Playing the Pain Game: Dealing With Injury

It's a great time of year for training. Sometimes, however, running can create or worsen injuries. For a doctor specializing in sports medicine, like myself, this is good for business.

For a serious athlete, like myself, this is a terrible way to start the season. Recognizing the injury signs early can help ward off a serious problem. Here are some of the common running injuries that many doctors see at this time of year, plus tips for how to avoid them.

Injury #1: Shin Splints

Technically, shin splints refer to a pain in the shin, and they are generally the result of excessive stress on either muscles or bones. Bone-related shin splints are usually the more serious variety and are characterized by pain in the shin bone (tibia) when pressure is applied.

If your shin hurts with pressure and after running, then a stress fracture (a crack in the bone from excessive stress) is likely developing. Listen to your body, and don't run through the discomfort, as shin-splint pain generally means the bone can't stand the pressure of running.

To fix this problem, a sports-medicine physician will look at your shins, your running shoes, your mileage and sometimes even your bone density.

All of these factors can cause the problem. Muscular shin pain, also known as exertional compartment syndrome, is a pain in the soft, outside part of the shin, which tightens during activity. This also can be made worse with running, but usually a physical therapist can fix this problem by loosening the fascia covering that surrounds the muscles.

The symptoms: Your shin hurts from pressure or during and/or after exercise.

The remedy: Shin pain can almost always be cured, but it can develop into a stress fracture if a runner isn't careful. Get properly fitted for your shoes, schedule an appointment with a doctor to see if you should get X-rays or an MRI.

Injury #2: Hip Pain

Pain in the hip also is a common running injury, and like shin pain, it can get worse if the cause is not identified and treated. The most serious cause of hip pain in runners is a stress fracture of the femoral neck, the top part of the femur (thigh bone). This tends to ache in the groin, especially after a longer run. These injuries can worsen quickly if not diagnosed and treated early. Running through the pain is a terrible idea.

Athletes will know they are developing a femoral neck stress fracture if the pain in the hip seems to worsen after a run and aches in the evening as well. The femoral neck stress fracture is linked to both activity and to bone density. Therefore, if hip pain is a persistent problem, runners should insist on a bone-density test called a DEXA.

The thinking here is that the underlying problem that leads to the injury is a low bone density. Bone density peaks at age 31, but athletes of any age can improve it with weight training, increased calcium intake and, depending on age and degree of osteoporosis, the use of new medications.

The symptoms: Aching in the groin or hip after a longer run.

The remedy: Hip pain and particularly femoral neck stress fractures are serious injuries made worse by running through the pain. Diagnosing this injury and finding the cause, including mileage, running mechanics and muscle strength can make a big difference. Any hip stress fracture requires bone density testing (DEXA).?

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