I've had shin splints in my left leg for at least two months now. I've tried icing it, ice massaging it, stretching like crazy, calf sleeves (3 kinds!), roller stick massagers, elevation, and, of course, just resting the leg by not running. I went back to my running store to make sure the shoes I had were good for me (they are, and my running form is actually pretty good when I can actually run). They just will not get better. During this time my left leg has also developed plantar fasciitis and sometimes i get sharp pains in the glute (sciatic pain?). Oh, also my calf has pain, too. I believe all of the other pains are due to the shin splints. My left leg is falling apart! My right leg is awesome and in perfect condition.

I visited my doctor who said it wasn't a stress fracture and then I went to a physical therapist who also said it wasn't a stress fracture. I'm seeing the physical therapist again on Thursday (2nd visit). My question is, what kinds of treatments should I bug her about? I really really really want this fixed ASAP. I'm tired of it. I'm tired of being told to just stretch because it's just not working. I want some serious treatments! Should I ask her about kinesio taping, ART, or ultrasound? Something else? I'm getting kind of desperate here. Thanks for any thoughts you guys may have.

Hi Chris,
Sorry to hear about your issues. Glad you are in PT. Since you have tried many types of passive cares on yourself, I would ask the PT to do what their specialty is...Active Care. You should get a home care active care routine developed by your PT that specifically addresses the areas in question. Pain causes movement pattern disruption....this is why your butt, foot, and everything else is feeling the brunt now. There should be a strengthening component, a flexibility component, and a patterning component. You should perform each regime knowing you will be seeing your PT every 2 weeks for the next level of rehab. Expect an 8 to 12 week program.

Keep me in the loop and let me know if I can help in any way.

Dr. Greg

Thanks for the advice. My PT used the Graston technique on my calf today and already it feels much better. She didn't seem to think that kinesio tape would do anything but I bought some anyway. Like I said, I'm just trying everything at this point and it can't hurt to try. I'm also not allowed to run for 2 weeks but I can walk or do any other type of crosstraining.

Chris
Glad you had a good PT visit. As I mentioned in my last response, passive modalities are helpful (i.e. Graston, massage, Kinesio Tape), however ACTIVE CARE is what is going to condition you for running and achieving a half and/or full marathon. I hope you were assessed and deficiencies were noted so that you can be prescribed the necessary rehab. This is much more than merely "rest and do something different for a while" Do not be afraid to ask for active care. Often, the therapist feels the patient may not want active care.....simply ask.


Keep us in the loop and let us know your progress.

Dr. Greg

I went to my PT last Thursday but she'd never heard of Active Care. It seems as though she's already had me doing the things you mentioned (except for "patterning"..I'm not sure what that is). I was active in the gym even before I saw her for the first time. When I first saw her, she added a few more stretches to my stretching routine. She also told me to add leg exercises back into my workouts (I'd taken out legs to "save" them for running).

Anyway, I haven't run at all since April 18th (Bridge to Brews 8k). I'm not allowed to run until Thursday so I've been walking instead. Walking doesn't hurt me and I think it's actually helped more than any other treatment I've done. I think maybe the walking has strengthed some muscles in my lower legs that I wasn't using enough when I was running. I started out just walking on the treadmill. This past weekend I joined the Purple group and walked the 8 miles and felt good during and after. I even did the second half faster than the first. This week, I'll try to run/walk the 9 miles with the Red group.

Finally, I've lost weight. I got on a diet provided by Max Muscle and I've already lost 7 lbs (I now weigh 166). I'd like to get down to 160 because for some reason I think this is the magic number for me. In the past I never weighed more than 155 when I was running. I think my leg just protested at having to move so much extra weight!

Chris
Glad to hear things are coming together for you. It is interesting to me your PT didn't understand the term active care.....after all, it's what PT's specialize in. Active care literally means YOU (the patient) are providing the physical effort/exertion to perform specific therapeutic movements/exercise. This is the initial part of a self care program. As you progress, and symptoms diminish, the therapist is to continue the same therapeutic focus and place you in sport specific movements in a effort to more effectively address the weak spots in one's "patterning". For those science purists, "engrams" is what "patterning" refers to. In your case, your running gait is inefficient or altered due to pain and/or insufficient conditioning of specific regions. My hopes was for your PT to help you enhance your gait through this process as this is what I do, not only in my current practice, but what I learned and utilized with Division 1 athletes as an athletic trainer over a decade ago.
Stretching is very necessary...keep doing it. The need for stretching will never go away, particularly with longer distances. It is a piece of the solution, keep in mind, not THE solution.

Her advice to add leg exercises to your workouts is kinda a round about way of adding active care. Let's see what happens.

Congrats on the weight loss and continued activity with walking. Follow the advice of you PT and be patient.

Keep me in the loop as to what happens.

Dr. Greg