We are beginning a new column where we will dive into some of the most common running injuries. First up: Shin Splints.
This is the pain felt along the front of your lower leg, at the shin bone.
Shin splints are common among runners who increase frequency, volume, or intensity of training, along with improperly fitting footwear or worn out shoes can cause problems. Also frequent running on hard surfaces can cause shin pain.
How to prevent them?
The first thing is to understand what they are. Then you know what stresses you are putting on your body. Consider the age and appropriateness of your shoes and review your training to make sure you aren’t making any huge sudden jumps. Many runners with shin splints also report tight calves and relatively modest strength in the lower leg muscles. Proper stretching and strengthening of the calf muscles can help. One productive exercise is heel walking. [Check out our Heel Walking Demo Video here.]
If we feel shin splints coming on, what should we do?
There is an inflammatory component here, so ice can help a lot. A reduction in training intensity and a change in running surfaces may be required to allow the symptoms to subside. Anti-inflammatories may be appropriate, but consult your physician to ensure they are a safe choice for you. If symptoms persist or become steadily worse, make an appointment with your doctor.
Your doctor will often suggest that you do the following:
Check with your doctor before restarting any activities. Warming up before exercising is also a good way to make sure your legs aren’t sore.
In March, we examine another common concern for many runners. Dr. Adam Tenforde returns to discuss a problem that can trip up runners like himself (28:23 for 10,000m), as well as recreational runners alike.
FNF: What is Achilles tendonitis?
AT: Achilles tendonitis describes a condition involving the tendon that connects the calf muscles (gastrocnemius and soleus) to the calcaneous (heel bone). The condition can either result from an acute stress (such as increase in training) or develop over time from chronic stressors, such as biomechanical factors or poor footwear.
Joanna ran an incredible race at the 2020 Houston Marathon. She talks about her journey to the finish line, how she ran a "dream time", while managing a busy schedule, minimizing distractions, and other obstacles. She encourages everyone to have fun and be kind to yourself through the process of gaining fitness.
Clyde Wilson was a naval service member who enjoyed weight training and working out, when his doctor on the USS Carl Vinson informed him he was on the verge of needing medication for high blood pressure and cholesterol. After making a transformative change in his nutritional habits, he went on to study chemistry and cell biology at Stanford and now teaches there and the University of California San Francisco Medical School. In addition, he runs The Center for Human Nutrition and Exercise Science in Palo Alto, California.
This month, we asked Dr. Clyde to weigh in about the lethargy many runners struggle through after a long run.
1. When many runners finish a big long run, often they report feeling extremely lethargic and low energy for much of the rest of the day, even after eating. From a nutrition perspective, what may be going on here?
Athletes need to replace their carbohydrate losses from training at a rate that their muscles are willing to absorb those carbohydrates. If you burn 1000 calories in a workout, roughly 800 calories of which are carbohydrate, and attempt to replace all of those carbohydrates at one sitting, the over-flow of calories into your bloodstream will send more than half of it to fat cells, where the carbohydrate will be converted into fat.
Therefore, eating enough calories is not enough.
The calories have to go into lean tissues to actually help you recover. Not eating enough is another way to fall short. So the athlete has to eat enough carbohydrate, but spaced out over time or eaten with vegetables so that the carbohydrate calories enter the body at a rate muscle is willing to absorb them. Protein helps re-build lean tissue but is unrelated to the feelings of lethargy after hard training.
2. What are some best bet tips on things runners can do after the run to avoid that day-long bonky feeling?
The number one rule for race day fueling; Don’t do anything new. Training with a race goal in mind, means that every run you do is practice for the race. You are training your muscles, your body, your mind, and your stomach. Learning to fuel and hydrate to get the most out of your training and racing will make a huge difference in the outcome of your performance, and it all starts in your daily practice.
Pre-Race Routine. For any run over 60 minutes, you will want to eat and hydrate beforehand. 
(See blog on Pre-Run and Post-Run Nutrition). This is a great opportunity to eat and drink the same thing you will on race morning. Once you know what sits well in your stomach, and fuels you for your miles, then stick with it! A standard pre-race breakfast is coffee (or tea) for a little caffeine, a bagel/toast/oatmeal and banana for carbs and fuel, and 16oz of electrolyte mix for hydration. Have this about 3 hours prior to the start of your race of any distance. Try this protocol before workouts and long runs and see how you feel! Adjust accordingly to determine what works for you, and then, don’t deviate.
Mid-Race Protocol. If you are doing a training run or race longer than 60 minutes, you may need to fuel and hydrate
throughout. Look up what electrolyte fluid and gels the event will provide. It is very common in half marathon and marathon distances to offer gels on the course, but you want to know the brand, flavor, and if they contain caffeine. Then you will practice with those fluids and gels leading into the race to confirm they work for you. If they do not, you will need to carry your own. In training and racing, take gels every 35-45 minutes. Get the gel in right before a water station, and then drink water to wash it down (do not take electrolyte fluid with a gel). In between, you can take water and electrolyte fluid to stay well hydrated. If you are racing less than an 60 minutes, you will need nothing, or only water to get through the distance.
Practicing your Pre-Race Routine and your Mid-Race Protocol will help you figure out what your body needs to be successful and run strong the whole way!
What is a Runner’s High?
When we exercise, we expect to feel better as a result. We achieve a fitness or time goal and are fired up by the accomplishment. We lose weight and like the result in the mirror. Maybe, we just do something we have never done before and appreciate the new mental or physical dimension in our lives. Some athletes, however, claim to feel better after exercise because the exercise itself makes them feel better. Significantly. Commonly, this is called a “Runner’s High.”
This “high” has been explained through the years as a rush of endorphins, neurotransmitters secreted by our bodies during things like pain, excitement, and sex. Endorphins act a bit like morphine chemically, so the conventional wisdom has been that they feel like it as well.
On the other hand, Jude Dickson and her University of Edinburgh colleagues, in their paper Does Exercise Promote Good Health, propose three hypotheses about the Runner’s High: the distraction hypothesis (it takes our attention away from painful things at the time), the mastery hypothesis (we learn new things and achieve a goal), and the social interaction hypothesis (things are often more fun and seem easier in a group). So, is the Runner’s High a chemical reaction via endorphins, or a psychological reaction that is somewhat coincidental to running? Regardless, all runners have days where we feel better than others, but the feeling of euphoria associated with this phenomenon can be fleeting or nonexistent for some runners, and relied upon as a pick me up for others. But, can it be captured, quantified, and achieved systematically?
Although an internet search of “endorphins” and “runner’s high” yields 70,000 results, that close association has been only modestly borne out by research. For one thing, it is hard to quantify what exactly a “high” is, as the reflections of athletes differ widely as to how a Runner’s High actually makes them feel. Secondly, although endorphin levels seem to elevate after exercise (likely because of the stress or pain the body has undergone during the exercise), that elevation doesn’t seem to have a uniformly positive result on mood, according to Sarah Willett in an oft cited article from Lehigh University.
The strong association between endorphins and Runner’s High in the wider public view persists. However, despite a well respected 2008 study by German researchers which found a strong correlation between endorphin production and the bloodstream of runners during and after two hour runs, not all agree that the correlation equals causation for the elusive high, in part because the large size of endorphin molecules make them difficult to pass the blood – brain barrier. And, after all, if there was such a strong direct result, wouldn’t we all enjoy Runner’s Highs after / during every hard workout or run?
Other relatively recent studies have linked the same type of brain receptors that play well with marijuana use to a naturally occurring endocannabinoid, which appears to be produced in the bloodstream in large amounts during exercise. A 2003 study with Georgia Tech college students yielded this finding, as have several subsequent similar or related studies with mice both in the US and abroad. These molecules appear to be much smaller than endorphins. If they can pass the blood-brain barrier, does this mean that all the times we’ve joked that “running was our drug” we weren’t really too far off the mark?
Ultimately, questions remain to be answered about how a Runner’s High occurs, why, and frankly, what it is, exactly. Runners are like snowflakes. Each of us is at least slightly different from the rest both psychologically and physiologically, and it might not be unreasonable to think that the difficulties science has had in firmly establishing a cause and effect with this phenomenon lies is the infinite amounts of ways in which running can create a positive effect in our lives. While we wait to find out what the chemical cause is once and for all, we encourage you to enjoy your Runner’s High not because of why you have it, but for the fact you have it at all.
