T Nation

leg pain when running

Hey guys, I put up a ‘freshman 15’ post a little bit ago, and although I’m happy to say that I’ve gained a lot of strength, I’ve also gained some girth (my legs have never been so thick is what I’m really trying to say)… So, I have been trying to up my running, but I’ve encountered a strange obstacle and I was wondering if I could get any advice…

My tibialis anterior becomes extremely tight and knotted whenever I run or walk. It’s really painful and it gets to the point where I can’t control my foot movements. So when I’m running, I feel like I’m dragging two dead appendages and they just clop along. Its extremely frustrating, and I’ve tried warming up, stretching, massaging, hot baths, and it doesnt seem to work. This has been going on for about 2 weeks now, and I could only run a half mile today because it was so bad. And this seems to be strict to running/walking because I can bike, stairmaster, jump rope, do jumping jacks, do burpees, etc just fine. BUT I MISS RUNNING. So, if anyone’s got advice, I’d love to hear it!!!

A very frustrated,

Katobie

Sounds to me that you may be suffering from acute exertional anterior and/or lateral compartment syndrome. This is where your fascia tissue does not accommodate the expansion requirements of your muscle under prolonged exertion (typically running and fast walking). As a consequence your may be feeling a distinct pressure build up in the anterior and lateral compartment of your calf muscle.

I myself have bilateral anterior and lateral compartment syndrome, so I know how prohibiting this condition can be.

My advice would be to get some proper diagnostics done by an appropriate musculoskeletal physician or sports medicine specialist.

If your physician concurs with my hypothesis upon your initial consultation, he or she will make appropriate arrangements for you to undertake ‘pressure studies’.

This entails injecting a local aesthetic into the area of complaint. From this you will be in all probability put on a treadmill and be made to run as a means of bring forth the symptomatology that you usually experience. From this, the physician will plunge a sizable needle into the area that has been numbed (don’t worry you wont feel a thing). Attached to this needle is syringe plunger like object.

This will be used to measure the amount of pressure in the area of concern. In normal post exertional circumstances (as told by my physician), the pressure reading will be around 20 (mmHg). However, in my circumstances where compartment syndrome is apparent, a pressure reading will be double that. In my circumstances, I had a reading of 53 (mmHg) in my anterior compartment. This is a clear-cut case of compartment syndrome.

You have indicated that you have exhausted all conservative remedies (eg massage, ice etc). The advice I have received from the physicians I have talked to (I work in the healthcare industry so I know some of best guys in the business) and my review of the literature on this condition (pubmed is great for this), the only viable remedy is surgical. The procedure is called fasciotomy/fasciectomy. This is where they surgically cut away at the fascia tissue as a means of relieving the pressure.

As a final note, I would advise that you should actively seek out the most reputable sports/musculoskeletal physician in your city. Most doctors in general practice do not know much about this condition (or musculoskeletal complaints in general) and you don’t want to be f&*king around with referral after referral and futile diagnostics.

I hope this information is of assistance and good luck in quest for a diagnosis and remedy.

p.s This is general information and not meant to replace the advice that one would receive from a qualified physician (I know too many lawyers!lol).

I have further reviewed your post (I got excited before) and you have indicated that you have only had this condition for 2-weeks.

This is promising. In some cases where treatment is sought in the early phases of symptomatology, a resolution can sometimes be gained via intensive deep tissue massage. This has to be performed by a either qualified physiotherapist, massage therapist or ART practitioner.

However, if the condition becomes chronic (ie greater than 3 months) my previous advice will definitely apply.

Nevertheless, I would definitely advise that you should immediately consult an appropriate physician so that this condition can be closely monitored.

I certainly hope you can remedy this situation through conservative measures, but now you should be better equipped to tackle this condition with the information provided.

Rodcore, thank you so much for the info. Yes, it is both anterior and lateral lower portions of my legs, though I feel it most intensely in my lower tibialis anterior. When I run my hands down my legs, the muscle definitely juts out right at that part, so I’m hoping the deep massage you were talking about will help. Thank you for being so helpful.

nice post rodcore… katobie, sounds like he is onto the right track.

however, although you said you tried conservative treatment, one thing you ommitted mentioning was Rest!..

if you have only been experiencing the shinsplint/compartment syndrome symptoms for 2 weeks, the first treatment should be to completely rest for about two weeks, stretch calves religiously during that time (maybe 3x per day? why not…), massage the shin fascia, ice, etc. all of the good stuff…

then come back to running, cut your mileage in half, and avoid hard running surfaces like the plague. including asphalt, which is softer than concrete, but not That much softer. avoid sand at first because it will cause calf tightness and stretch the weakened shin tissue.

once you start running again, don’t run until you hurt (don’t even attempt to find your limits yet)! if you feel pain in your shins you are exacerbating the condition. if you want more cardio, sounds like you have the elliptical/stairmaster options, or consider breaking your runs into a morning and an evening run, each 1/2 of your daily goal.

just my experience… i have had shin splints or something like them twice, both times after i added 10-15 lbs (muscle :wink: ) and this method worked for me.

Thanks use2ruck,
Yeah, I plan on doing biking/swimming. I actually don’t have access to a gym this summer, so I won’t be able to use the other machines for a while. Since I’ve been jumpring rope now to get in some cardio, I’ve been getting shin splints. Arggg. But thank you very very much for the advice, much appreciated!