Doctor's Advice
Dr. Gordon has been kind enough to donate some of his time into answering some questions athletes, coaches and parents may have concerning running. Below is his profile, and all of the topics he has covered.
Topic #2 - Shin Splints
As the weather begins to turn (eventually, anyway) runners will return to the roads and track with a vengeance. They will be welcomed by warm breezes and melting piles of snow and…shin pain. The dreaded shin splints rear their head like the ground hog that announces how much longer we have to wait for spring. Unlike the ground hog, though, shin splints can linger on well into a racing season and may even shut you down altogether. Here are the basics of shin splints and what to look for if they pop up. There are basically two types of shin splints. One is easy to fix, one can progress to debilitating stress fractures.
The first type shows up as soreness and pain on the outside front of the shin in the meaty part. It is stretched by pointing the toes down. This pain results from overusing the sore muscles (anterior tibialis) to pull the foot up as the heel strikes the ground during running and walking. Actually, this muscle is more active in walking than running. This version of shin splints is easily treated with icing, stretching, and perhaps temporarily altering your workouts to allow the muscles to get used to the increased work. Anterior shin pain can also be the result of over-striding. A video analysis of your running gait may be valuable for figuring this out and fixing it.
The second type of shin splints is the more sinister of the two. It is characterized by pain on the medial side (inside of the leg) of the tibia. The tibia is the big, weight bearing bone of the lower leg and is susceptible to twisting bending side to side. Medial tibial stress syndrome, the actual name of this type of shin splints, can progress from a mild pain to a full-blown stress fracture if left unaddressed.
So what is the deal with medial tibial stress syndrome? It is usually caused by pulling of the posterior tibialis muscle on the bottom third of the medial tibial in response to too much rotation of the tibia. This is most commonly seen as over pronation of the foot. However, over pronation may not be the cause, but rather the effect. Tibial rotation can also be due to problems at the hip or core. If you are a runner with medial tibial stress syndrome, get to a rehab professional who specializes in running injuries and biomechanical analysis. The cause of the problem is usually due to muscle imbalances (weakness in one area and stiffness in another), training surfaces, sudden increases in training volume / intensity, or just simply how you run. My best advice is to get your running gait analyzed and fix the CAUSE. It is like having a car that is out of alignment. Instead of dealing with tires that wear out too quickly, get the alignment fixed instead.
Bottom line: Shin splints on the outside front of the shin: rest, ice, stretch, progress gradually. Shin splints on the inside of the shin: rest, ice, see a rehab professional who specializes in running BEFORE it becomes a stress fracture.
RUN ON, FRIENDS!!
Topic #1 - Stretching
Stretching for Runners: Overblown or Underused?
This is a question that I often get from new runners, elite runners and everyone in between. The real answer is, “It depends.” How’s that for politically correct? The reason it depends is because not all stretching is done for the same purposes. Here is the skinny on the facts of stretching.
Static stretching (stretch and hold) is the most common and most familiar type of stretching. This type of stretch is isolated to a particular muscle or group and held constant for a period of time. The goal is muscle relaxation and elongation. To truly be effective these stretches need to be held for at least 30 seconds due to the time it takes for the nervous system to relax a muscle and let it stretch out. Excellent research has been done on the effects of static stretching on running performance. And the results are….(wait for it, wait for it)…STATIC STRETCHING IMMEDIATELY PRIOR TO RUNNING DOES NOT IMPROVE PERFORMANCE AND MAY ACTUALLY HINDER IT. This should really come as no surprise considering muscles are calmed and relaxed after static stretching. Of course muscles don’t contract well or powerfully immediately after being calmed down. And for the “it depends,” if there is a lack of range of motion at a particular joint that is needed for the activity, the static stretching is needed to get that needed range of motion back.
What the research is showing is that dynamic stretching/warm-ups (lunges, squats, push ups, jumping, strides, bounding, etc) IS effective for preparing for running. However, for many of us who have pretty normal flexibility and are going out for a normal tempo or long run, just starting out slowly and gradually increasing speed over the first 5 minutes is quite sufficient.
So as a runner this all means that you NEVER need to stretch again, right? WRONG. The fact is that static stretching still has a place in the lives of runners. It needs to be done at the end of your run, not the beginning. Static stretching (isolated and held for 30 seconds each) helps your body recover from your run and helps prevent getting stiffness in areas that you don’t want it and that can cause problems when it is there.
In a nutshell:
Before running = stretch areas that are too tight (generally IT bands, calves, hip flexors), start out gradually or do a dynamic warm-up
After running = stretch all major muscle groups with 30 second holds for each. This should take about 5-10 minutes at the most.
Run On, Friends!
Dr. Jamey C. Gordon, DPT, PT, ATC, CSCS (jcgordon@selectmedicalcorp.com) - "Staff Doctor"
Dr. Gordon is a graduate of Washington University School of Medicine Physical Therapy Program with a master's degree in 1997 and post-professional doctorate degree in 2007, both in Physical Therapy. He holds a bachelor's degree is in exercise science and athletic training from Manchester College. He obtained Certified Strength and Conditioning Specialist designation in 2003. He has worked with professional, collegiate, masters and youth athletes for rehabilitation and performance enhancement training and served as a volunteer for USA Baseball, USA Track & Field, Indiana Athletic Trainers' Association Reimbursement Committee Chair, and is on the board for Fort-4-Fitness and the World Baseball Academy.
Dr. Gordon has served as an adjunct professor of biomechanics, human anatomy and therapeutic modalities at Manchester College. He is a member of the National Strength and Conditioning Association (NSCA), the National Athletic Trainers' Association (NATA) and the American Physical Therapy Association (APTA). His physical therapy practice (Select Physical Therapy) is located in Carmel, Indiana and Fort Wayne, Indiana and focuses on determining the biomechanical factors that cause injuries. This includes extensive use of digital video analysis
Other professional activities include writing for www.PureHealthMD.com, doing weekly tv reports the last couple of years for health & fitness promotion as seen on http://www.indianasnewscenter.com/features/fitness, and speaking nationally on the evaluation and treatment of runners, effects of exercise on diabetes, diagnosis of the cervical spine using the Movement Systems Impairment approach, and general evaluation techniques for athletes.