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Confessions of a Serial Runner

I have been running regularly since high school and typically run about 4 miles, 4-5 times a week. Undoubtedly, there are times when I don’t have the energy to work out or plain just don’t feel like it. But for the most part, I’m very dedicated to my runs. The best part for me is of course that runner’s high at the end of a run. Getting in my workout also always lifts my mood and really helps me fall asleep more easily at night.

Admittedly, I may take my running a little too seriously sometimes. This happened the few months leading up to my wedding. Instead of my usual 4 miles, I amped it up right away to 7 miles, 6 times a week! Before I knew it, I developed this shooting pain in both of my shins, the front part of my lower legs, when I began my run. And because of my dedication, I unwisely kept right on running. Pretty soon, the pain occurred even when I was just standing or walking. That’s when I knew that I potentially could have a significant injury.

Shin splints and stress fractures are both overuse injuries. A shin splint is when you get tiny tears in the muscles that attach to your tibia, or your shin bone. You may feel a shooting ache or pain at the front of your lower leg when running and the pain subsides when you stop running. With shin splints, walking or other less strenuous activities should not cause the pain.

On the other hand, stress fractures are actually small cracks in the bones of your lower legs – either the tibia or the other smaller bone of your lower leg, the fibula. This will cause pain in the lower part of your shin, swelling and tenderness, and pain if you press on your shin. The pain associated with a stress fracture does not go away even if you stop running. Other activities including walking or climbing stairs will cause similar pain as well. This type of overuse injury can be much more serious. If you continue activity with a stress fracture, you can cause more breaks in the bones of your leg leading to a fracture, or a larger break of your shin bone.

If your injury is a shin splint, try decreasing the intensity of your workout. Run using intervals – walk or jog and then add in sprint intervals rather than running at an intense pace the entire workout. Running on a softer surface such as

grass or dirt instead of concrete can give your legs some relief. Follow the 10 percent rule – add distance and pace by just 10 percent with each workout. Warming up your muscles with some gentle stretching before a run may also be helpful.

With the more severe stress fracture injury, a trip to the doctor may be needed. You may receive an X-ray and possibly a follow up X-ray to determine if you are indeed suffering a stress fracture. Sometimes the injury may not be demonstrated with an X-ray and you may need a special study called a nuclear medicine bone scan to diagnose your injury. Sometimes an MRI or CT scan may be needed to determine the extent of the injury. With a stress fracture, you likely will have to completely stop running and rest your legs for six to eight weeks. If complete lack of exercise sounds too daunting, you can partake in lower impact activities such as swimming, walking, biking or an elliptical machine. But if you don’t rest your shins properly, the area may never heal and may lead to a complete fracture. Once you are healed, you can gradually rebuild the intensity and distance of your workout slowly.

There are also many ways to help prevent overuse injuries. Eating a healthful diet that includes calcium and vitamin D can help ensure stronger bones. Wearing proper training shoes will also decrease your risk of injury. Rest days are also beneficial to give your body some time to rejuvenate and re-energize you for your workout the next day. And always speak to your physician if you are planning on participating in a rigorous new exercise regimen such as training for a marathon.

When I was diagnosed with my own stress fracture, forcing myself to stop running was pretty tough. But now armed with the knowledge of overuse injuries, I can do my best to prevent any future serious running injuries and so can you.


Originally from Orange County, California, Karen Tran-Harding is a radiology resident physician that found love, education, life lessons, and two corgis in the heart of the bluegrass. She has interest in medical media and education. She is a regular contributor to StantonMD and Everyday Medicine.

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