I am hoping to become an injury-free triathlete

"I'm writing you because I saw your video on how to strengthen the tibialis posterior. I have shin splints and I have suffered from ITB syndrome. I am a biker and a swimmer, and I am hoping to become an injury-free triathlete, but my shin splints are stopping me from running at this point in time. If I am currently suffering from shin splints and a moderate case tibialis posterior tendonitis will it helpful to perform this exercise. I don't want to exacerbate my condition as I am taking time off from running to try to recover.

Also, on a semi-related topic, do you think it could be preventitive to run barefoot? Not on the cement of course. I feel like running in shoes, almost always with arch supports, have weakened tibialis posterior and anterior."
Matt
________________________________________
Gary:
(This video has now had over 165,000 views - wow!)

This exercise, done as described in the video, about every 3rd day will assist with maintaining strong feet and ankles.  It targets exactly the muscles and tendons that you are writing about.

Barefoot running, simulated wearing footwear such as Nike Free or Five Finger running shoes will assist with keeping injury free.  If you have been raised in shoes take care introducing barefoot running.  Start with short jogs and with 2-3 days between simulated barefoot sessions, otherwise you may actually make matters much worse!

If you have shin splints and ankle pain then you need to do a course of deep tissue massage of the feet and lower legs.  Repeat one deep tissue session per week for as long as it takes for these to be painless massages.  Significant progress will be seen by the 3rd session if the therapist is doing a good job.

You will find many other articles and training guides on this website about this injury issue and training for events like triathlon and marathon.  enjoy the reading Matt!

_______________________________________

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I am training for the Police and have shin splints

I’m 43 and training to become accepted as a NZ policeman. Unfortunately, I’m not as fit as I used to be but, through regular running and swimming my levels of fitness are improving. The downside to the running is that I am suffering badly from shin splints and in turn can’t run often enough to help reduce my 2.4km run time to that required.

In your opinion, should I seek professional assistance for a tailor-made insert or would it make financial sense to try your product. Are Formthotics Active designed to rectify stance and running faults over time or are they manufactured just to effectively alleviate small inaccuracies quickly?
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Gary responds:
First of all; 43 is not all that old. While it may take some time to make up for lost ground, there is nothing to stop you from being as fit and strong as you were in your 20's.

Please click on the "Key Words" tab of this web page and look for key words such as "shin splints" and enjoy the reading.

The best you can do for your shins is get the Formthotics Shock Stop and get the legs massaged weekly. There is seldom, if ever, the need for expensive orthotics. Have a look at all the nutrition advice, perhaps starting with a daily Balance Ultimate Recovery Stack drink.

Do the exercise for foot pronation, as demonstrated in the video, every 2nd day.



Please take careful note of the wealth of running training advice on this site. Shin splints happen when you exceed your capacity to recover by either running too fast, running too long, running uncontrolled downhill, running on hard pavement, running in lousy shoes, or not having enough recovery between sessions - or all of the above! have a look at the articles under the keywords "Oxfam Trailwalker" for a start.

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I have shin/calf muscle pain just two weeks out from running a marathon!

Lorraine Moller winning Osaka with ease.

"Hi Gary

I have been following your training programme for the Auckland marathon. Things have gone really well until Sunday when I went out for my two hour run. I was about half way in when I had this tightness and ache in my right leg, the muscle just above the ankle towards my shin. I stopped and stretched a little and then tried running again. Unfortunately it didn't go away and since it always seems to be when you are furtherest from home, I ended up walking home.

At home I did the ice and elevation and rubbed on anti-flam. I already take the Balance Joint food for athletes powder and Balance sports multi plus vitamins. Is there anything else I can do to be ready for the marathon in two weeks?
Regards"
"D"

__________________

Gary advises

The good news, "D", is you have done about as much training as you need and all you need do with two weeks to go is to concentrate on freshening up while not losing any of that hard-earned form.

The injury that you describe is most often mistaken as an Achilles Tendon injury or "Shin Splints" and the reason it is so hard to fix is because the therapist is busy treating the wrong problem.

The most likely cause is the Flexor HallucisLongus, Flexor Digitorum Longus muscle, or even the Tibialis Posterior muscle - most probably the Flexor Hallucis Longus.   The muscle may be in spasm from sheer exhaustion caused by cranking out huge miles; especially if there is excessive pushing off of the big toe such as can occur if one has, say, a sore heel, a blister, a sore instep or just running up a steep or undulating slope.  Or it may have something to do with the shoes.  

Have a close look at the diagram to the left and see if you can pinpoint the pain as per the photo.

Here is my advice about what to do:

• Stretch the ankles about once a day - only gentle.  Do not do too much and do not be forceful.  Do not worry about fancy flavour of the times exercises like eccentric calf contractions - waste of time for you.   Your running is about 70% eccentric contractions.
• Get a firm sports-type massage on the affected areas, as per the picture and the actual location of any pain and swelling where the muscle is bunched.  But do not stop there do all the legs - do the lot; calf, thighs and backside and even the low back shoulders and arms.  Repeat every 4-7 days - no more frequent than that. 
• You may have developed a tissue salts imbalance, including the magnesium, potassium and calcium salts.  The easiest way to start the process of correcting this is to complete an Active Elements Assessment and take the tablets as per the instructions that come with the report; but you will need to get onto this quick.  I will give additional advice once the assessment has been done.
• Read this article here about mineral salts replacement when running a marathon.
• Keep your running fitness and form by aquajogging.  You could also do some power walking.  If you have access to a gym, jump on a cross trainer.
• Be guided by pain as you carefully resume running; but do not bother about any long or overly strenuous runs between now and the marathon.  Your priority is to ensure that the shin pain is 100% gone by race day.
• It may be advisable to avoid running up steep hills that have excess pressure pusing off the big toes.
• Do not run out and back because Murphy's Law dictates that the injury will flare up at the furthest point away from home.  It is better to resume running by running a circular course that can be easily terminated at any time.
• On race day do not do anything other than easy stretches.  You could start the day with a gentle massage of the legs.
• Start the race conservatively and gradually wind up the pace over the first 10-15km.

I hope this helps and please let us know how you get on.

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Advice sought about shin splints caused by running

Hi Gary,
I am 17 and was wondering if you could help me. I am an athlete, i run 400m and 800m and have competed internationally twice. Over the past year i have been experiencing pain on and off on the inner side of my left shin. I have been told it is shinsplints and that it is not too serious yet i cant get rid of it permanently. I get it treated whenever it hurts which allows me to resume training for a while(few weeks or so), but it always returns eventually. I would really appreciate it if you could offer some of your expertise on treating/preventing this injury.
Thanks
Finbar

Photo: Drills like stepping and bounding up a grassy slope strengthen the legs and hone the reflexes for efficient running
_____________________________
Gary Moller comments:

Finbar

what you might have is a weak tibialis posterior muscle. Please go to my website and read this.

You should also look at purchasing a pair of Formthotics Active which will give your foot the support it needs during training and competition.

I also recommend that you get a weekly deep tissue massage on all of your leg muscles.

Most sporting injuries are coaching issues: Not medical problems

Finbar, remember that you are only 17 and you must give your body time to grow and mature. You do not hit your running peak until you are 28 or so years. Excessive training and injuries suffered now will shorten and limit your athletic career. Few junior champions ever succeed as seniors for reasons of chronic injury, ill health and mental burnout.

So, cruise your way through the junior years, concentrate on skills rather than effort. Eat well and get plenty of rest. Concentrate on good grades at school with your sport second and be careful not to be pressured into short-sighted training and competition by others like over-ambitious coaches and sports officials. Once you are in your 20's you can then decide how far you want to go knowing that you have the strength, vitality, the skills and the emotional maturity to handle the punishment and the pressures.

A good running resource is the Lydiard Foundation

No injuries and concentrate on skill development. School grades come first.

Will cortisone injections fix my shin splints?

Jennifer from the USA wrote asking about cortisone injections for treating shin splints. In reply to my questions she wrote:

"I am 24, 5'10", 180. I have played sports all of my life; softball and basketball.

About three years ago, I walked this really rocky trail (3.5 miles) and I developed shin splints. Well, like an idiot I didn't immediately stop exercising, and stress fractures developed. I took about a year off from all exercising, and then I got back into the gym. This one day I got on an elliptical for 30 minutes and then a bike for 30 minutes, and that familiar pain came back. I kept riding a bike, and my shin splints were not getting any better so I took about another year off. I got back into the gym last week and rode a bike for 20 minutes, and I could feel that dull ache.

I have read hundreds of Internet articles about shin splints. I have tried treating them with ice, heat, massages, stretches, ibuprofen, Aleve, tape, and nothing has worked. I went to a family doctor and he told me to take ibuprofen which I had been doing all along.

I have been calling sport medicine doctor offices, and none of them will treat them. They are all into knee injuries. I live in Indiana, if you know someone please recommend him or her to me.

No one has actually recommended the cortisone. I just figured that it was my last option (besides surgery).

Please help. I love sports and I love working out. I don't want to be benched any longer."

_______________________________________
Gary Moller responds:
Jennifer, I can understand your frustration. There are several things that you could try. Bear in mind that I am reading between the lines and making some assumptions. In doing so, the following advice is healthy, even where it might be off the mark! The advice centres about:

• ensuring that the underlying physiology of your body is such that you are able to heal properly and grow stronger because something is amiss in this regard
• Removing any muscle spasm, improving circulation and softening any scar
• Strengthening the affected areas and improving mechanics

Is it in the water?
Jennifer, you say that you drink a lot of water. While water is essential for life, you can still have too much of a good thing. I do not advocate drinking any more water than one needs because there is a risk that you end up flushing your body of minerals which are certain to already be in short supply in your body. If your minerals are depleted, you will suffer fragile tissue, weak muscles, cramps and spasms and poor healing. Much of this will be sub-clinical and never diagnosed. I would strongly recommend an assessment of your mineral levels by way of a hair tissue mineral analysis (HTMA). I can send you the kit for taking and sending off samples. This takes out the guessing.

In the meantime, drink only enough to ward off thirst - your body will tell you how much. Ensure it is mineral water and not distilled.

Multivitamins
Taking a multi is fine but just the recommended daily allowance probably has no significant effect on your status if you are already low. Furthermore, most multis contain synthetics that are of questionable health benefits. You are better seeking out quality natural supplements and you may have to take more than one or two different concoctions. These usually look like horse tablets! I would place priority on the fat soluble vitamins - A, D, E and K which you are probably low in.

Low iron
With young women, one can assume that their iron levels are low unless confirmed otherwise by a recent test (The HTMA will provide this information). Low iron is indicative of overall mineral status and will be a factor in poor healing etc as earlier described. Drinking lots of water will flush the body of this and other minerals - and the water soluble vitamins, of course!

Is it in the sunlight?
Low levels of vitamin D are associated with joint and muscle pain, including tendonitis and slow healing - and stress fractures, of course! Your run of injuries may have a common factor - low vitamin D and depleted minerals. It does no harm and potentially an enormous amount of good to do everything you can to boost your levels of vitamin D.

This website (http://www.garymoller.blogspot.com/) has a wealth of information about this topic.

Exercises for pronating feet

The exercises are your first exercises for preventing further episodes of shin splints and even stress fractures of the lower legs and feet. In conjunction with the exercise I recommend that you replace your shoe inner oles with Formthotics Acitve which mould to the shape of your feet and give the foot just that little bit of support it needs when working hard out. I have them in all of my shoes, including work shoes. I wear Formthotics Low profile in my cycling shoes and find that numb, cold feet while cycling has been all but eliminated.

Shin pain and only a week to go before the marathon!

Hi Gary
I have been training to do the Rotorua marathon and trying to stay with a
basic programme ie not an advanced runner.
Last Sunday I ran 26 Km and experienced pain in the shin area (both front
and rear) of my right leg. I have not run since but have had a leg massage
which eased the stiffness and reduced the pain.
I have done a fair amount of training and wish to do Rotorua, is there
anything you can suggest I do at this late stage to overcome this setback ?
Thanks for your help,
"A"
_______________________________________
Gary Moller comments:
No need to panic: Your body is telling you it is in need of a rest. You have done your training and it is time to freshen up for the marathon.

First of all, take as many days off running as is necessary to be able to run freely again. All runs from now must be close to home so that you can cut any short if there is an increase in calf pain. Be careful of long out and back courses because the law of nature dictates that you will seize up at the furthest and most remote point!

While the initial couple of jogs may be on grass, you should continue to run on pavement since the marathon is on pavement. All runs must be easy, not exhausting and cause no residual strain on the legs. The work has been done - ok!

Do an easy jog early in the am partly because you need to be used to being up and active in the morning in preparation for running the marathon. The early jog is also your opportunity to carefully test the leg before doing anything substantial later on in the day. If the leg is niggling, then rest up.Always run tall. As one tires, the knees and hips bend and the body gets lower and lower to the ground. This is an enormous strain on the legs, including the calf and ankle areas.

Stretch the calves, thighs, hips and hammys. Do so once daily. Best in the evening after a log hot bath when you can take your time and be really thorough. Strong flexible hips allow better use of the big butt muscles when running, thus taking stress off the smaller calf muscles that are further from the heart and therefore less well supplied with blood.

Do not over stretch the calf muscles before the marathon start! Just do a few quick and gentle stretches and then use the first 10km to warm into the race.

Have another person thoroughly massage both legs once daily, concentrating on any tender spots. Any massage within 3 days of the marathon should be gentle.

Begin a course of magnesium and B vitamin supplementation and continue up to the day of the marathon. Magnesium and B vitamins help relax muscles and promote circulation through them and improves strength (If you are deficient). I would also add a glutamine supplement to your daily regime, including on race day. Glutamine is the muscle amino acid that is most damaged and depleted during extreme exercise like happened during your past big training run. Adequate glutamine intake may reduce muscle soreness, speed recovery and improve endurance. Fish oil with vitamin E may improve circulation.

When you are running Rotorua, bear in mind that it is a 42km circle and you could end up running the whole way on a shoulder camber which is a huge strain on the legs and even the lower back. Vary which side of the road you are on during the sections where the roadd is closed. The best place to run may be the middle of the road. When you are running on the side, pick the flattest spots, including the gravel edging, but be carefull of large stones and pot holes!