I keep getting pains in my shins when I run

Every week Cork GP Dr Pixie McKenna answers your medical questions

I STARTED running about a month ago to get in shape for Christmas. The problem is that the past four times I ran, I’ve had brutal pain in my shins on both sides. I thought it would just loosen out the more I ran but it hasn’t. Any idea how I can get rid of it?

Jim, Waterford

THIS sounds like shin splints, a general name given to a pain that comes on either during or after exercise. The pain is felt on the inner part of the shin in both legs and it occurs frequently in runners.

If you are overweight or running on very hard surfaces, it is more likely to occur. We also see it hit people who pound the pavements in worn-out trainers.

Remember a hardly worn pair of trainers could still be defunct, despite looking new, because the rubber fibres wear out with age as well as with use.

If you have foot problems such as flat feet, tight Achilles tendons (take note ladies who wear heels) or roll your feet inwards when you run, then all of these can increase your chances.

So what is the actual cause? Generally speaking, it’s overuse of the muscle and bone tissue due to repetitive exercise.

A sudden change in intensity (time or distance) or altering your running terrain can all be a trigger. The pain can range from a dull ache to an intense sharp pain, which is made worse by touching the shin.

Stopping exercise is the best remedy and ideally will involve avoiding the activity which provoked the pain for about two weeks.

Don’t be fooled into thinking no pain no gain — if you run through it you will make it worse.

THE first thing to do when the pain hits is to ice the area for around 20 minutes. You can do this using frozen peas wrapped in a tea towel. Don’t apply them directly to the skin as the cold can damage it. Taking pain-relieving antiinflammatory tablets will also help — for example ibuprofen.

If you have flat feet or other mechanical problems, you should consider putting an insert into your shoe to correct the problem.

In terms of exercise it doesn’t mean no exercise, it just means no running. Swimming or cycling is fine. Exercises such as calf stretches, ankle mobilisation and toe raises may all help.

Whilst you can get access to these on line, a session with a physio would be most helpful in terms of instruction on what to do.

If the problem persists or reoccurs soon after your rest period, seek a review from your GP.

The underlying problem could be a tendon issue or even a stress fracture (hairline fracture from overexertion) rather than simple shin splints.

From what you are saying, I feel shin splints are the source of your pain. If you sit it out for two to three weeks, you will be back running off those pounds before Christmas. MY 22-YEAR-old daughter has developed a habit of eating ice cubes and, rather strangely, earth. She’s what I would describe as a very well-adjusted girl. When I ask her why she does it, she says she can’t help it. Could she have worms or something?

Marie, Galway

WHAT you are describing is a condition called pica. This is a situation where someone develops a pattern of behaviour whereby they ingest non-food items.

Whilst it may seem quirky or put down to going through a phase, it shouldn’t be ignored.

In younger children who exhibit pica, we worry that it may represent underlying problems with learning and development. In an elderly patient, the first thing we would think of is the possibility of underlying dementia.

Where your daughter is concerned, given her age, the first thing I would want to rule out is pregnancy. Is this a possibility? Pregnancy can be associated with not only food aversions or cravings but also pica.

I have had patients eat everything from earth to carpet underlay. So rest assured, as a medical entity, your daughter’s problem is far more than a phase and is unlikely to have started without any underlying reason.

The next thing you need to consider is her general health. Could she have any nutritional deficiencies? The key offenders are iron deficiency and lack of zinc. In terms of iron, even if she has a healthy dietary intake she may still be running on empty if she suffers from heavy periods.

As such, a general blood check via the GP is advised.

The final thing that should be considered here i s her mental health. Has this habit evolved as the result of a form of OCD or underlying psychosis?

This is f ar l ess l i kely than a deficiency or pregnancy but nonetheless should not be discounted.

So, what are the worries and what damage could she be doing? For starters she may damage her teeth as a result of the excessive ice eating.

Choking is another possibility if she is ingesting a lot of earth or ice. Once the earth is swallowed, she could also end up damaging her bowel or introducing infection as a result of the earth because it is contaminated with organisms.

From the point of view of her general health, she may find that she gets constipated or starts to feel fatigued if she is substituting real food for the earth and ice cubes.

I would suggest that you broach the subject with your daughter so it is out in the open and then make a GP appointment.

At the very least, she will need a blood test. If she has developed some sort of habit-forming behaviour, she will also need some psychological help to break the cycle.

Whilst her fascination with ice cubes and earth may seem funny, this is in fact no laughing matter.

For the record, whilst worms may potentially be a cause, it would be way down my list of suspects.