Running

Shin splints is a term that, in essence, simply refers to lower leg pain. It is a common injury amongst runners, especially long distance runners, but it can manifest in anyone whose prime activity involves running or jumping.

Typically, shin splints are divided into three separate conditions.

Anterior compartment syndrome (ACS) – this is pain felt on the front of the shin. When we exercise our working muscles need an increased amount of blood to provide the oxygen they need, as this blood supply increases so does the size of the muscle. A thin but tough layer of tissue called fascia that keeps the muscles separate and contained surrounds muscles. As the working muscle expands, the fascia must stretch to accommodate, however in the case of ACS the fascia does not expand sufficiently, causing an increased pressure in the muscle and pain.

Medial Tibial Stress Syndrome (MTSS) – typically felt on the inside of the shin, directly on the side of the bone, this condition is caused by stress between the outer layer of the shin bone and tendon attachments. Typically seen in runners with ‘flat feet’ where the constant rolling inwards of the feet pulls on the shin bone via the tendons causing an irritation and inflammation of the bone.

Stress Fractures – constant repetitive impact gradually leads to a weakening of the bones and small hairline fractures appear causing a great deal of pain. This does not only occur in the shin but is also seen in the heel and up into the neck of the thigh bone.

What are the causes of shin splints?

• Poor running biomechanics – when you run what does your foot do? We don’t often give this much thought… we just run! There’s a lot that should happen in the split second your foot is in contact with the ground.
• Using the wrong shoes – for sports or activities that involve repetitive impact, make sure your shoes are giving you the support and protection you need.
• Muscle imbalances, restricted joint movement, especially around the foot and ankle.
• Sudden changes to your training – what type and level of training are you doing? Have you progressed gradually to this level? Sudden increases or a sudden change of surface you are training on will over-stress your lower limb.

How can I prevent shin splints?

• Warm up properly before every training session.
• Spend plenty of time stretching at the end of your session, especially your calf and shin muscles.
• Try to avoid excessive running on roads. Stick to grass, tracks or cross-country.
• Ensure your shoes are giving your foot the support it needs. For runners, make sure you have shoes specifically fitted to your running style and be aware of when to retire them, generally between 500-700 miles.
• Keep well hydrated.
• Spend time training in other sports to vary the training effect, especially sports which involve lateral, side-to-side, movements.

The most important point to consider with these injuries is to listen to the messages from your body. If you feel any new ‘niggles’, aches and pains, especially in the lower leg, don’t ignore them. These are overuse injuries and the body needs rest to help them recover. It is a common trait of the long distance runner to ignore these signs for fear that resting will affect future goals, but think about the big picture, eventually, if left unchecked these pains may develop into a debilitating condition that may prevent any running for several months.

Bridge to Health are offering running assessments for anyone who is concerned with their training and the risks of developing injury, followed by any relevant treatment and rehabilitative exercises. Please contact the clinic for more information.

Two more patients’ stories have been added to the testimonials page:

• Treating a sporting injury – running in pain – a patients’ experience preparing for Ironman Austria
• Living with chronic back pain – having been told by a consultant that apart from pain management nothing could be done for her pain, Fiona looked up Uxbridge osteopath

Both were first published in our monthly newsletter. Click here if you would like to subscribe to the  Bridge to Health newsletter. It’s free, easy to sign-up, keep informed about what’s happening at Bridge to Health, tips and advice for a healthier lifestyle, plus special offers too.

Several of our patients are being treated for Repetitive Strain Injury (RSI for short) – most frequently tennis elbow and achilles tendonitis – and other patients often ask us about what lies behind RSI. Today’s post aims to provide some basic answers to these queries.

What is Repetitive Strain Injury?

Repetitive Stain Injury is an “umbrella diagnosis” that accounts for a wide range of musculoskeletal pain disorders as a result of overuse of the body. This is most often experienced in the arm due to occupational strain.

(Musculoskeletal = bones / muscles / tendons)

The pain is usually a sharp stabbing pain which initially comes on once the aggravating cause has ceased, however this may then go on to flair-up more often. There are many conditions that fall under this term such as Tennis elbow, Carpal tunnel, Thoracic outlet syndrome, Tendonitis and many more.

What is the cause?

When a movement or action is repeated over and over, the tissues of the body become overused and begin to break down. This leads to a build-up of inflammation as the body tries to repair the damage. Typical triggers are sporting injuries where an action is constantly repeated, for example running, swimming, serving a tennis ball can all trigger these conditions. Also, hobbies such as playing the guitar, fly-fishing, you name it! However, the most common cause of RSI in the modern age is overuse due to occupational strain and the biggest culprit of all is the computer keyboard – especially laptop computers.

How to fix/cure RSI

The most important element of the healing process is rest to allow the body to heal the tissue; however the dilemma faced by most patients is how to recover from an injury such as this when the causative factor is the one which puts food on the table. Other treatment methods are cryotherapy (using ice/cold water to help heal sprains) to reduce the inflammation and manual therapy such as osteopathy, physiotherapy and acupuncture.

Others methods involve applying a joint splint or forearm compression bandages to alleviate the pressure on the muscle insertion point.

How can I prevent Repetitive Strain Injury?

For many office-bound people, inevitably the bulk of the day is spent on a laptop but this needn’t be a guarantee that you will be affected by RSI.

• Seek advice on correct setup of your workstation, both at work and at home;
• Take regular breaks throughout the day, even if some are just 2 minute breaks, to stretch the arms, shoulders and back;
• Maintain good hydration at all time: you should be aiming for 1.5 to 2 litres of water each day. Tea and coffee are diuretics which lead to an increased expulsion of water from the body, leading to dehydration;
• Ensure a well balanced natural diet which avoids refined and processed foods and includes plenty of fruit and vegetable intake, as it is vital for promoting tissue health;
• Maintain good posture, this is important at all times but especially when at your desk as long periods in a poor position (typically slumped) will lead to poor circulation and nerve conduction and increase the risk of developing RSI;
• Ensure regular exercise, which is essential for muscle health, 30 minutes of walking a day is a great boost for circulation and will improve overall health in many ways;
• Seek good manual therapy, as it is a great way to keep muscles and joint moving correctly; a regular Osteopathic maintenance treatment will help.

If you have the symptons of RSI, don’t put off doing something about it. Bridge to Health Osteopathic Healthcare is based in Uxbridge, West London where we specialise in workplace based musculoskeletal complaints – visit our website at www.bridgetohealth.co.uk.

Over the first few months of practice in Uxbridge, we have treated quite a number of patients training for marathon events.

Some visit because they have sustained an injury in the course of training, others because they are seeking supportive physical treatment and general advice in the context of their preparation and recovery.

The priority with injured marathon athletes is to “fix the patient” so that they can get back to their training schedule as fast as possible, with minimal interruption; but also to ensure the weakness that caused the injury is remedied and postural imbalances are corrected.

In all cases, we provide osteopathic treatment alongside a broader range of tips and advice to ensure that our patients are fit on the day, but also continue remaining fitter and healthier thereafter.

This advice covers a broad range of topics, including:

• Holistic osteopathic treatment to ensure not only lower limb fitness, but also optimal neck, shoulder and rib cage function, and core strength for peak performance;
• Deep tissue massage routines in the run-up and recovery phase of the run;
• Warming up and warming down routines;
• Input on a well-balanced running schedule that takes into account the athlete’s general health and fitness at the outset;
• Advice on fitness training to achieve the right balance of cardio-pulmonary fitness, musculoskeletal strength, flexibility, endurance and balance;
• Dietary advice to ensure that the right balance of nutrients is taken to deliver top performance and recover from the effort;
• The imnportance of adequate hydration before, during and after the run;
• Use of cryotherapy and contrast hydrotherapy to preserve and enhance muscle and organ health;

We have detailed this advice in a handy tips help sheet for our patients and other friends who are preparing for this great test of physical and mental endurance. Don’t hesitate to get in touch with us if you would like us to email you a copy.