach the top of a hill without being short of breath and permit you to return to your pre-hill speed (often passing many runners that overexerted on the hill).
3. Use proper running technique. As you run, arms should swing at your side toward the front and back. Never allow arms to swing across the body as this reduces efficiency of running and interferes with proper swing of the legs. Legs should move straight forward (not to the side, not crossing).
4. Arm swing should be shorter and lower. By less aggressive arm swing, you are keeping the legs closer to the ground allowing better propulsion up the hill.
5. Set mental goals as you move up the hill. A majority of hill running is mental (as is most running) and setting short goals helps keep you moving up the hill. Don't allow the hill height to win by thinking your not moving very fast. I don't like to stop and walk when running, therefore I break hills into little sections and countdown the sections as I complete a long or difficult hill.
Uphill running can be a great addition to any running, and can provide you with an edge when racing. Run smart and keep running...
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
Monday, April 20, 2009
How I Recover After A Marathon
Everyone is searching for the quickest route to recover from a long run or a strenuous race. The recommendations are found throughout the magazines and across the internet. I have my own special regimen that speeds my recovery, and once again has helped me progress to almost complete resolution of muscle pain and weakness after just 48 hours. Let me list the process I underwent after my marathon:
1. Cool Down
It is recommended in all research I can find that a runner should not stop to stretch or lie down after a strenuous exercise. The cool down can be a simple walk or jog after the race. I walk for at least 10-15 minutes without sitting or stretching to ensure the muscles have time to cool down with a light stretch from regular motion. Sitting or lying down will allow cramping. Stretching may overstimulate the stretch mechanism in an exhausted muscle and produce cramping or even injury. Stretching can be done after the cool down and is a good idea if done at the right time. If the cool down is done effectively, it will alleviate some of the after marathon recovery.
2. Refuel
Any amount of exercise utilizes the glycogen in muscles as an energy source, with blood glucose and free fatty acids. As the exercise level progresses to longer exercise or more strenuous exercise, these sources become depleted more quickly and "anaerobic" (without oxygen) mechanisms are utilized to produce lactate. The lactic acid in muscle fibers or even the muscle breakdown to obtain necessary energy can lead to muscle pain and stiffness. The speed of muscle recovery is determined by the amounts of lactic acid or protein (muscle) breakdown is required to repair the muscles (especially after an exercise is completed).
The University of Illinois did a study on rats in 1999 that showed quicker muscle recovery from this depletion with refuelling with foods containing Leucine (an amino acid) immediately after exercise. They showed muscle stiffness and soreness would subside more quickly. More recent studies have found 30 minutes to be the key time for muscle recovery. The foods eaten in the first 30 minutes after exercise help rebuild the muscles, while foods eaten later have less benefits for muscle repair.
Leucine is found in protein products such as meats and dairy products, as well as in protein bars and some sports drinks. It is not recommended, however, that pure amino acid supplements be taken, because the beneficial amount is not known. In the study, they made the following findings: "It [Leucine] stimulates muscle protein synthesis, provides fuel for the muscle and helps to maintain blood glucose. What really surprised us was that its activity is not seen when leucine or protein is consumed before or during exercise. Instead it has a dramatic impact on protein synthesis during the recovery period after exercise."
So how do I refuel after a race? After any run, and especially after this marathon, I drank a large glass of milk withing 30 minutes of completing the exercise. Fluids are also imperative as are some other carbohydrates to help further maintain blood glucose and reduce lightheadedness from low blood glucose. When I don't want to eat within 30 minutes after an exercise, I eat anyway, especially the large cup of milk and/or a yogurt to get the Leucine benefits.
3. Fluids, Fluids, Fluids...
Part of refueling is getting the necessary fluids to replenish the body. I have a tendancy to start sweating when I think about exercise. I therefore must replace a large amount of fluid after any form of exercise. This replacement is both for refueling and for providing the reservoir for flushing out waste products from the body and especially the muscles. It requires more fluid to carry all these waste products out of the muscles into the kidneys for excretion. Try to drink 6-8 ounces of water every 2-3 hours during the initial recovery period.
4. Hot or Cold?
Everything I have read recommends ice baths or ice massage after a strenuous exercise, and often they recommend avoiding the heat after exercise. I will say now that I aggressively treat my muscle soreness after an exercise (even after the marathon) with soaking in a warm bath or hot tub. Let me explain the scientific basis for my actions. (Note that for me this works really well and decreases my muscle soreness significantly within the first 24 hours and reduces it nearly completely by 48 hours.)
The body reacts to hot and cold by dilation or contracture of blood vessels. Cold (ice) will reduce(vessel contracture) the blood flow into the area or cause the body to pull the blood from the area. Heat will increase (vessel dilation) the blood flow to the area and allow increased blood flow through the area. Since muscle pain is often due to lactic acid in the muscles or other waste products of "anaerobic" muscle metabolism (contracture), heat will allow blood flow through the muscles that can remove these waste products. Heat is only recommended by me during the first 12-24 hours. Ice can be utilized at anytime, but is rarely necessary if I undergo my usual exercise recovery regimen.
I have found through the use of these 4 simple techniques that I can continue to run, recover quickly and not suffer for days - weeks after a strenuous exercise. I plan to continue to train and run marathons and will evaluate the benefits of this regimen after any strenuous exercise. The proof will be in my recovery. Currently I am basically painfree the Monday after a Saturday 26.2 miles...I hope this helps.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
1. Cool Down
It is recommended in all research I can find that a runner should not stop to stretch or lie down after a strenuous exercise. The cool down can be a simple walk or jog after the race. I walk for at least 10-15 minutes without sitting or stretching to ensure the muscles have time to cool down with a light stretch from regular motion. Sitting or lying down will allow cramping. Stretching may overstimulate the stretch mechanism in an exhausted muscle and produce cramping or even injury. Stretching can be done after the cool down and is a good idea if done at the right time. If the cool down is done effectively, it will alleviate some of the after marathon recovery.
2. Refuel
Any amount of exercise utilizes the glycogen in muscles as an energy source, with blood glucose and free fatty acids. As the exercise level progresses to longer exercise or more strenuous exercise, these sources become depleted more quickly and "anaerobic" (without oxygen) mechanisms are utilized to produce lactate. The lactic acid in muscle fibers or even the muscle breakdown to obtain necessary energy can lead to muscle pain and stiffness. The speed of muscle recovery is determined by the amounts of lactic acid or protein (muscle) breakdown is required to repair the muscles (especially after an exercise is completed).
The University of Illinois did a study on rats in 1999 that showed quicker muscle recovery from this depletion with refuelling with foods containing Leucine (an amino acid) immediately after exercise. They showed muscle stiffness and soreness would subside more quickly. More recent studies have found 30 minutes to be the key time for muscle recovery. The foods eaten in the first 30 minutes after exercise help rebuild the muscles, while foods eaten later have less benefits for muscle repair.
Leucine is found in protein products such as meats and dairy products, as well as in protein bars and some sports drinks. It is not recommended, however, that pure amino acid supplements be taken, because the beneficial amount is not known. In the study, they made the following findings: "It [Leucine] stimulates muscle protein synthesis, provides fuel for the muscle and helps to maintain blood glucose. What really surprised us was that its activity is not seen when leucine or protein is consumed before or during exercise. Instead it has a dramatic impact on protein synthesis during the recovery period after exercise."
So how do I refuel after a race? After any run, and especially after this marathon, I drank a large glass of milk withing 30 minutes of completing the exercise. Fluids are also imperative as are some other carbohydrates to help further maintain blood glucose and reduce lightheadedness from low blood glucose. When I don't want to eat within 30 minutes after an exercise, I eat anyway, especially the large cup of milk and/or a yogurt to get the Leucine benefits.
3. Fluids, Fluids, Fluids...
Part of refueling is getting the necessary fluids to replenish the body. I have a tendancy to start sweating when I think about exercise. I therefore must replace a large amount of fluid after any form of exercise. This replacement is both for refueling and for providing the reservoir for flushing out waste products from the body and especially the muscles. It requires more fluid to carry all these waste products out of the muscles into the kidneys for excretion. Try to drink 6-8 ounces of water every 2-3 hours during the initial recovery period.
4. Hot or Cold?
Everything I have read recommends ice baths or ice massage after a strenuous exercise, and often they recommend avoiding the heat after exercise. I will say now that I aggressively treat my muscle soreness after an exercise (even after the marathon) with soaking in a warm bath or hot tub. Let me explain the scientific basis for my actions. (Note that for me this works really well and decreases my muscle soreness significantly within the first 24 hours and reduces it nearly completely by 48 hours.)
The body reacts to hot and cold by dilation or contracture of blood vessels. Cold (ice) will reduce(vessel contracture) the blood flow into the area or cause the body to pull the blood from the area. Heat will increase (vessel dilation) the blood flow to the area and allow increased blood flow through the area. Since muscle pain is often due to lactic acid in the muscles or other waste products of "anaerobic" muscle metabolism (contracture), heat will allow blood flow through the muscles that can remove these waste products. Heat is only recommended by me during the first 12-24 hours. Ice can be utilized at anytime, but is rarely necessary if I undergo my usual exercise recovery regimen.
I have found through the use of these 4 simple techniques that I can continue to run, recover quickly and not suffer for days - weeks after a strenuous exercise. I plan to continue to train and run marathons and will evaluate the benefits of this regimen after any strenuous exercise. The proof will be in my recovery. Currently I am basically painfree the Monday after a Saturday 26.2 miles...I hope this helps.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
Friday, April 3, 2009
Final Preparations For A Marathon
I am two weeks away from the Salt Lake Marathon, and I am once again reviewing my preparation. What am I doing to ensure that I am running the race correctly, to protect my health, avoid injury and compete at a good level? Here is the thought process I undergo as a physician specializing in foot and ankle health.
Physical Preparation
Physical preparation starts months to years before the marathon and must include regular running with increasing endurance. You can't physically prepare for a marathon if you are not consistently running and able to increase your distance to near marathon distances (20-22 miles are recommended). During the week, longer runs can be split between two runs in the same day (10 miles can be run as two runs of 5 miles in the same day), but at least one long run must be done each week. The advantage of splitting some longer runs into two is decreased chance of injury from stress fractures or other running related injuries.
As you move closer to the race, the training should continue, but be modified to allow full muscle strength and full body preparation for the run. A marathon, due to adrenaline and competition, will usually be faster and harder on the body than other runs. This is what brings the runners high from such a long run.
Therefore, at this time, I am ensuring regular runs with some modification of mileage to protect my body during these last 2 weeks. I am also doing what I can to eat right (regular, healthy, energy rich foods), sleep good at night and trying to avoid sickness that could interfere with the functioning of my lungs. I am doing what I can to be physically prepared.
Mental Preparation
I am still strongly of the opinion that the most important preparation for a marathon is mental. As part of the physical preparation, you get to the point where you believe you can complete a marathon. During any given run, there will be times that are hard and times that are less hard. If you believe you can do it, you will.
Often when I am running I will hit what many call "the wall" and just tell my body that it is not an option to stop running. I run because I can and mental preparation keeps legs moving when the muscles ache, the lungs are tired and the body is ready to stop. This mental attitude is the key to running distances, running hills and even starting a run when the desire may not be there.
I feel that I am mentally prepared, but it is a constant process. My goal is to "run and not be weary, walk and not faint." Mental attitude definitely helps.
Correct Equipment
With all the physical and mental preparation, injury can occur in a 26.2 mile run easily if poor equipment (or even worn out equipment) is utilized. Things to consider are the shoe, and what clothes will be worn for the run.
With shoes, mileage over 300 - 400 miles will wearout a shoe. A new shoe, however, should also not be worn without a breakin period. I plan to use a good shoe that has participated in about half of my training. This shoe, however, will be replace before my next marathon.
Clothing choice is more variable. What will the weather be like? How will you limit rubbing that can cause soreness throughout a run? What will you do to limit sunburn or other discomfort during the run? Will you wear a hat? Whatever the clothing choices may be, it is important to train with these clothes, even utilizing them on long runs to ensure that you are able to enjoy the 26.2 miles without interruptions from the clothing you wore (or didn't wear).
I can truly say that I am excited for this marathon and I am doing everything in my power to be prepared for this run. Besides I have already registered for other marathons that I must be ready for also...
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
Physical Preparation
Physical preparation starts months to years before the marathon and must include regular running with increasing endurance. You can't physically prepare for a marathon if you are not consistently running and able to increase your distance to near marathon distances (20-22 miles are recommended). During the week, longer runs can be split between two runs in the same day (10 miles can be run as two runs of 5 miles in the same day), but at least one long run must be done each week. The advantage of splitting some longer runs into two is decreased chance of injury from stress fractures or other running related injuries.
As you move closer to the race, the training should continue, but be modified to allow full muscle strength and full body preparation for the run. A marathon, due to adrenaline and competition, will usually be faster and harder on the body than other runs. This is what brings the runners high from such a long run.
Therefore, at this time, I am ensuring regular runs with some modification of mileage to protect my body during these last 2 weeks. I am also doing what I can to eat right (regular, healthy, energy rich foods), sleep good at night and trying to avoid sickness that could interfere with the functioning of my lungs. I am doing what I can to be physically prepared.
Mental Preparation
I am still strongly of the opinion that the most important preparation for a marathon is mental. As part of the physical preparation, you get to the point where you believe you can complete a marathon. During any given run, there will be times that are hard and times that are less hard. If you believe you can do it, you will.
Often when I am running I will hit what many call "the wall" and just tell my body that it is not an option to stop running. I run because I can and mental preparation keeps legs moving when the muscles ache, the lungs are tired and the body is ready to stop. This mental attitude is the key to running distances, running hills and even starting a run when the desire may not be there.
I feel that I am mentally prepared, but it is a constant process. My goal is to "run and not be weary, walk and not faint." Mental attitude definitely helps.
Correct Equipment
With all the physical and mental preparation, injury can occur in a 26.2 mile run easily if poor equipment (or even worn out equipment) is utilized. Things to consider are the shoe, and what clothes will be worn for the run.
With shoes, mileage over 300 - 400 miles will wearout a shoe. A new shoe, however, should also not be worn without a breakin period. I plan to use a good shoe that has participated in about half of my training. This shoe, however, will be replace before my next marathon.
Clothing choice is more variable. What will the weather be like? How will you limit rubbing that can cause soreness throughout a run? What will you do to limit sunburn or other discomfort during the run? Will you wear a hat? Whatever the clothing choices may be, it is important to train with these clothes, even utilizing them on long runs to ensure that you are able to enjoy the 26.2 miles without interruptions from the clothing you wore (or didn't wear).
I can truly say that I am excited for this marathon and I am doing everything in my power to be prepared for this run. Besides I have already registered for other marathons that I must be ready for also...
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
Tuesday, March 24, 2009
Shin Splints Can Be Avoided
Commonly runners are sidelined or limited by the presentation of leg pain during and often after runs. The pain is usually located at the sides of the "shin" bone and can be debilitating, even limiting the ability to walk. Over the years, this has been a problem that I sometimes have encountered in my running. Since I love running (and don't like not running), I have researched over the years some ways to limit the presentation of shin splints while training for a race, or in my case a marathon. I will discuss some ways that we can "run smart" and limit the injuries that have been commonly classified as shin splints.
What is a shin splint?
A shin splint can be located on the medial (inside) or lateral (outside) of the lower leg below the knee. Medial shin splints are commonly inflammation of the muscle attachment to the shin bone (tibia) and hurts as from pressure to the muscle just inside the bone. Lateral shin splints are commonly inflammation to the tendon (posterior peroneal tendon) and adjacent tissues in the front of the outer lower leg. In either case, the pain can present during a run, immediately following the run or sometimes the next day.
What causes shin splints?
The exact cause of shin splints are not known, but usually it is related to rapid increase in running or jumping (or sometimes walking fast), changes in shoegear, or pronation (flattening of the foot). Some secondary causes may be balance problems (leaning to one side during a run), poor training technique (progressing too fast, poor running technique or surfaces), leg length problems or even injury.
What I have learned...
1) Using correct shoes.
Since commonly over pronation (excessive flattening of the foot) or over supination
(increased arch height - rolling out) can cause stress to the muscles or tendons in the area and create shin splints, a quality exercise or running shoe will help improve and prevent these symptoms. In choosing a shoe, price is not the most important, but cheap priced shoes are usually cheap shoes. Get a quality shoe, designed for the exercise you are doing (running shoe for running or walking, basketball shoe for basketball, etc.).
2) Training smart.
As you run or train, Run Smart! Let me explain…
If you are running on a track, understand that always running the same direction on the track will work muscles differently than switching directions. One of the possible causes for shin splints is working muscles at different rates, therefore switching directions regularly will work all muscle of the legs equally and reduce the chances for shin splints.
If you are running on a road, most roads in most locations throughout the country are canted (or tilted to improve water runoff). Therefore, running against traffic always will cause supination of the left foot and pronation of the right foot. With supination, you will work the lateral (outside) muscles of the leg more than the medial (inside) muscles of the leg. Pronation does the opposite. By switching sides periodically, you will again work all muscles equally and prevent the presentation of shin splint symptoms.
Lastly, in running smart, the speed of training should be carefully controlled. Start slow and progress slowly to the amount of running you desire. Give the leg muscles time to get strengthened before forcing them into harder regimen. The speed of progress will require understanding of how much running you have done and where you should start. Cross training (elliptical or bike) can also help even the muscle strength as you progress.
In all these aspects of running smart, it should be understood that shin splints are caused by overusing a muscle group and creating an injury. By adjusting the training to reduce this overuse, you will have a more enjoyable run.
3) Evaluation for possible "gait" abnormalities.
“Gait” abnormalities are best described as running or walking abnormalities. Do you have a leg length problem? Do you over pronate or over supinate? Do you have imbalance issues, back problems, knee problems, or other reasons to overwork a muscle group that may cause your shin spints?
Let me discuss some of these running issues:
Leg length abnormalities (left leg longer/shorter than right) can be a large problem when running. The APMA has found that running produces 4-5 times your body weight through your feet. If one leg is shorter, the body is designed to adjust…you will pronate the shorter foot to make it longer and supinate the longer foot to make it shorter. This will lead to overworking the muscles and cause leg pain and possibly shin splints. A simple adjustment to your shoes (or orthotics) will alleviate this problem and produce continued running without pain.
Imbalance issues, often caused by weakness of ligaments (like chronic ankle spraining) or ear problems. One of my patients is deaf in one ear and runs lopsided (towards the deaf side) and has issues with shin splints. With a simple orthotic, a custom item to replace a shoe insert in your running shoes that maintains your foot in neutral position and helps the foot function as it should, his shin splints have been eliminated.
Pronation or supination is also a form of imbalance of the feet and can cause overuse of some muscles and may also lead to shin splints. Orthotics are the answer here also.
By being evaluated for your running, your “gait” abnormalities can be evaluated and often adjusted to help you return to running without the pain.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
What is a shin splint?
A shin splint can be located on the medial (inside) or lateral (outside) of the lower leg below the knee. Medial shin splints are commonly inflammation of the muscle attachment to the shin bone (tibia) and hurts as from pressure to the muscle just inside the bone. Lateral shin splints are commonly inflammation to the tendon (posterior peroneal tendon) and adjacent tissues in the front of the outer lower leg. In either case, the pain can present during a run, immediately following the run or sometimes the next day.
What causes shin splints?
The exact cause of shin splints are not known, but usually it is related to rapid increase in running or jumping (or sometimes walking fast), changes in shoegear, or pronation (flattening of the foot). Some secondary causes may be balance problems (leaning to one side during a run), poor training technique (progressing too fast, poor running technique or surfaces), leg length problems or even injury.
What I have learned...
1) Using correct shoes.
Since commonly over pronation (excessive flattening of the foot) or over supination
(increased arch height - rolling out) can cause stress to the muscles or tendons in the area and create shin splints, a quality exercise or running shoe will help improve and prevent these symptoms. In choosing a shoe, price is not the most important, but cheap priced shoes are usually cheap shoes. Get a quality shoe, designed for the exercise you are doing (running shoe for running or walking, basketball shoe for basketball, etc.).
2) Training smart.
As you run or train, Run Smart! Let me explain…
If you are running on a track, understand that always running the same direction on the track will work muscles differently than switching directions. One of the possible causes for shin splints is working muscles at different rates, therefore switching directions regularly will work all muscle of the legs equally and reduce the chances for shin splints.
If you are running on a road, most roads in most locations throughout the country are canted (or tilted to improve water runoff). Therefore, running against traffic always will cause supination of the left foot and pronation of the right foot. With supination, you will work the lateral (outside) muscles of the leg more than the medial (inside) muscles of the leg. Pronation does the opposite. By switching sides periodically, you will again work all muscles equally and prevent the presentation of shin splint symptoms.
Lastly, in running smart, the speed of training should be carefully controlled. Start slow and progress slowly to the amount of running you desire. Give the leg muscles time to get strengthened before forcing them into harder regimen. The speed of progress will require understanding of how much running you have done and where you should start. Cross training (elliptical or bike) can also help even the muscle strength as you progress.
In all these aspects of running smart, it should be understood that shin splints are caused by overusing a muscle group and creating an injury. By adjusting the training to reduce this overuse, you will have a more enjoyable run.
3) Evaluation for possible "gait" abnormalities.
“Gait” abnormalities are best described as running or walking abnormalities. Do you have a leg length problem? Do you over pronate or over supinate? Do you have imbalance issues, back problems, knee problems, or other reasons to overwork a muscle group that may cause your shin spints?
Let me discuss some of these running issues:
Leg length abnormalities (left leg longer/shorter than right) can be a large problem when running. The APMA has found that running produces 4-5 times your body weight through your feet. If one leg is shorter, the body is designed to adjust…you will pronate the shorter foot to make it longer and supinate the longer foot to make it shorter. This will lead to overworking the muscles and cause leg pain and possibly shin splints. A simple adjustment to your shoes (or orthotics) will alleviate this problem and produce continued running without pain.
Imbalance issues, often caused by weakness of ligaments (like chronic ankle spraining) or ear problems. One of my patients is deaf in one ear and runs lopsided (towards the deaf side) and has issues with shin splints. With a simple orthotic, a custom item to replace a shoe insert in your running shoes that maintains your foot in neutral position and helps the foot function as it should, his shin splints have been eliminated.
Pronation or supination is also a form of imbalance of the feet and can cause overuse of some muscles and may also lead to shin splints. Orthotics are the answer here also.
By being evaluated for your running, your “gait” abnormalities can be evaluated and often adjusted to help you return to running without the pain.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
Saturday, March 7, 2009
Running On A Trip
Most runners have a favorite route, or even a favorite run. Whatever the distance, most runners will also agree that running outside is easier than on a treadmill. This makes running on a trip more difficult, especially when training for a marathon. If traveling on a weekend, this may even raise greater difficulty to make long runs and consistent training. Many people have this difficulty, but are required to run on a trip. What are your options.
Recently, a friend and more experienced runner Dr Marybeth Crane of Grapevine, Texas helped me find an answer. In fact, I can say she provided an inspiration for me on my current trip to Pittsburgh, PA. In my training regimen, I was scheduled to run 16 miles today. Knowing that the travel would make this more difficult (based on Dr Crane's experience), I ran the long run on Wednesday prior to traveling. Running at home, on my regular routes is much easier and allows me to stay on track.
Today I did run a 6 mile pace run, which allowed me to continue to stay on my training regimen while traveling. Other options would include cross-training or even a shorter run in the morning and a second run in the evening. I was very happy with my 6 mile run, and glad that I ran the longer run back in Utah.
Thank you Dr Crane for helping me stay on track in my training...
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
Recently, a friend and more experienced runner Dr Marybeth Crane of Grapevine, Texas helped me find an answer. In fact, I can say she provided an inspiration for me on my current trip to Pittsburgh, PA. In my training regimen, I was scheduled to run 16 miles today. Knowing that the travel would make this more difficult (based on Dr Crane's experience), I ran the long run on Wednesday prior to traveling. Running at home, on my regular routes is much easier and allows me to stay on track.
Today I did run a 6 mile pace run, which allowed me to continue to stay on my training regimen while traveling. Other options would include cross-training or even a shorter run in the morning and a second run in the evening. I was very happy with my 6 mile run, and glad that I ran the longer run back in Utah.
Thank you Dr Crane for helping me stay on track in my training...
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
Friday, March 6, 2009
Cross-Training With An Elliptical
One of the big concerns with running at greater frequency and greater distances is injury, often called "repetitive stress injuries", such as muscle strains, sprains or stress fractures. Many of these injuries don't just limit continued activity, but completely stop the exercise for a period of recovery. With my current goals for the year of running, injury is not an option.
With this information in mind, I have continued to run (including a most recent 16 mile night) and am heavily training for an upcoming marathon. What are my other options for staying fit, working the muscles and reducing possible injuries? Swimming, although a good exercise utilizes different muscles and different motions than running. It is a good activity for cross-training, but will have minimal benefit for my running. Biking adds greater leg strength and greater aerobic benefits, but still is not a perfect match for running. A newer exercise modality, the elliptical, is a similar modality and has been shown to be valuable with cross-training for runners.
So, over the years I have been able to cross-train with the benefits of an elliptical trainer. I have also recognized a higher aerobic benefit in a shorter period of time. In my current exercise regimen, I am utilizing the elliptical as an additional activity for the day or an alternate when I have less time to exercise that day. Although use of an elliptical will not prepare me for a marathon, it is a good adjunct and should be considered especially by those that commonly get stress fractures or other stress injuries. I will keep you informed at how it works for me...
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
With this information in mind, I have continued to run (including a most recent 16 mile night) and am heavily training for an upcoming marathon. What are my other options for staying fit, working the muscles and reducing possible injuries? Swimming, although a good exercise utilizes different muscles and different motions than running. It is a good activity for cross-training, but will have minimal benefit for my running. Biking adds greater leg strength and greater aerobic benefits, but still is not a perfect match for running. A newer exercise modality, the elliptical, is a similar modality and has been shown to be valuable with cross-training for runners.
So, over the years I have been able to cross-train with the benefits of an elliptical trainer. I have also recognized a higher aerobic benefit in a shorter period of time. In my current exercise regimen, I am utilizing the elliptical as an additional activity for the day or an alternate when I have less time to exercise that day. Although use of an elliptical will not prepare me for a marathon, it is a good adjunct and should be considered especially by those that commonly get stress fractures or other stress injuries. I will keep you informed at how it works for me...
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
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