Periostitis: causes and treatments

Possible causes of periostitis in runners

Among injuries that can plague new runners, periostitis is probably the most common. It often appears as pain in the middle third of the inner leg, near the junction between the bone and the calf muscle. It causes inflammation of the periosteum (the layer of tissue that surrounds the bone) due to overly intense contractions. It is sensitive to the touch and can extend over several centimetres. 
In addition to the sharp pain or even burning sensation, the tissue may become indurated (hardened), since periostitis is always associated with a degenerative process. The root cause of the problem is the deterioration of the tissue due to a stress that exceeds the body’s ability to heal itself. That’s why it’s so important to figure out what caused the runner to develop periostitis.

Faulty technique

One of the most common causes of periostitis is a faulty gait. An improper foot strike can place additional pressure on the bones and myofascial system. Here are some common errors: 

• A pace slower than 170 steps per minute;
• Too much bounce (vertical lift) in your stride;
• Knee in full extension when the foot strikes the ground.

Recommendation: Make an appointment with a running expert for a detailed assessment of your gait. They will give you some tips on how to conserve your energy and prevent injuries.

Click here to find out more about the running assessment.

Lack of mobility

Periostitis is often caused by limited mobility of the tissues in the leg. An old trauma or gradual loss of mobility can cause tissue adaptation, reducing the connective tissue’s stress threshold. To prevent running injuries, it’s important to work on the flexibility of all the muscles and joints in your calves and thighs.

Recommendations: Stretching exercises for the posterior chain muscle are crucial to developing the flexibility needed to relieve the pain caused by periostitis. A good exercise to complement running would be yoga, especially if you struggle with generalized mobility issues, for example, due to poor posture.

Lack of stability

A very common problem in beginner runners is a lack of stability in the pelvis and core. Proper joint alignment when running is key to preventing injuries. A common mistake is allowing the knee to fall inward past the second toe (knock knees). The twisting motion caused by this instability will increase the tension on your periosteum.

Recommendations: Strengthening exercises for the glutes and core muscles should be part of every runner’s routine. A set of 4-5 exercises at least 2-3 times a week will go a long way toward preventing injuries.

Examples:

Training mistakes

The most overlooked aspect of any training program is gradual progression. All running injuries are related to an excess of mechanical stress. When the stress exceeds the tissues’ capacity for adaptation, tissue damage occurs. We need to give our body enough time to heal itself and become stronger. The amount of time varies depending on your age, your experience, the intensity of your workouts, etc. Above all, you need to pay close attention to the following aspects of your training:

1. Total volume (“Too much”)
2. Duration (“Too soon”)
3. Speed (“Too fast”)

Recommendations: Consult a trainer, a kinesiologist, or other expert in periodization for advice about your training program. They will be able to recommend an appropriate training load for your running ability and recovery capacity, based on your goals. When it comes to progression, the basic rule is roughly 10% more per week.

Genetics

Certain rheumatoid diseases, including osteoporosis, can affect tissue density, making the body less resistant to the mechanical stresses of running. In that case, you’ll need to account for extra adaptation time and be hyperaware of how quickly your training progresses.

Recommendations: As we age, our body’s tissues become more fragile and take longer to heal. A proper diet plays an important role in getting all the foods you need to help your body recover. A nutritionist can help you determine your needs and guide you toward the right food choices.