Q & A from Injury Clinic on Thursday 7th April 2016:

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Question:   I have been experiencing a sharp pain on the right side of my shin on my right leg recently. This is worse during the early part of my runs and then disappears. It is also sore after runs. Any help would be appreciated.

Answer:  Thanks for your enquiry. The good news is that nearly all shin pain can be cleared with the correct treatment regime and in nearly all cases the person can return to running again pain-free. There are a few different causes of shin pain and they are all treated differently. Rebecca Nelson, our Director of Physiotherapy here at Apex Clinic Belfast wrote an article on tackling shin splints which you may find helpful to read and it can be accessed on the NI running website, under the Physio section.

From the information that you’ve given us, the shin pain that you’ve described is likely to be from either, poor or altered nerve movement (altered neural dynamics) of the nerve which runs down the shin or secondly, due to referred pain coming from the lower back region which occurs as a sharp pain in the shin.  If your shin pain is worse going uphill, then it’s more likely to be referred pain from the lower back whereas if your pain is worse going downhill or during faster runs, then it’s more likely to be altered neural dynamics.  The other common causes of shin pain are unlikely in your case, but a thorough examination by an experienced physio would definitely be needed to rule out- a stress fracture, inflammation of the tibialis posterior muscle on the inside border of the shin bone and compartment syndrome.  An accurate diagnosis is essential in order for your pain to be cleared.  With the correct treatment regime, you should certainly be able to return to painfree running (maybe with a few softer surfaces thrown into your training regime!) Feel free to give us a call if needed.

Question:   During longer runs I have been developing a pain on the underside of my right foot, around the ball of my foot. Any advice would be appreciated.

Answer:   From the information that you’ve given, your pain is likely to be due to overloading of the joints in the forefoot, namely the MTP joints (metatarsophalangeal joints) and once this overloading is addressed, the pain should clear. This will either result from- poor foot biomechanics alone, where insoles/ orthoses will be needed to improve this or from stiffness in one or more of the MTP joints from overuse of these joints.  In either case an experienced physio would need to assess your foot biomechanics to see if you need over the counter orthoses or referral to a podiatrist for custom made orthoses.  If there is stiffness of the MTP joints the physio would need to manually mobilise the affected joints to restore their full mobility.  At this stage you need to reduce your run length and only run on softer surfaces (grass, bark, or treadmill).  In both of the scenarios mentioned above, you should also stretch the plantar fascia (the soft tissues on the sole of your foot, these stretches can be found online)  and the two calf muscles- gastroc and soleus, which can also be found online. Perform these stretches twice daily for 5 repetitions each time, holding each stretch for 20 seconds.  Hope this helps.