Corey asks: After a yearlong running break, I'm back at it but experiencing crippling shin splints. I've tried changing shoes, exercises, slowing down, wrapping my shin, but nothing helps. Recently, I found that running on my toes or forefoot helps, but it seemed to transfer the pain to my calf muscle. I know many things may be causing this—like my 20-pound weight gain over the last year—but I was hoping you might be able to help me get back on the road (for life this time).
It's great that you're coming back to running and fitness. A year off, a year weaker, and 20 pounds heavier may be the culprit. The reasons you took the time off may also be a part of the equation, especially if injury was involved.
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Shin splints is a "waste basket" term for lower leg pain that does not specify the actual reason for the pain that you are experiencing. The short list of causes for such pain include: stress fracture, medial tibial stress syndrome, posterior tibialis muscle strain, peroneal muscle strain, exertional compartment syndrome, and popliteal artery entrapment syndrome.
The combination of strength loss and weight gain does put added stress on you lower legs. The soft tissues and bones may not be conditioned to handle the extra stress and strain. The loss of strength may alter the kinetic chain mechanics and change the forces on your lower leg tissues. Trying to alter your foot strike to a forefoot or midfoot landing will transfer the forces to different muscle groups and shift the pain, as you've noticed.
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You probably need to back off your running and let the tissues heal. As long as it doesn't hurt, walk, cycle, use the elliptical, and spend time building your core strength—these activities will all help you shed the weight and gain fitness. When you do resume running, start slowly and alternate running and walking a block or so at a time until you can do so comfortably for 30 to 40 minutes.
After that, gradually make the run segments longer until you're able to run continuously.
It would be best to see someone who can make a more specific diagnosis and set up an individualized treatment plan.
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