Adam, M.D.

Among my many self-proclaimed qualifications (mechanic, physicist, philosopher, snake wrangler, brew-master, Iron Chef, lady-pleaser Ph.D, etc.), I am a sports doctor.  Not a doctor in the med school, residency, treats patients sense, more of a doctor in the "I have the internet and know how to use it" sense.

So after some (read:  2-3 hours) research, I've concluded that my injury is a mild case of Medial Tibial Stress Syndrome (MTSS).  What is this, you may be wondering?  MTSS is true shin splints.

What do most people feel when they say they have shin splints?  They feel pain in the lower front of their legs.  This is typically muscular, due to an imbalance between the muscles in the back and front of the lower leg.  The back muscles are either tight, or too strong, keeping the front muscles in a constant state of tension.  When you run, those front muscles provide the braking force for each step.  Doing this while stretched loads them eccentrically, leaving them sore, and leading the runner to think they have an impact injury to their shin - which it isn't.

MTSS is different.  As the name suggests, it is caused by stress to the medial (side nearest the center of the body) region of the tibia (large bone in the lower leg).  It is a pain in the tibia itself, not the muscles around it.  It comes from various things related to how you run - the way you land your feet, the degree to which you pronate, how quickly/slowly you increase your mileage, etc.  These things result in eccentrically loading and fatiguing the soleus muscle, the lower part of your calf.  When this happens, the soleus cannot do its job effectively, and you get increased torque about your tibia.  Ironically, one of the contributing factors to my shin splint is landing on the balls of my feet - the very thing that helps protect my knees from injury is causing a pain in my shin.  I suspect this, plus a few other factors such as my higher mileage (which I may have progressed to a little quickly) have caused this injury.

My case is mild, and the best thing I can do for it is rest.  I have to avoid repetitive stress on the bone, meaning some time off running.  How long?  I don't know.  I'm going to start with a few days and see how it feels.  I'm hoping it will heal quickly since it isn't severe.  I should be able to continue working out without stressing it, and I plan to do some swimming this weekend (or rather, plan to try to swim).

Who needs med school.