Hi Dr. Roberts,
I hope you can help me with my question. I just took up running and am now running three four-mile sessions per week, along with a 5-K park run. I had some shin pain, so I went to a reputable store and purchased some better shoes. I’ve seen an improvement in my shin pain, but I’ve noticed some pain, which feels muscular, on the outside of my right leg.
Should I just persevere?
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Thanks, Natasha
Natasha,
“New runner” catches my attention pretty quickly. You are now at 15 miles per week and experiencing shin pain. Runners new to the sport often advance their mileage too quickly, part of what is often called the “terrible too’s:” too much, too soon, and too fast.
I am going to assume you had never run before, since that is different than when, say, a soccer midfielder takes up road racing. Someone who has not run in the past has to build muscle strength and endurance in the legs and the core. In addition, the soft tissues and bone have to “toughen up” to take the stress and strain of running. External factors like running surface and road crown can also contribute to injury, so looking at your training sites may also help you find the cause of the pain.
Shin pain can be the result of several problems, the most common, in my experience, being a posterior tibialis muscle strain. The posterior tibialis helps cushion the impact through the foot and helps support the arch. When it is worked beyond tolerance, pain develops on the medial (middle) side of the shin. The anterior tibialis and peroneal muscles can also get sore as they work to keep the foot from slapping on the pavement during heel strike. That soreness is in the lateral (outside) part of the shin. There are also boney pains like medial tibial stress syndrome and stress fracture that cause pain in the shin.
Even if the tissues are toughened and ready for training, you have to determine if the shin is the victim or the culprit. It is easy for the tissue to be overstressed if the running mechanics are not balanced and symmetric. A provider trained in kinetic chain evaluation and manual therapy may be able to help evaluate the problem and resolve the pain. New runners need to learn to listen to the body, adjust training, and allow injuries to soft tissue to heal to become seasoned runners. Starting slowly and building slowly will help you become a “lifer.” It is smart to get help from your specialty running store with shoe selection that fits your foot and running style.
I hope this helps and you have many years of running ahead of you.
Cheers, Bill
Have a question for the Sports Doc? Email him at sportsdoc@rodale.com. NOTE: Due to the volume of mail, we regret that Dr. Roberts cannot answer every email.
