"Hi Gary
Lorraine Moller winning Osaka with ease.I have been following your training programme for the Auckland marathon. Things have gone really well until Sunday when I went out for my two hour run. I was about half way in when I had this tightness and ache in my right leg, the muscle just above the ankle towards my shin. I stopped and stretched a little and then tried running again. Unfortunately it didn't go away and since it always seems to be when you are furtherest from home, I ended up walking home.
At home I did the ice and elevation and rubbed on anti-flam. I already take the Balance Joint food for athletes powder and Balance sports multi plus vitamins. Is there anything else I can do to be ready for the marathon in two weeks? Regards" – "D" __________________
Gary advises: The good news, "D", is you have done about as much training as you need and all you need do with two weeks to go is to concentrate on freshening up while not losing any of that hard-earned form.
The injury that you describe is most often mistaken as an Achilles Tendon injury or "Shin Splints" and the reason it is so hard to fix is because the therapist is busy treating the wrong problem.
The most likely cause is the Flexor HallucisLongus, Flexor Digitorum Longus muscle, or even the Tibialis Posterior muscle - most probably the Flexor Hallucis Longus. The muscle may be in spasm from sheer exhaustion caused by cranking out huge miles; especially if there is excessive pushing off of the big toe such as can occur if one has, say, a sore heel, a blister, a sore instep or just running up a steep or undulating slope. Or it may have something to do with the shoes.
Have a close look at the diagram to the left and see if you can pinpoint the pain as per the photo.
Here is my advice about what to do:
Stretch the ankles about once a day - only gentle. Do not do too much and do not be forceful. Do not worry about fancy flavour of the times exercises like eccentric calf contractions - waste of time for you. Your running is about 70% eccentric contractions.
Get a firm sports-type massage on the affected areas, as per the picture and the actual location of any pain and swelling where the muscle is bunched. But do not stop there do all the legs - do the lot; calf, thighs and backside and even the low back shoulders and arms. Repeat every 4-7 days - no more frequent than that.
You may have developed a tissue salts imbalance, including the magnesium, potassium and calcium salts. The easiest way to start the process of correcting this is to complete an Active Elements Assessment and take the tablets as per the instructions that come with the report; but you will need to get onto this quick. I will give additional advice once the assessment has been done.
Read this article here about mineral salts replacement when running a marathon.
Keep your running fitness and form by aquajogging. You could also do some power walking. If you have access to a gym, jump on a cross trainer.
Be guided by pain as you carefully resume running; but do not bother about any long or overly strenuous runs between now and the marathon. Your priority is to ensure that the shin pain is 100% gone by race day.
It may be advisable to avoid running up steep hills that have excess pressure pusing off the big toes.
Do not run out and back because Murphy's Law dictates that the injury will flare up at the furthest point away from home. It is better to resume running by running a circular course that can be easily terminated at any time.
On race day do not do anything other than easy stretches. You could start the day with a gentle massage of the legs.
Start the race conservatively and gradually wind up the pace over the first 10-15km.
I hope this helps and please let us know how you get on.