It's Just a Step To The Left...

No, this isn't doing the "Time Warp!" I'm more interested in my runners who come in complaining about foot, ankle, shin, knee, or hip pain ON ONE SIDE. Here in Houston, TX we have major drainage issues, so all of our streets are banked.

So when runners come into my office, they have done online searches and have a million reasons why they are hurting. They have bought all sorts of supports and liniments to make them feel better...but they don't seem to work. They come in complaining of their IT band hurting, or some shin splint pain on one side and expect me to run a whole barrage of tests to tell them in a high-tech way why they hurt and how to solve it. Then, after I listen to them, I ask the most important question:

What surface are you running on?

Invariably I'll hear an answer that they're running on the side of the road, or another similar uneven surface. I watch as they brace to hear a lecture on how "asphalt is a terrible surface" or "never run on concrete." Instead I ask my next question:

Where on the road do you run?

This is a loaded question...I know pretty well that they're not running in the middle of the road (if they were, there would be bigger problems than limb pain). They're, of course, running harmlessly on the side of the road. A-ha!!

When someone runs on the side of a banked surface, like the local Houston roads, they are essentially creating a leg length difference. This will cause the two feet to function very differently. One limb is going to compensate by attempting to lengthen and the other is going to shorten. A significant imbalance will result and can cause a variety of pains. My great wisdom for these runners?

Take a step to the left...

That's all? That's what they came in for? Well...yes. Sometimes a simple change makes a huge difference. By running on a more even surface, it allows for a more stable and even base and doesn't overwhelm the mechanics. My advice is to not take time off. Nurse the injury with ice and some anti-inflammatory medication, and be more aware of where they're running. I ask them to call me in a week to tell me how they're doing.

The results are amazing! A small adjustment like this causes the lower extremity to even up and makes a huge impact on the biomechanics. The pain gradually improves with essentially no time away from training!

Run Smart And Avoid Shin Splints

Commonly runners are sidelined or limited by the presentation of leg pain during and often after runs. The pain is usually located at the sides of the "shin" bone and can be debilitating, even limiting the ability to walk. Over the years, this has been a problem that I sometimes have encountered in my running. Since I love running (and don't like not running), I have researched over the years some ways to limit the presentation of shin splints while training for a race, or in my case a marathon. I will discuss some ways that we can "run smart" and limit the injuries that have been commonly classified as shin splints.

Although I will not discuss the full causes of shin splints, or what a shin splint is here, additional information can be found at another blog: Utah Running Doctor. For this blog, however, here is the findings I have:

1. Use Correct Shoes --> Running shoes should be used for running, not cross trainers or walking shoes. A quality running shoe will assist in the running motion by limiting over pronation (excessive flattening of the foot) or over supination (increased arch height - rolling out). In choosing a shoe, price is not the most important, but cheap priced shoes are usually cheap shoes. Get a quality shoe, designed for the exercise you are doing (running shoe for running or walking, basketball shoe for basketball, etc.).

2. Train Smart --> As you run or train, Run Smart!

If you are running on a track, understand that always running the same direction on the track will work muscles differently than switching directions. One of the possible causes for shin splints is working muscles at different rates, therefore switching directions regularly will work all muscle of the legs equally and reduce the chances for shin splints.

If you are running on a road, most roads in most locations throughout the country are canted (or tilted to improve water runoff). Therefore, running against traffic always will cause supination of the left foot and pronation of the right foot. With supination, you will work the lateral (outside) muscles of the leg more than the medial (inside) muscles of the leg. Pronation does the opposite. By switching sides periodically, you will again work all muscles equally and prevent the presentation of shin splint symptoms.

Lastly, in running smart, the speed of training should be carefully controlled. Start slow and progress slowly to the amount of running you desire. Give the leg muscles time to get strengthened before forcing them into harder regimen. The speed of progress will require understanding of how much running you have done and where you should start. Cross training (elliptical or bike) can also help even the muscle strength as you progress.

In all these aspects of running smart, it should be understood that shin splints are caused by overusing a muscle group and creating an injury. By adjusting the training to reduce this overuse, you will have a more enjoyable run.

3) Evaluation for possible "gait" abnormalities.

“Gait” abnormalities are best described as running or walking abnormalities. Do you have a leg length problem? Do you over pronate or over supinate? Do you have imbalance issues, back problems, knee problems, or other reasons to overwork a muscle group that may cause your shin spints?

By being evaluated for your running, your “gait” abnormalities can be evaluated and often adjusted to help you return to running without the pain. Once you start to run and love it, everything should be done to keep you running.