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How Do I Get The Fun Back In My Run? · MIT - Conversations with MIT Health

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  Emily Wade (Host): Welcome to Office Hours with MIT Health, where we answer
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  your curious, confusing, and sometimes cringe-worthy health questions.
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  I'm your host, Emily Wade, and today we're talking Shin splints with Dr.
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  Sean Faro, our Deputy Chief Health Officer.
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  Hey Sean, thanks for being on the show.
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  Shawn Ferullo, MD: How are you happy to be here?
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  Emily Wade (Host): Thanks.
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  All right.
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  Before we get started, I'm going to, remind everybody that the
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  information in this podcast is for educational purposes only.
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  It's not a substitute for medical advice, diagnosis, or treatment.
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  So if you have a medical concern, consult your primary care provider or another.
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  Qualified medical professional.
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  All right, so I'm gonna get to today's question, which came from
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  one of our, MIT community members.
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  Dear Office hours, I'm trying to get into running, but every time I try to build
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  up mileage, my shins just freak out.
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  I keep hearing that if you're a pronator, you're doomed to shin
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  splints, but I don't know if that's me.
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  Can shoes fix this problem or am I dealing with something deeper?
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  So Sean, This is like good timing because we just attended the, kickoff
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  for the MIT get Fit yesterday, so I'm sure we have a lot of people out there
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  who are trying to get into running.
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  so maybe you can start by just kind of explaining what Shin
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  splints are And what causes them.
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  Shawn Ferullo, MD: Yeah, happy to.
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  It's a great question.
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  Well formed.
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  so I think the easiest way to think about shin splints is that they're,
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  they are technically an inflammation along the lining of the shin bone, the
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  tibia, which is on the inside of The leg, the fibular is on the outside our
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  calf muscles and some of our muscles that help us push off while running.
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  Attach along that, border of the tibia.
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  And what shin splints are is a tightness and irritation, And then a
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  resulting inflammation of the lining of the bone, the periosteum that
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  occurs from tension and traction and pulling of the muscles on there.
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  So frequently not uncommonly experienced by people building into running for,
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  the beginning, but also sometimes, overuse or other things as well.
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  But, that's the easiest way to think about what chin splints are.
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  Emily Wade (Host): So it's kind of a little bit of a way of your body kind of
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  saying maybe you gotta take a little extra time to get from the couch to the 5K.
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  Shawn Ferullo, MD: Yeah, I think that's a great point, right?
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  Oftentimes it is, muscle tightness, muscle imbalance, tightness or
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  as you're building in, right?
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  So oftentimes what I experience, especially in New England, is
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  people are sometimes in shape.
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  Cardiovascularly from going to the gym in the winter and doing biking or
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  swimming, but then their legs aren't as in shape as their cardiovascular system.
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  So when you start into that running, it's almost too much for your legs all at once.
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  And that coach to 5K or walk, run walk cycles for a truly new novice
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  runner is really helpful to kind of.
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  Gauge a bit of the tension and muscle strength And then a little bit of walking
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  with blood flow, flexibility And then back and forth and gradually build up.
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  And so it's a really good technique for building into running for sure.
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  Emily Wade (Host): That's reassuring because, I, feel like I'm kind
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  of a runner, but just sort.
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  To chug along.
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  I'm not that good at it.
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  And So, it, but hard because, if you're on, it's a little snowy right now,
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  but if you're like running on Memorial Drive and you see somebody flying past
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  you, it's just a little hard to just not instinctively try to speed up.
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  So it's, good to know that it's not so embarrassing if you need to like
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  slow down and walk a little bit, to, while you're getting used to it.
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  Shawn Ferullo, MD: Not at all.
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  That's another great point, right.
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  So, in that intro to running both speed.
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  where, more muscle force is needed, more muscle contraction
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  is needed to propel faster.
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  And when we run faster, our gates, our stride gets shorter
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  in order to increase cadence.
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  Right?
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  So you take more steps.
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  So both speed and distance or things that people should be
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  thinking about, as you're kind of building into that running program.
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  But no, not embarrassing at all.
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  Shouldn't be.
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  I think getting out there and doing things is way better than not doing things.
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  I think another unique part of New England is we are blessed with a few great months
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  for running weather And then it's too hot And then a few great months of running
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  weather And then it's icy and snowy.
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  So even people who are avid runners often have these periods
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  of less road running because of the climate and changes that happen.
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  Emily Wade (Host): So are there any, good ways to prevent.
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  This from happening besides kind of like taking it slow maybe adhering to one of
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  those kind of like walk run programs.
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  Shawn Ferullo, MD: Yeah, I think it's a great question.
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  I think of it holistically always, right?
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  So what are all the things our body needs to do to run, right?
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  So I think one of them is, training program, right?
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  Walk, run, walk cycles.
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  Sometimes I advise people to just.
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  If they don't wanna do that, like walk the first half a mile, run a half
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  mile, walk the last half a mile, right.
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  And then gradually build in.
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  There's an, You know, it doesn't always have to be so broken
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  up, but, build in that way.
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  I think, as with other things, a good flexibility program,
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  which is not comfortable to stretch ever as a human, I think.
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  And I think.
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  To that point, I think one of the key features in Emily And in prevention
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  is that oftentimes a dynamic warmup is more important than just stretching
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  for five minutes before you run, right?
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  So cold static stretching evidence shows that it does not reduce
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  injury risk, and actually it's not, it doesn't improve performance.
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  What does is this kind of little bit of stretching and warming the muscles up,
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  so, a little stretch, walk a bit warm up or jumping jacks or something along
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  the lines of just getting the muscles.
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  And blood flowing is, I think, a really important piece of that prevention.
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  'cause it's not just stretch for three minutes as we were taught as kids
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  in a circle And then just go run.
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  so I think there's a big piece, certainly running shoes, right?
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  So, if someone's truly building into running, making sure you do have a
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  running shoe and not like a walking shoe or a flat sneaker That is more.
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  For design, then support, that sometimes will help people who
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  pronate alone just by getting a good arch support and a running shoe.
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  Pronation does put more pressure on the inner ankle because as we stride,
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  the foot turns in so those muscles on the inside of the calf are holding
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  up, which is why shin splints are more common, but it doesn't necessarily
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  mean people can't run like some strengthening, sometimes physical therapy.
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  If someone pronates a fair bit as a, as a.
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  Bootcamp strengthening program.
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  good shoes, good supportive shoes, hamstring stretching, even like quad hip
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  and glute strengthening because as we run all those muscles support our leg.
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  so it's hard to give one dynamic program, but all these factors come into play.
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  And, to the question to us, no, a pronator is not doomed to never be a runner.
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  but there are different techniques that can help that for sure.
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  Emily Wade (Host): So you, mentioned shoes and I, am a little curious, do
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  you recommend that somebody who's maybe getting into running get fitted for shoes?
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  Is it something where it makes sense to go to like a running store or is
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  it something where is that overkill
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  Shawn Ferullo, MD: it's a great question, right?
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  one of the, most complicated part in advising people for shoes is that shoes
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  have become such a fashion component now, And the same companies that
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  make running really good high quality running shoes make lower cheaper model.
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  Similar, looking from the outside fashion forward shoes that aren't as supportive.
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  So there isn't, it's not easy to just say this one brand or that one brand.
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  I think there is something you get what you pay for sort of mode.
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  That doesn't mean you have to go out and buy the most expensive shoe.
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  That doesn't mean it's the best shoe, but a good shoe That is well built does
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  tend to cost more than you'll find in a.
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  Bargain basement store or something, unless you get really lucky and they're
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  trying to move the product along.
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  So I do think there's good, truthfully, in a good store that works with
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  runners and can give honest guidance and advice is really the key.
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  And some of the more.
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  Mall forward stores are, younger workers that are, not as trained in fitting
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  shoe type And that sort of stuff.
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  Not that that's bad, but I think a little bit of research into shoe type.
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  I think a little bit of.
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  Certainly there are stores around that are quite good at this,
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  and I wouldn't call it overkill.
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  And many of those stores or good ones aren't gonna just try to
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  sell you the highest model, right?
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  They're gonna really talk to you about how much running do you do,
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  what's your mileage, You know, right.
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  Because that then factors into what type of shoe might be best and they'll
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  even watch you walk and sometimes even walk on a computer as pad.
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  All of those things to kind of fit you to the right type of shoe.
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  So.
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  I don't say to people they have to go to one of those stores, but I certainly
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  don't discourage people from trying that.
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  cause it, is a, good way to try to get a good shoe so you don't just keep buying
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  something and it doesn't feel right.
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  And then you buy another thing And then you go round and round.
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  Emily Wade (Host): I've definitely, been guilty of that, uh, buying
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  a bunch of different, well,
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  You know, but they, sometimes they just look so cool, you're not thinking about
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  like, whether it's actually good for
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  Shawn Ferullo, MD: Yeah.
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  And what's interesting too is, years ago, God gonna date myself,
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  but 20 years ago or so, right?
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  Cross training shoes were really, really popular, right?
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  You can do all your activities in it, but they didn't always have
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  the best running support, right?
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  And so, yeah, I think just thinking of all of those factors, does come
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  into what support you get out of that shoe when you're running.
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  Emily Wade (Host): So this just came in my mind.
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  have, I have a friend who's really, really a serious, serious runner.
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  And, she's also a very serious, foam roller user.
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  Shawn Ferullo, MD: sure.
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  Emily Wade (Host): is that something that can kind of help with shin splints?
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  I, am so incapable of using a foam roller.
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  I just sort of like fall off of it every time I try to use
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  one.
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  But is that Oh yeah, they're so painful.
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  So, is that something that, can help with the shin splint?
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  Shawn Ferullo, MD: Yeah, it definitely is.
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  And the way that I describe this to patient's is, think of
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  your muscle as a rope, right?
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  And so our muscles can be stiff and you can have a rope that's really
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  tight, but we also can get little spasms and knots in our muscles.
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  And, the analogy of that would be, and it's not a perfect science
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  analogy, is if you had that rope and there was a knot tied in it.
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  The more you stretch, the more you just tighten that knot.
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  And so in some ways, if we have these areas or trigger points or spasms in
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  our muscles, in our calfs, you can stretch, but you might actually be
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  just tightening that knot over time.
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  And what the foam roller, or like a rolling stick or that sort of
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  my myofascial release is doing, is trying to untie those knots.
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  And then followed by stretching can actually get you much more relief.
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  And so, foam rolling.
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  Rolling sticks.
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  Uh, rolling.
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  Sticks are a little easier, than foam rolling.
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  Do have a, place, in there.
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  they're not mandatory, but there is definitely a component of that.
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  Emily Wade (Host): So, okay, we have Get Fit kicking off.
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  The beginning of next week, although this episode will probably come out.
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  After GetFit is started, it occurs to me.
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  but we have a lot of people who are on these teams and they're trying
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  to get up their mileage so that they can hit that, 300 minute mark.
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  And their team can win.
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  and if they start to feel pain or, they've done everything we've recommended in
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  this video, and, they're still kind of feeling not great when is the moment
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  when they should give, sports medicine, maybe sports medicine at MIT Health, A
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  call, and, see about getting treatment.
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  Shawn Ferullo, MD: Yeah, it's a great question.
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  So we're always there to help and people have questions even if their
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  symptoms are not debilitating.
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  We're always available.
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  I think that like when should you really seek professional guidance?
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  I think pain That is escalating.
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  So happening, earlier in runs or more often or, lingering, not just during
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  the run, but for days after the run.
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  And that then is affecting the next run.
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  Certainly any pain or discomfort even That is lingering into walking, right?
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  Or anything That is sore enough that you're limping.
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  we always want to think about stress fractures as a, another potential
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  source of bony pain in the legs.
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  but I think certainly persistence, frustration if you feel like you're
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  doing all the right stuff, but it's still not getting better,
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  even if they're not horrible.
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  And then certainly like escalating discomfort where a little bit of
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  rest or a little bit of, training break isn't actually helping
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  it or it is coming right back.
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  For sure.
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  And then of course, any swelling or bruising, like any odd symptoms that
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  are different than that for sure.
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  Emily Wade (Host): Okay.
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  So I hope you all paid attention to that.
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  don't just, smile through the pain.
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  Give us a call if you need us.
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  so, to recap, seems like, these chin splints are kind of come down to.
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  Trying to get started, with a program too quickly or having tight muscles
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  or tired shoes and, making sure that you're kind of thinking about dynamic
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  stretching and using appropriate supports and using those good shoes is
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  gonna really kind of help you along.
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  Does that sound
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  good?
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  Shawn Ferullo, MD: yeah.
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  And I think, you there's a little bit of, muscle soreness from building
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  into any new exercise routine.
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  And so, Fitting in that, stretching that, maybe rolling stick, as part
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  of that routine, is important.
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  But that sounds exactly right.
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  Emily Wade (Host): Excellent.
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  Well, thank you so much, Sean, for being here and being on our very
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  first episode of Office Hours.
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  I hope we have you back again.
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  I have a feeling we will, so that's the end of the episode.
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  and if you have a question for our clinicians, head on
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  over to our website@health.mit
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  edu slash thrive.
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  That's at THR Ive, and, you can find the web form so that you can
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  submit your very own question.
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  Thanks so much for tuning in.
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  See you next time.