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Ask Dr. Dan: Take It On the Shin

Is there any true cure for shin splints? Not really.

Q: I’ve been trying to do some more cardio by walking outside while the weather is nice, but I can only go about half a mile before I get a terrible pain in my shins. It can’t be my conditioning because I do two miles on the treadmill three times a week. Do you think I might have a fracture or something?

A: You’re describing a very common condition called anterior compartment syndrome, or, more commonly, shin splints. I can empathize, as I suffered from severe shin splints in college.

The pain is caused by swelling of the anterior tibialis, a muscle that runs down the front of the lower leg and lifts the front of the foot. The reason the swelling is such a problem is that the anterior tibialis is contained within a tight compartment. Unlike most other muscles, which can swell without restriction, the anterior tibialis only has a limited amount of space.

When the anterior tibialis swells, it’s compressed against the compartment and blood flow is restricted, cutting off the supply of oxygen. As the swelling increases, so does the amount of damage.

Is there any true cure for shin splints? Not really. The swelling will be relieved with rest, though the medical literature notes many cases that required surgery to relieve the pressure and prevent muscle damage or cell death. You might consider changing your route to avoid steep hills. Many people use massage, ice or anti-inflammatory medicines such as ibuprofen or aspirin with limited success. Rubbing DMSO on the affected area relieves the pain, though a sour, garliclike odor permeates the sweat and breath of users. Some DMSO users have become ill after using it on an area that was not clean. Apparently, bacteria on the skin passed into the bloodstream, causing the athletes to become very sick.

Take shin splints seriously. Many times they are associated with minor fractures and can lead to severe muscle damage. If the condition persists or you experience it frequently, see your physician.

Q: I want to get the most from my creatine supplement and have been looking at using vanadyl sulfate. Does it work, and, if so, how much should I use? A: You’re probably after the insulinlike effect of vanadyl sulfate.

Vanadyl sulfate was the first insulin mimetic to really grab market share. It is derived from vanadium, a naturally occurring element. Interest in vanadium forms has grown since researchers noted that it corrected diabetic conditions in certain rats. The data on vanadium is very extensive, and it all seems promising; however, the data from the animal studies did not translate perfectly to humans. The rats used in the studies were poisoned with a chemical that destroyed the pancreas, which produces and releases insulin. After the poisoning the rats were unable to respond to carbohydrates. When the rats were given vanadyl sulfate, their blood sugar became normal. Test tube studies showed that vanadyl sulfate drove sugar into the muscle cells.

Similar relief was noted in some studies done with diabetic humans. They suggest that vanadium drives sugar, amino acids, creatine and so forth into the muscle cell; however, that did not necessarily happen. Healthy athletes are different from diabetics’and from rats. Vanadyl sulfate appears to offer little to people who have normal levels of insulin production and release. The signal of vanadyl sulfate does not overwhelm that of insulin and does not appear to change the amount of insulin released following a meal. Additionally, there may be a down-regulation, or decreased response, to vanadium over time.

Vanadium may nevertheless offer promise. It may decrease the liver’s use of amino acids to generate sugars and starches for energy and thus may preserve muscle-protein stores. Vanadyl sulfate won’t be of any noticeable benefit to most athletes, though. Caution would be the best approach because some heavy metals can be toxic to certain organs, such as the liver, bone marrow and heart. You should take no more than 50 milligrams a day and only with meals, if at all.

Q: I just competed in a bodybuilding show and noticed that the posing caused more soreness than I get after the most intense workout. Why?

A: Posing is very like isometric training. I, too, have awakened the day after competing feeling as though I’ve had the most intense workout ever. I have heard similar comments from people who practice martial arts, particularly those forms where maximum tension is held through slow, smooth motions.

The strain and damage caused by isometric exercise are similar to but not exactly like eccentric lifting. In eccentric lifting you’re fighting a weight as the muscle is lengthening. Lengthening muscle in the contracted state causes the micro-damage, which is supposed to stimulate the recovery and growth in muscle size and strength.

The same type of damage seems to occur with isometrics, although the muscle contracts against a fixed point rather than contracting as it lengthens. There are studies showing that the size of the muscle relates very closely to isometric strength.

So is it possible to grow or strengthen your muscles by just squeezing them a few times? No. It appears that optimal isometrics requires performing the movement to fatigue. Include isometrics as an alternative style of training’but not with every workout. I would suggest adding whole-body isometrics session for about 20 minutes or less once a week. That doesn’t mean holding an isometric pose for 20 minutes. Try to hold for 20 to 30 seconds, then take a short break, hold another pose for 20 to 30 seconds, repeat. You can alternate the types of poses you use. You’ll end up going through 30 or 40 during a full session. My experience tells me that you’ll need to condition yourself to holding maximal tension in an isometric manner. You’ll be lucky to get five minutes’ worth during your first session. Don’t get discouraged. You will become conditioned to the posing and will be surprised at how the new training style will harden your appearance and stimulate vascularity.

Editor’s note: Daniel Gwartney, M.D., is a clinical pathologist and a graduate of the University of Nebraska College of Medicine. He’s been bodybuilding for more than 18 years. The material presented in this column is for general-information purposes only and is not to be construed as medical advice or an individual recommendation. Consult with your physician or health care provider before embarking on any fitness, training, diet or supplementation program. The author and IRONMAN assume no liability for the information contained in this column. IM

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