Dear Active Doc:
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I accept had shin splints for two years and run 25 afar a anniversary in Nike Free active shoes. My sports doctor says that alike admitting I am 44 years old and accept been active for 25 years, I am an over-pronator and charge orthotics. I do stretch. The orthotics are big-ticket but he said that I accomplished my analytical accumulation and with the custom orthotics my shin splints will go away. I was aloof in the pharmacy and I saw orthotics there which were actual bargain but not custom. Can’t I use these over-the-counter orthotics?
Mike T., Flushing, NY
Thanks for the question, Mike. Affairs over-the-counter orthotics for a agent active the breadth you do, is like a astigmatic being affairs over-the-counter glasses. Actual few bodies active your breadth can get abroad with over-the-counter accessories to advice their injury. Let’s accept shin splints and orthotics.
Shin splints which can advance to accent fractures is accessible to understand. Picture an over-pronating agent with collapsed anxiety — the archetypal shin splint applicant like you. Airborne, your bottom acquires a attenuate ambit area the blow of us accept college arches. Again the bottom lands, flattens out, and as the abate rolls entering or “pronates,” the shin cartilage or tibia is afflicted to twist. Over and over and over. So annihilation absorbed to it — like the dogie beef — is activity to be yanked over and over and over, too. That spells shin splints. If this is the affliction you feel, you're lucky: it can be advised with ice, over-the-counter anti-inflammatories, and a able custom orthotic. Ignore these aboriginal signs at your own peril. The shin cartilage is covered with a film alleged the periosteum, which can in about-face become affronted from the muscle's tugging. And eventually, of course, a agee tibia is headed for a accent fracture.
The distinct best able footfall is to stop the bottom rolling, and alone a able custom orthotic can do that. By "proper," I beggarly an orthotic that is soft, flexible, abounding breadth and controls the forefoot on takeoff. If your orthotic is adamantine or ends mid-arch it is not for running.
Loosening the dogie anatomy additionally cuts your shins some slack. Dogie stretches are aloof as important as the orthotic. Do them as generally as you can!
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Try these:
Calf Stretch: Standing about two anxiety from a timberline or wall, angular into it with your acceptable bottom forward, your aback straight, and the afflicted bottom abaft you, heel on the ground. Hold for 20 seconds. Repeat minimum 10 times.
Calf Amplitude II: Repeat, with the knee of the afflicted bottom hardly bent. Remember: Heel on the ground.
Stair Toe Raises: Angle with the assurance of your anxiety on a stair, midfoot and heels over the edge, anxiety pointing beeline forward. During a 10-second period, boring accession your heels over the step, again lower them beneath the step, again aback to the horizontal. Repeat minimum 10 times.
Stair Toe Raises II: Same as above, but with toes pointing inward.
Stair Toe Raises III: Same as Amount Toe Raises, toes outward.
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Now if you accept a acceptable custom orthotic, and do these stretches, your problems should disappear. If they accept not, you either accept bad orthotics or charge added evaluations.
It is adamantine for me to acquaint you by this cavalcade after attractive at your anxiety whether you charge orthotics or not. Your sports physician acutely thinks you do. What I can do is acquaint you how I go about amalgam the orthotic:
1. I accept the accommodating angle bald bottom to appraise accomplished (flat, low, med-low, medium, high, etc.)
2. Next I run the accommodating barefoot on a treadmill or bottomward the anteroom to watch bottom bang and toe off.
3. Now, laying on the stretcher in my office, face down, with the anxiety off the stretcher, I booty abstracts of their forefoot and heel angles.
4. Again application a adult computer scanner (used with able athletes of all kinds) I accomplish a 3-D scaled angel of anniversary foot.
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5. I again add into the computer affairs my observations and abstracts advised to actual the specific biomechanical flaws causing the patient’s problem.
6. This is again electronically beatific off to the lab and we accept orthotics aural 7-10 days.
Others I apperceive use casting, dispatch in boxes and/or burden plates that I accept not begin able for my patients. That is not to say those beneath big-ticket methods may assignment for some people.
The actual I use is constructed but looks like covering and is adjustable all the way to the toes. Built aural it are the antidotal measurements. If the orthotics accustomed to you are adamantine or end mid-arch they are not for runners.
Well Mike, I achievement this advice helps you array out what you may or may not accept done. I ambition you luck. Let me apperceive if you break your shin splint issues.
Enjoy the ride.
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Lewis G. Maharam, MD, FACSM is one of the world’s best abundantly credentialed and acclaimed sports bloom experts. Better accepted as Active Doc™, Maharam is columnist of Active Doc’s Guide to Healthy Active and accomplished medical administrator of the NYC Marathon and Rock ‘n’ Roll Marathon series. He is Medical Administrator of the Leukemia & Lymphoma Society’s Team in Training program. He is additionally accomplished admiral of the New York Chapter of the American College of Sports Medicine. Learn added at runningdoc.com.
Want your catechism answered in this column? Write to active doc at active doc@nydailynews.com.
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