Shin Splint Saga

Peter Attia podcast with Irene Davis, Director of the Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School.

Jump to 33:30 for shin splints. The entire podcast is very good.

#128 – Irene Davis, Ph.D.: Evolution of the foot, running injuries, and minimalist shoes

https://peterattiamd.com/irenedavis/

I’d also recommend this excellent video.

Irene S Davis | Why movement matters – treating overuse injuries | ISB/ASB 2019 ASB Borelli Award

https://www.youtube.com/watch?v=I1QZS7BWgAo

Cycling is very good for cardio  and low impact. I know a number of runners who have switched over. Doesn’t help with your shin splits though.

Interesting info, Bob…and kind of counterintuitive until you start wrapping your head around it. I’m really bad about landing on my heels, and it seems like the shock loading might be causing most – if not all – of my symptoms. I’ve never thought about going to a more minimal shoe for running; I’ll definitely have to look into that.

Cycling is very good for cardio and low impact. I know a number of runners who have switched over. Doesn’t help with your shin splits though.

I’ve thought about giving it a try, although the area in which I live is somewhat more cyclist-unfriendly than most places…and I mean that in all aspects of the phrase.

Man goes to doctor and complains: Doc when I do this it really hurts. What do you recommend?

Doc: Well, stop doing that.

I’m not a doc, but think you should stop doing what huts for a while.

Bicycling of stationary bike and eliptical machines work. You don’t have to get your heart rate as high as running for backpacking. I train at about 130 and I still pass most backpackers up out on the trail…

1) stop doing what hurts

2) do low impact exercise, like bicycling or bike machines…

3) buy some max cushion shoes, like Altra Olympus or Hoka Stinsen

(when I went to max cushion shoes year ago all my shin splints went away)

4) when, if you do start running again don’t run on asphalt… run on dirt or better yet grass… start slow and short runs to kind of build back up to where your shins can take some pounding..

5) if you want to try to shorten recovery from the pain, try these things: anti-inflammatories (personally, I like aspirin), heat, ice, cycle both heat and ice, massage, physical therapy, tens, acupuncture…. other?

6) if you are heavy, lose some weight…

just my 2 cents… feel free to ignore :)))

I’ve never had good luck with stationary bikes or ellipticals; they seem to bother my knees for some reason…which is why I started running in the first place.  But yeah, “stop doing what hurts” is why I immediately took a month off from any kind of running whatsoever.  I never run on asphalt: I only do trails or grassy areas that are manicured enough to let me focus on running instead of what I might be about to trip over.  I may well have to change shoes; maybe that’ll help me change my stupid heel-strike problem.  For now, though, I’m not going to do anything that even comes close to re-injury potential.

Regarding heart rate: no, I don’t have to get it up into the 160’s – I don’t even like doing that, honestly – but the 130-145 range would be great for me.  That’ll let me lose some weight (very difficult for me to do, no matter my level of activity) and help my cardiopulmonary fitness, which is my main weakness.  It’s a very hard level to hit, though; I seem to operate like an Italian V12, in that my heart instantly revs up…and then instantly goes back down to normal speed when I stop.  I mean, I don’t like a V12 on a good day, so comparing myself to one really sucks…but it’s accurate.  Hopefully I have better durability than the average Italian engine, though.

My ultra-running buddy suggested short hill repeats at a walking pace; I’m going to try that later today and see how I feel.  Hopefully I won’t end up back on the couch with ice packs on my legs and a sad-sized bowl of ice cream in my hands.

Hey, maybe that’s why I can’t seem to lose weight…  ;)

Bonzo… I hear ya on the ‘sad-size bowl of ice cream’… lol….

Years ago I would have the beginnings of shin splints when doing a long day hike on rocky trails… couldn’t wait to get to my car to change into my sandels… After switching to mega cush trail runners, I immediately stopped having the shin splints, sore calves, and sore feet and never even think about changing out of my shoes at the end of a hike… the big cush makes a HUGE difference… I wear them around town and every where…

B

Shin splints vs stress fracture

https://my.clevelandclinic.org/health/diseases/17467-shin-splints

Good link, John; thank you!

I couldn’t try the hill-repeat walking yesterday: a snap thunderstorm decided to end that plan before it got off the ground…so I’ll give that a shot today.  I’m also thinking on something like Nordic Walking, where I can take some of the stress off of my legs and move it elsewhere.

To be clear on the swimming issue – because that’s what literally every video, website, physical therapist, doctor, guru, messiah, friend and/or enemy knows to correctly suggest – I have a lot of trouble doing it because of my balance and coordination: those abilities basically don’t exist for me, in certain situations.  It’s always been like this, and I have trouble riding a bike as well; that’s why I’m searching for alternatives.  I can do basically one swimming stroke in a pool: backstroke…and that’s a resting stroke, so… < shoulder shrugging emoji >

I haven’t had shin splints in years, but past experience tells me there’s something to the minimalist shoes thing.  But I think it’s less about minimalicity and more about low-dropness. The higher the heel, the longer your shin muscles have to resist the force as you lower your toe, and the more those muscles have to stretch.  My two cents.

Oh, and whoever first decided an athletic shoe, which is what a hiking boot is, should have a high heel needs to be tarred and feathered.  For various reasons I usually have to buy high-tops for hiking, but you just can’t find low-drop high-tops.

For various reasons I usually have to buy high-tops for hiking, but you just can’t find low-drop high-tops.

Have you tried this one?

https://us.joe-nimble.com/collections/men-1/products/wandertoes-2-0-men

Let’s see,  You can’t run because of shin splints (been there, done that.)  You can’t/won’t ride a bike or swim (I ride a bike.)

Part of dealing with any injury–and I am sorry to tell you this, but this is going to happen more often as you get older–is adapting to the new reality.  Think of it as an opportunity for growth, rather than a limitation on your activities.

You could always just do lots of other exercises that don’t use your legs for cardio:  sit ups, pushups  etc,

One that I sometimes use is to lie on my back and lock my hands behind my head.  Then touch right elbow to left knee, followed by left elbow to right knee.  Do that for about one minute and your heart rate will zoom up nicely.

For various reasons I usually have to buy high-tops for hiking, but you just can’t find low-drop high-tops.

I have 3 different pairs of Xeros — zero drop, minimalist shoes and boots.  This is one of their boots….

https://xeroshoes.com/shop/boots/xcursion-men/

You can’t/won’t ride a bike or swim (I ride a bike.)

I can ride a bike, but not well.  Thankfully this inability has made me immune from the desire to own a motorcycle.  I actually got coaching for swimming to even be able to do a resting backstroke; I’m not kidding when I say that it’s very difficult for me!

You could always just do lots of other exercises that don’t use your legs for cardio:  sit ups, pushups  etc,

One that I sometimes use is to lie on my back and lock my hands behind my head.  Then touch right elbow to left knee, followed by left elbow to right knee.  Do that for about one minute and your heart rate will zoom up nicely.

I have to be careful with my lower back as well, but this is a good idea; I could try bodyweight circuits or lighter, more repetitive exercises.  Thanks!

Several pointers to low-drop high-tops above–thanks–but the usual problems are there:  no size 15s and/or they’re minimalist high-tops.  I want a full, heavy boot sole, without the stupid high heel.

Todd… maybe you could find a boot repair shop to grind down the heels?

Or rebuild the sole entirely with no heel or low heel?

Well this does not address cardio nor recovery, but I have had two episodes on the trail that have changed my conditioning pre-hike. The first was when I got hobbled after mile 75 when I embedded with a PCT friend who was obviously in better hiking shape after going 1000 miles. It seemed like a stress fracture but was probably a tendon. After that, I started conditioning a lot more pre-hike, and also using therabands to hit the tendons. The second episode was actually last month when on the first night of a hike I got shin splints that were unbelievably painful. My conclusion was that despite my obsessive training, I did not train with the same shoes.

None of this is that revelatory, with the simple advice in training to try to replicate in all ways the hike; altitude gain, shoes, backpack weight. Oh, and yes, the other thing is to watch out when you go hiking with people half your age.

… I actually got coaching for swimming to even be able to do a resting backstroke; I’m not kidding when I say that it’s very difficult for me!…

Not trying to beat a dead horse (you know you), but this is just a thought I had. You are mostly looking to keep your legs in shape in a low-impact way. Why not swim with a kickboard? You won’t get the total body workout, but you can get a nice workout for your legs without needing much of the coordination needed for swimming.

Another off-the-wall thought I had, ice skating is low impact and good for cardio. Although if coordination is an issue, you probably have difficulty with it.

Why not swim with a kickboard?

Not a bad thought, honestly.  I would look like a doofus, but since I already look like a doofus I’m not losing much!

Another off-the-wall thought I had, ice skating is low impact and good for cardio. Although if coordination is an issue, you probably have difficulty with it.

Let’s not even talk about that: I think I would be better served to just drown myself. ;)

I’m looking into high-rep exercises this afternoon; there are some very simple ones that I might be able to introduce, and that might not have serious leg-injuring impact.

HIIT on a stationary bike is a good one.  Just three 20-second all-out intervals in a 5-minute total is quite effective.

https://www.youtube.com/watch?v=vLOu9tJPpgI

https://www.amazon.com/One-Minute-Workout-Science-Smarter-Shorter/dp/0399183663/ref=sr_1_1?dchild=1&keywords=one+minute+hiit&qid=1628707883&sr=8-1

Bob – thanks!  I’ll look more into HIIT as well.