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Unpleasant periostitis: symptoms, causes and treatment

Unpleasant periostitis: symptoms, causes and treatment

24. 10. 2022 6 min. reading

Periostitis is one of the common health complications for runners. With inadequate treatment, the pain can last for months. How to recognise it, cure and put on running shoes again?

A sharp pain in your shin that makes it impossible to run. Periostitis, or tibial syndrome, is one of the most common health complications for runners. Are you sitting at home with this problem right now? Keep on reading to see what treatment options you have and how to prevent it in the future!

What is periosteum?

It's not a bone, it's not a tendon, it's not a ligament. Then what is it? The name periosteum is actually quite accurate and can tell you a lot - it is the thick fibrous membrane that is found around a bone. It's made up of blood vessels, capillaries, and nerve endings and this means that it's superbly vascularised and very sensitive to pain.

The symptoms of periorbital inflammation

It probably won't surprise you that pain is one of the primary indicators. Specifically, tibial pain that occurs during exercise, but also at rest or when palpating the affected area. Next comes swelling and problems with mobility. While these symptoms may look innocent at first, pay attention to them. Catching them early and then starting to solve the problem is the key.


What are the causes of tibial syndrome?

Periostitis is one of the most common health problems in runners. It can surprise you at the beginning of your running journey, in preparation for a race, but it also haunts professional athletes. What are its most common causes?

  • Inappropriate footwear - Again, we know, but the proper running shoes are the basis. However, the word "proper" means something different to everyone. Choose shoes not only based on design, goals, or preferences but most importantly, based on your health and foot shape. Check out our guide on how to choose running shoes.
  • Poor running technique - Poor stereotypes and movement patterns can cause joint overload, muscle imbalances, and other discomforts in addition to inflammation of the periosteum. There are tried and tested tips on proper running technique, but the best advice is given by a running coach in a personal meeting.
  • Ankle deviations - Running deviations, pronation, and supination, are primarily related to ankle misalignment, but affect the overall posture and movement of the legs during running. If these deviations are excessive, they can cause health complications, including tibial syndrome.
  • Excessive physical load - A sudden increase in the volume of running kilometers is a shock to the body and it is the pain that makes the body ask to slowing down and rest. If you start to feel pain, don't ignore it, but adjust the volume and frequency of your workouts.
  • Bad regeneration - And the rest again. A hackneyed but unfortunately still neglected topic. The body needs plenty of time to recharge and recover after exercise. Basic forms of recovery include rest days, regular stretching, quality sleep, a balanced and rich diet, and drinking water. You can also use a foam roller, sports massage, or cold water therapy.
  • Previous health problems - If you have had Achilles tendonitis or a fatigue fracture of the tibia or fibula in the past, you will be more likely to develop periostitis. If this is your case, the emphasis on proper footwear, running technique, or recovery needs to be even greater!

Top4Running TIP: As a running specialist, we can help you choose your shoes. Try our Shoe Finder and find out which shoes we recommend!


How to heal periostitis?

We know that no runner wants to hear this, but the most effective healing method for periostitis is rest and a break from running. The exact time depends on the severity of the inflammation. If it is caught in the early stages and the pain is not that sharp, allow yourself two to three weeks of rest. If the inflammation is widespread, the rest period can go up to two months.

How to speed up the healing of inflammation?

  • Icing - Ice the affected area at intervals of 15 - 20 minutes and repeat several times a day. Do not put ice on the skin but over a towel to avoid hypothermia or, in the worst case, skin burns.
  • Gels - Ointments and gels for the tibial syndrome are also effective in relieving pain, and swelling and speeding healing. Try a hemp or zinc ointment.
  • Compression sleeves - They improve blood circulation to the limb and effectively fight swelling.
  • Shock wave - A painless method of physiotherapy that accelerates the treatment of inflammation and relieves pain.
  • Kinesiotaping - Proper application of the tape helps to circulate the lymph and relax the affected area.

Although treatment can be lengthy, don't underestimate it. If neglected, you risk a return of inflammation in an even greater form, chronic pain, and in the worst-case scenario, the periosteum being torn right off the bone, which means tremendous pain and a running stop for a long time. But don't worry, it doesn't mean you can't be active. You can try other sports that won't put stress on your foot, such as cycling, swimming, or skating.


How to prevent periostitis?

How can you reduce the risk of inflammation?

  • Add physical load (volume of km) gradually and systematically.
  • Warm up before each workout.
  • Focus on running technique and try to learn to stride through the middle of the foot.
  • Combine road and hard surfaces with soft forest paths. Check out the shoes suitable for running in the forest.

The above tips are functional but general. For individual advice, consult a running coach who will help you with proper technique and create a running plan in line with your goals.

What does a running plan look like? Read our articles for advice on the first 5k or 10k.

5k running plan 10k training plan

Back to running slowly but surely

Your foot is no longer sore and no longer swollen, two to three months of rest are behind you and you can't wait to put on your running clothes and go for a run. We totally understand! But listen, your "back on track" process should be gradual. First, include an easy run two to three times a week (depending on your performance) at a leisurely pace and make sure the pain is really gone. We recommend that you consult an experienced physiotherapist who will keep an eye on your condition for treatment and return to running.

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