You may well be pushing yourself too fast. Other potential causes include tiny stress fractures of the tibia, visible only on detailed X-rays or a more specialised type of scan that can see ?hot spots? in the bones.
It is said that people who over-pronate (roll the ankle inwards excessively) during running may suffer shin splints and be helped by shoe inserts (orthotics), preferably custom-made for them after careful analysis by a podiatrist.
One other possibility concerns the circulation to the leg muscles. Although at your age your arteries will all be in excellent condition, it is possible that one of those that supply blood to the muscles in the painful area is being pinched somewhere along its course. This might cause no trouble until you increase the muscles? demand for oxygen during exercise. Oxygen-starved muscles are painful muscles.
Getting further with that theory would involve specialised investigation of your arteries ? something that is commonly done in older people who get calf muscle pain on exercise but not commonly in your age group. Exactly how far to take this depends on the degree of your disability and exactly what has already been done, but start with the basics as outlined by Tony.
TONY GALLAGHER WRITES:
Sorry to hear of your predicament. Three years is a lengthy time to bear an excruciating pain as you describe in your question. I am somewhat surprised that you haven?t had any follow-up advice or treatment, especially after visiting a consultant (type not specified), a chiropractor and a physiotherapist.
When exercise produces endorphins and serotonin it can be a very useful tool in helping to decrease pain. In your case, however, the direct correlation between running and resulting immediate pain suggests that you should cease this activity immediately. As you are a keen athlete, possibly focus on swimming, cycling and aqua-running if it is not too uncomfortable for you.
You obviously require further investigation of your condition. Orthopaedic consultation may be of benefit. Being 20, and having had this pain since you were 17 suggests your injury could possibly be related to your ?growth plate?, also called the epiphyseal plate ? the area of growing tissue near the ends of the long bones in children and adolescents.
The growth plate determines the future length and shape of the mature bone. Injuries to the growth plate are called fractures. Since these growth plates are the weakest areas of the growing bone they are vulnerable to injury. On a positive note, about 85 per cent of growth-plate fractures heal without any lasting effect. Some tests that may help to diagnose a growth-plate injury include magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound.
Generally when exercising, to help minimise the risk of unnecessary injury, it is beneficial to acquire good habits from the beginning. Maintaining good technique is always vital, as is using correct equipment for whatever sport you are involved in. Performing a proper, suitable warm-up that mimics your sporting activity will help reduce injury. Don?t permit your calves to become too tight. Avoiding excessive activity in terms of accelerated intensity, frequency or time will allow your body to adapt to the extra strains.
If you can manage to be active in a variety of sports rather than being involved in the same sports all year round, it will help reduce the likelihood of injury.
Another possibility in your case is ?compartment syndrome?, which can be caused by repetitive activities such as running. If this is the situation, the pressure in a compartment (or confined space) such as your lower leg only increases during that activity. The compartment is taken to include the muscle tissue, nerves and blood vessels. Similar to the way in which insulation covers wires, fascia surround these structures.
There are several symptoms to look for before determining if this is what you have. The presence of pins and needles, weakness, decreased sensation, paleness of skin or severe pain regardless of painkillers would all be examined.
I hope you manage to get further examination and advice for your pain, which has been going on for too long.
I have an awfully itchy back, from my shoulders to my waist. It?s driving me mad. The only relief I get is after showering. My GP gave me Betnovate, and I use E45 and aqueous cream without any great effect. Teresa F, by email
DR DAN RUTHERFORD WRITES:
Itches can be really difficult to puzzle out because there are so many possible causes. Some arise from internal reasons, for example, liver inflammation, or a side effect of some drugs. When these are the cause the itch is usually felt widely over the body.
The fact that your itch is localised to a fairly specific area suggests the skin itself is the problem. Seborrheic dermatitis is a common skin condition that may affect the back. Although it may also appear on the scalp, face and front of the chest it doesn?t have to.
Fungal skin infection is a cause, so I suggest you try applying clotrimazole anti-fungal cream (available without prescription) twice a day for a week. If no use, then it?s back to your GP, I?m afraid.
I cycle with a club one day a week and most days for about half an hour on my own. We have members who now avoid the hills or have an electric motor to assist on the uphill. Is it possible to continue to develop muscle or is muscle atrophy inevitable? Mike Skiffins, Sussex
TONY GALLAGHER WRITES:
It is truly heartening to hear about you and your colleagues.
It is accurate to say that functional capacities decline with age. The most prevalent of these are maximum oxygen uptake and muscle strength.
In addition to the decline in muscle mass there is usually a decrease in flexibility and lung capacity.
A key point, however, is that some of the decline in functional capacity is due to inactivity. Age group records for many sports show that individuals who remain active are capable of high levels of physical activity even into their seventies.
As with younger people, the body retains an ability to adapt to exercise throughout life. Such adaptations that occur in older exercisers after a period of training include improvements in oxygen uptake, muscle mass and strength.
An active lifestyle can help counter the age-related decline in functional capacities and mobility. What you are doing will help maintain your cardiovascular levels.
Resistance training is useful, too. After an initial lower level of intensity targeting muscular endurance, it is worth trying three sets of eight repetitions to enhance muscle hypertrophy (where muscles increase in size), but allowing plenty of rest between workouts.
More muscle means stronger bones, so maintaining muscle mass will help fight off osteoporosis.
SECOND OPINION Dr James Le Fanu
In short, growth is important
Height should not matter, but it does. Tallness has always been a valuable characteristic, particularly in men, distinguishing the ruler from the ruled, the rich from the poor. Those fortunate enough to be 6ft or more benefit from a persuasive discrimination in their favour. The short, conversely, consider themselves at a disadvantage, and are more prone to low self esteem and hypochondriasis.
There was a time when height was powerfully determined by the amount and quality of food during childhood, with the result that in the 18th century upper class recruits to Sandhurst were, on average, an astonishing 7�in taller than the (much humbler) recruits to the Marine Society. By 1950, this differential had shrunk to 3in and now stands at a minuscule quarter of an inch.
Hence nowadays the prospects of boosting the height of short statured children rests with injections of growth hormone. This was at one time distilled from ground-up pituitary glands removed from the brains of the recently dead and proved an effective treatment for dwarfism due to a deficiency of the hormone.
But when in 1986 it became available in a genetically engineered form; the possibility arose of extending this benefit to the much greater numbers of the ?naturally short?.
This was clearly controversial, and expensive at �80,000 for a 10-year course of treatment ? whose long term effects, as analysed by Dr Annalisa Deodati of the University of Rome, add a modest extra inch and a half to the final predicted height.
The important exception is for children whose short stature is associated with being born prematurely or who have ?delayed infancy childhood transition? at 36 months ? known as slow development.
health magazine for women women health services women and mental health issues health care for women womens-health.co.uk
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