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 demonstrated here 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.

Read more!

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.

Read these guides here:
Mobility Exercises
Running Stretches
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. Use a quality massage cream, such as is available from the selection at www.myotec.co.nz. 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. These are available from www.myotec.co.nz

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!

Read more!