[trygve.veslum]

Hi,
Ive been feeling some slight pain (feels almost like needling) in the transition area on the inside between my ankle/calf transition the last couple of weeks and I strongly suspect Posterior Tibial tendonitis. Im not a doctor so of course take it with a grain of salt. Id say my foot arch is pretty average but in conjunction with a stress fracture earlier in a phalang in my other foot the doctor claimed I had very tight calf muscles. (Actually to a point considering to do surgery to lengthen the muscles). All my running is done forefoot, but I might be cheating on my foot placements when using my most plushy shoes.

Do you have any advice on what to do and what NOT to do going forward in order to recover as quickly as possible?
As lessons learnt, how to prevent this sort of trouble in the future? Ive been reading a few non-scientific, anecdotal articles claiming that barefoot running or use of minimalist shoes may have a preventive effect.

Using the search function I could only find posts on tibialis anterior.

Thanks in advance for any response.

Best regards,
Trygve

Topic

[Rachel]

Rachel on December 18, 2020 at 11:52 am #48354

I’ve been dealing with shin splints on only my right leg (they are on the inside but I think they might be anterior shin splints, I’m not totally sure).

I’m doing this exercise I read about that is helping: Gizmodo’s shin splint exercise

At the same time I know something is off with my biomechanics. I’m working on my running form in general, and also improving my toe/foot strength and improving my hip internal rotation range of motion (I have really poor control of my toes it turns out, and not enough internal hip rotation). That stuff I learned about from the FootFunction Reddit group which I’ve found to be a great source of information.

My shin splints have gotten much better since I started that exercise above so I recommend giving it a go, I don’t think it will hurt!

[Anonymous]

Anonymous on December 20, 2020 at 8:01 am #48390

I’ll jump in here since I think Pete is on the World Cup circuit tending to the US SKi Team right now. Disclaimer: I am not a Physical Therapist and I don’t even play one on TV but I’ve picked up a few things form Pete over the years.

Running places the most stress on the connective tissues of the lower legs of any of the activities our athletes normally do. Those soft tissues are very poorly vascularized so they gain strength (by growing new protein structures) much slower than muscle does. I’ve read 1/7th as fast! Most of these soft tissue running injuries come from either poor biomechanics or ramping up mileage too fast (before those connective tissues are prepared for the impact loading).

First thing is to stop doing what hurts it. Begin to add some eccentric loading exercises to the tendon. These should be non-dynamic (not running or jumping). Do these daily and gradually increase the volume.

Hopefully Pete will have time soon to come in here and clean up my mistakes 🙂

Scott

[Pete Dickinson MS,PT]

Pete Dickinson MS,PT on December 22, 2020 at 7:37 pm #48485

Thanks for covering for me Scott as I’m just now back from the World Cup….in a pandemic….story for another time.
Trygve: Burning/tingling symptoms might speak to a nerve traction of the tibial nerve in the tarsal tunnel just behind the medial malleolus. Tight calf muscles create greater loads throughout this region, and should be addressed with both straight and bent knee calf stretching. Many lower leg injuries are caused by training errors, too quick progression of loading. This is a great reason to use one of the great Uphill Athlete Coaches!!!

Rachel: Again, training errors are more responsible for calf injuries than most anything else. Along these lines, most athletes don’t have sufficient strength and stiffness in their lower extremities to handle running, which basically is bounding from leg to leg. Back to basics with deadlifts, single leg step downs/dead lifts, single leg calf raise isometrics go a long way to less pain in the lower leg…..Gizmodo….talking to you:)

[trygve.veslum]

trygve.veslum on December 23, 2020 at 1:20 am #48491

Rachel, Scott, Pete,
thank you for your responses. An eccentric training block with stretch band followed by blocks of calf raise isometrics sounds like a reasonable plan then, combined with calf stretching along.

Any experience from your end wrt correlation between running shoe type and frequency on lower leg injuries? As stated above I`ve read some anecdotal claims that highly cushioned shoes might mess up with stride / foot placements and cause injury in the long run (No pun). Therefore Im wondering if use of minimalist shoes or five-fingers on some of my shorter runs would be a good idea.

Wish you a merry christmas.

-Trygve

[Pete Dickinson MS,PT]

Pete Dickinson MS,PT on December 23, 2020 at 9:44 am #48508

Trygve,
This is a fairly complicated topic depending on your foot structure and training status. The change in running form can just switch the injuries to different locations. Not that you can’t try this approach, just be aware that there isn’t one best way to do things.
Pete