Run Well by Juliet McGrattan (reading books for 5 year olds .TXT) 📕

condition seems to result from an increase in stress in this area, but there’s confusion as to the cause, with some believing it results from tiny amounts of bleeding between the periosteum (the outer layer of bone) and where the muscles attach. Some studies using scans have found no actual changes to the bones or tendons that explain the symptoms of pain and tenderness. It certainly seems to be an over-use injury that starts gradually, is worse when running and is eased by rest.

While we may not fully understand the causes of the pain, there are certain factors that seem to make people more likely to get shin splints, and these can be addressed to help prevent them occurring and enhance recovery. People who are overweight are more at risk due to the increased load on the lower legs. Beginners are particularly vulnerable too, especially if they increase distance rapidly without allowing sufficient time for the lower leg muscles to adapt. If you’ve had shin splints before then you’re more at risk of getting them again and women are affected more than men. These two factors may well be linked to biomechanics and it seems that weaknesses or imbalances in the hip and core muscles may have a role to play. Interestingly, there’s also some evidence from a small study in high school athletes that running with a lower cadence (slow step rate) might put you at higher risk of shin splints than running with a higher cadence.

Q I’ve got shin splints. How long should I rest for?

A Rest is important and you need to wait until you are pain free with no tenderness on pressing your shins, and no pain on walking and jumping, before you begin to run again. You can apply ice to your shins (see here) and take pain killers such as paracetamol or ibuprofen if you need to. It will probably take between two to four weeks for the pain to go. During that time it’s thought to be OK to exercise if what you’re doing isn’t causing you pain. Cycling and swimming are ideal things to try.

If you think your shin splints were just due to increasing your distance too rapidly then you can manage your own gradual return to running. However, if you have had shin splints before or you think there may be an underlying cause, such as your running gait, then it would be advisable to seek an assessment from a physiotherapist with expertise in running. They will be able to look at the bigger picture, spot weaknesses that may be triggering your shin pain and devise a recovery programme for you. They may recommend that you are fitted with orthotics for your shoes to correct pronation of your feet as this can be a cause for some people, but it’s a little controversial as to how big an issue this is.

Returning to running gradually and slowly increasing the load on your tibia is the key. It’s a good idea to start on softer ground, such as grass, and consider doing some of your runs every week off-road in the future. Strengthening your calf muscles may reduce the recurrence of shin splints. Calf raises while holding weights in your hands is a simple exercise you can do at home.

Be guided by pain. Don’t try to run through it. If it’s flaring up again, then return to your cross training and try again after another period of rest. If it’s recurrent, then seek an expert opinion to look for an underlying cause and to rule out a stress fracture.

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AT HOME

Healthy bones

It’s vital to take steps to maintain your bone mass, particularly if you are a women around menopausal age. Here are some simple things you can do to maximise your bone health:

• Run regularly. Weight-bearing exercise will strengthen bones.

• Add muscle-strengthening to your training plan. This helps to stimulate bone growth too.

• Stop smoking. Smokers have a higher risk of osteoporosis.

• Cut down on alcohol. People who drink a lot of alcohol have a higher risk of osteoporosis. Stick to a maximum of 14 units per week.

• Eat a healthy diet to give you all the vitamins and minerals needed for bone health. Include calcium rich foods such as dairy products, green leafy vegetables and almonds.

• Consider taking a Vitamin D supplement. We get most of our vitamin D from sunlight and it can be hard to get enough from our diet, so you may want to consider taking a daily 10 microgram supplement, especially in the winter months.

Q How do I know if I’ve got a stress fracture?

A Repeated over-use and overloading of bone can sometimes lead to stress fractures where bone has literally cracked from overwork. They account for 15 to 20 per cent of musculoskeletal injuries in runners and are most common in feet, shins, knees, hips and the pelvis. Women are affected more than men and if you have had a stress fracture before, or have osteoporosis, then you are at a higher risk of having one.

The pain from a stress fracture tends to come on suddenly, in contrast to the more gradual onset of shin splints pain. It will get worse when you run, whereas many musculoskeletal conditions seem to loosen up and ease once you’re running. It also tends to hurt when you aren’t running and pain at rest is a red flag that there’s something significant going on. Another red flag is that you can identify a point where the bone is tender. Shin splints tend to give a diffuse area of tenderness, but you can literally ‘put your finger on it’ with a stress fracture. You might also notice some swelling at the site of the tenderness or further down your leg.

Like shin splints, stress fractures tend to occur when people over do it, running long distances frequently, often without adequate recovery time. Whether certain running styles, such as heel striking or forefoot landing, put you at