ZC sports therapy

Training & Nutrition blog

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Shin Splints, Periostitis, Stress Fractures and Compartment Syndrome

I’d like to share with you something that happened to a friend of mine who has just run his first 100 miler ultra. He finished the in just over 25 hours and in second place. Not bad for his first 100! That night after the race he was taken ill and the next day was sent to hospital. Long story short. During his training he had ignored shin pain. He ignored the signs of shin splints (Medial Tibial Stress Syndrome) and continued training.
The MRI and X-rays at the hospital showed he had suffered multiple stress fractures in his tibia. These had probably come as a direct result of ignoring the shin splints.

MTSS anterior and posteriorThe stress fractures had caused the muscle groups in the calf to swell within their fascia and further progressed to suspected Compartment Syndrome.
If not treated within literally a few hours, muscle tissues can begin to die in a process called necrosis. When this happens nerves die as well. The result can be a loss of a limb. There is a procedure to treat Compartment Syndrome, a Fasciotomy. Trust me NO ONE WANTS TO SEE PICTURES OF THAT PROCEDURE! the lower limb is surgically opened thought the skin, fascia and muscle and left open to allow the compression to ease. So after completing his first 100, he then spent 48 hours in hospital.
Know the first red flags of shin splints. Shin splints can lead to Periostitis, can lead to stress fractures, can lead to Compartment Syndrome. I am not here to scare you, I’m just being the hard voice of reason. Do not think you can run through them. Go and see a therapist who will treat you and give you advice on how to proceed with your training.
Running 100 miles is an awesome achievement. Winding up in hospital with what CAN turn out to be a fatal condition, isnt’.
Be safe. Be savvy. Be respectful of your body.




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Tapering is an interesting thing isn’t it. Slightly baffling as well. I’ve been lucky enough to be able to speak to quite a few experienced endurance runners, athletics coaches and fellow therapists. Some interesting advice all of which makes sense and some of which has been eye-opening. 

a) You don’t need to over taper. Some runners cut back so much in their tapering for fear over doing too much that they end up doing too little.

b) When tapering, you don’t need to eat as many heavy carbs as you did when you were running long. The old saying of ‘carbo-loading’ ie; pasta parties and the like the night before, just puts your digestive system under too much strain. You need to ‘load up’ right the way throughout training and in the week before. Not the night before. It’s normal to put on some weight but not arrive at the start line overweight.

c) Eat light three days before the event. Eat well but avoid heavy starchy carbs and go for more protein. Some people I know have a purely liquid diet the day before so they race ‘light’ on the day.

d) Work on you mental preparation in the week before.

e) Enjoy the experience. (!) forgot this bit….

d) After the race, as long as you’re not injured! aim to do a light tempo run no more than 36 hours after the event. If you can’t manage that, swim. If you can’t walk, roll to and then into the pool. And then roll home.

These have been the last snippets of advice given to me. Some of it I knew, some of it I certainly didn’t. This is not from a book or ‘how to’ manual. Just stuff from people I thought I’d pass on because I found it useful.

Oh and AVOID WETSUITS!! I tweaked my hamstring getting out of mine when I went sea swimming. Dangerous bloody things.

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‘Time on your feet’

Stanmer Woods


Now I’ve done the longest run on this training programme which was 22 miles of the 3 forts, I’m just going out to do ‘time on your feet’ runs. Not looking at pace or distance so much but how long you’re running for.

Did a relatively sedate 2 hours through Stanmer Woods today. Avoiding the South Downs this week as my Achilles took a bashing after 22 miles of hills in the last.

Into the last section of this 27 miles training and I can’t help feeling a little inferior to those friends I have who are ultra runners of 50 and 100 miles. I said to someone earlier this week that he started somewhere. He wasn’t just able to go and run 100 miles. He’s done 50’s to build up. The fact he is an ex Royal Marine also helps. Significantly. His ability to deal with pain is quite different from mine. Military conditioning.  If I could learn some of the coping techniques from him, I reckon I’d be a better long distance trail runner. I’ll have to ask!

I’ve never run more than 13 miles last year and swore I wouldn’t, and here am I being cajoled into contemplating a 30 miler called the Doyen of the Downs later this year, that’s after I’ve gone to the Lake District and done another trail marathon in July.

Ultra runners. They’re like dealers pushing their gear. Run this 30 miles race it’ll be so much fun….so you do and then what. You’re hooked! Damn them.

The woods today were just springing into life. The trees smelt wonderful! Wish the MTBers would stop creeping up on me though giving me heart seizures! Pesky bikers.




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Beeding Hill….Bleeding Hell


Decided to run a 27.2 mile trail race on my ah hem ‘big’ birthday this year. It will be my first marathon. I could have decided to go for a marathon on the flat, but instead I picked the hilliest local race that I could find. Well, why not.

I will have run the whole course by the time race day gets here, broken into sections. This weekend I’m going to do the entire ‘east of the river’ section and then on the Sunday next day, I’ll go back out and do the entire ‘west of the river’ section.

This is a training suggestion from a friend who is a tri coach and himself an IM. Run the whole course but split over 24 hours.

I’m not sure what is worse, the slow and relentless uphill of the South Downs or something far more aggressive and sudden. Either way they hurt and there’s an elevation total of 3,450 of climb. Nothing in comparison to what you’d get up North, but it’s painful enough.

Apart from the obligatory blisters and feeling sick (!) the runs have been solitary but manageable. Always preferring to run by myself. No point running trails if you need someone with you to chat or you have to plug into your music. Misses the point in my eyes. But then I’m not running 100 plus miles so maybe when you get to that level of endurance running you need a buddy there.

The chia seed frenzy that many local Brightonians are embracing is soon coming my way I feel. With offers of gels and biscuits and this and that being given to me, it won’t be long until these rather tasteless Peruvian seeds claim me as one of their devoted.

I’m almost looking forwards to the pain and the tears; for there will be tears once I get across the finish line.

Bleeding Hell


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“What exactly do you do?”…

Today I was asked, “What exactly do you do?” If you come to me with an injury or persistent nagging pain, I will look to the cause of the problem and treat. I don’t go in for patch up jobs that leave you coming back week after week, month after month. I work in a dynamic and interactive way, using a wide variety of soft tissue techniques, stretching, sports strapping and taping, foot mobilisations and medical acupuncture.

Working with you, I can advise on rehab and what you can do to keep on enjoying the sport or exercise that you love. Far more than just massage, I’ll look at the biomechanics and functionality of your body. No patch up jobs. No unnecessary repeat visits.

The race season is nearly upon us, again. Nagging injuries, nag for a reason. Please don’t ignore the red flags.

Listen to your body.