Client: Marathon Runner

Problem: The client complained of pain in several areas: the left and right shins, across the lower back in the knees whilst training and weakness in the ankles and upper legs. The pain would start during running and gradually worsen. The pain would remain for at least 24hrs after training. The client wanted to continue his hobby, but increasingly felt the pain outweighed the enjoyment.

Assessment: The effects of impact on the body whilst running were discussed and how to help relieve these problems. We looked at posture, especially feet to make sure there was no over-pronation.
After undertaking a visual examination I observed the following:

  • Back - tension across the lower back and in the left buttock needed releasing.
  • Hamstrings - the muscles in both legs showed tightness with small adhesions.
  • Knees - some scar tissue on the ligaments around the Patella (knee cap).
  • Shins/ankles - on palpation I felt the tight Achilles and calf muscles were causing the pain and discomfort and scar tissue on the medial tibia inside of both legs at 4 - 6” from the ankles.

Shin splints (Medial Tibial Stress Syndrome (MTSS): "The pain associated with shin splints is a result of fatigue and trauma to the muscle's tendons where they attach themselves to the tibia. In an effort to keep the foot, ankle and lower leg stable, the muscles exert a great force on the tibia. This excessive force can result in the tendons being partially torn away from the bone."

Treatment: The following course of treatment was undertaken:

  • Deep tissue massage was applied to the muscles to release muscle tightness and remove adhesions.
  • Soft tissue massage was applied across the shins and knee ligaments to remove the adhesions.
  • Sports massage was applied to the Hamstrings and Quadriceps.

Results: A couple of days after the 1st treatment the client did a 6 mile run – there was no pain in his knee, his ankles felt stronger and he felt increased endurance in his legs. There was still in the lower back and some discomfort in the shins. After 2nd and 3rd treatments, when training the only pain now experienced was in the lower back, but this was decreasing. The client was surprised to feel stronger and have improved endurance when running. After 4th and 5th treatment, whilst training there was still discomfort in the lower back, but a distinct improvement in leg strength. After running the Wilmslow half marathon the client required treatment. He reported that during the first 3 miles his shins were hurting due to his initial starting speed but on slowing slightly this wore off. After completing the race he experienced some pain in his lower back. On palpation of the shins there was pain and a build up of scar tissue; this was removed with massage. We discussed the continuing discomfort of the lower back following a run. Massage has increased the strength and endurance of the clients running. He now receives fortnightly sports massage to help keep the muscles from re-injuring and to maintain his level of running.