Thursday, December 1, 2011

The problems with running

            Running is something that people do to stay in shape, clear their head, take care of stress, or go off into their own little world that no one else can reach.  Well I run for all these same reasons, it has been something that helps me escape from my everyday stresses associated with my life.  But, after running for awhile, I experience something that is also very common in some people, shin splints.  The pain has caused me to stop running, or even playing some sports, and it does not allow me to actually enjoy something I like doing.  I have decided to look further into the injury of shin splits to help me gain a better understanding of them, but also how to prevent or treat them.
According to a research done by Carr and Sevenston (2008 pg 406), “shin splints are an early indicator of abnormal stresses that can lead to periostitis along the tibia”.  The research was based on the idea of how to help prevent and treat shin splints.  They performed 12 trials with young military men.  Five of the trials were performed by the men having to stretch and four trials with different sole insoles.  This showed no results with helping shin splints.  Then three studies showed that reducing the intensity, frequency, and duration of running helps reduce the injuries (Carr and Seventson, 2008, pg 407).  That can help prevent shin splints; the treatment of shin splints is rest, ice and taking a break from activity.  If someone cannot just stop working out, they can change their work out to swimming or cycling.  (Carr and Seventson, 2008, pg 407).
In the one of the articles, A prospective study of gait related risk factors for exercise-related lower leg pain, it talks about gait related lower leg injuries which they called, “exercise-related lower leg pain” or ERLLP (Clercq, 2004, pg 91).  ERLLP is very common in athletes and military personnel; the reasoning was that people are putting too much strain on their lower limbs so that strain is causing pain.  ERLLP is just another name for “shin splints, shin pain, medial tibial stress syndrome (MTSS), periostitis, comparative syndrome and stress fractures” according to the article (Clercq, 2004, pg 91).  The purpose of the study was to see how young active people’s gait can be related to some risk factors that can lead to ERLLP. 
The study was conducted by having 400 physical education majors, 241 men and 159 women, from ages 17-28, to be followed around for about 26 weeks per the academic year.  The subjects were asked to work out at the same areas, use the same equipment, participate in the same intramural sports, and they had to write down any other outside activities.  Throughout this time they were asked to explain any injuries that they sustained to the same doctors (Clercq, 2004, pg 92).  Before the students started the experiment, they “were tested for 3D kinematic combined with plantar pressure measurements during running and static lower leg alignment characteristics” (Clercq, 2004, pg 92).  The students had to wear certain equipment, like a marker placement, they were videotaped for better observation, and they then performed eight trials. 
The researchers looked at two different groups, an injury group with ERLLP and a group that did not have any injuries.  While looking at these groups, the researchers looked at how the time at risk affected the subjects (Clercq, 2004, pg 94).  The study ended with 46 of the 400 students to have an injury related to ERLLP, while 29 ended with having bilateral symptoms.  The researchers found that, “overpronation and increased velocity of pronation was associated with an increase incidence of ERLLP as suggested before by many investigators”, (Clercq, 2004, pg 96). 
There was a case study that followed a woman who had experienced shin splints after a 5k walk and her aerobics classes.  The study points out that there is no real definition of shin splints; it is a broad term to explain pain in the tibial tuberosity to the ankle (Reed, 1996, pg 82).  The woman went to the doctors to be diagnosed with having shin splints, or pain that was a result of micro tears from the muscle and its origin (Reed, 1996, pg 83).  Since there is no real medical treatment for shin splints, the doctors just recommend to not exercising for a couple of weeks and wear different shoes.  They have found that the kinds of shoes you wear can either help or hurt your shin splints.  According to the article, the doctors recommend wearing shoes that have “1. Shock absorbing soles, 2. Impact air heel pads, 3. Stiff supportive heel counters, 4. Strong lace fastenings.” (Reed, 1996, pg 84).  With different shoes, she was able to help reduce the shin splints and continue with her activity.
One of the other case studies that I researched, Medial tibial stress syndrome (Crabtree, 2009, pg 233), involved another person who was experiencing shin splints after they had gotten done running.  This study mostly focuses on MTSS, medial tibial stress syndrome, which consists of stress fractures, periostitis, and deep posterior compartment syndrome.  This study focused on MTSS and how it can affect the body and the person.  The article mentions that it is a good thing to look into the patient’s history to help figure out how this problem is occurring (Crabtree, 2009, pg 234).  By looking into the patient’s history, the doctor/researcher is able to see how much time the patient spends working out, how healthy they are, if the problem is old, and where the problem occurs the most.  With the help of their history the doctor is able to diagnose the patient and to help decrease their shin splints.
The final article that I researched, chronic shin splints: a review of the deep posterior compartment, mentions everything about what happens with shin splints.  It talks about the different types of MTSS, “type one involves osseus tissues, type two: the periosteal-fascial junction, and type three: the soft tissues posterior to the tibia”(Finch, 1998, pg 119).  With this system, it can help to define the difference between shin splints and something more serious, stress fractures on the tibia.  This article still mentions that the best treatment for shin splints or any form of MTSS, is rest and reduction of activity.
After looking at these articles, I have found that shin splints are something that is very common and it happens to everyone.  Each of the articles talks about ways to help prevent and treat shin splints, but there is no real treatment for them.  The best thing for shin splints is to just rest, ice them, change the shoes you wear, and then also reduce the intensity of work outs.  Another thing that was mentioned in the case study with the woman study was that hills are something that should be avoided.  Hills increase the chances of shin splints occurring because the foot is in a dorsiflexed position for a period of time (Reed, 1996, pg 84).  Now that I know this information, I will now know what to do whenever my shin splints flare up again.

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