Jon Beyle wrote me this: “I would also like to get your thoughts on something. I just got off the phone with a girl who has been playing field hockey at Princeton and her career is being threatened by lower compartment syndrome. She had the release surgery and it did not help much as of yet. she has a friend who plays D1 soccer who has the same thing. She told me also that she ran into a D1 field hockey coach at another major university who said this is becoming epidemic (shin splints, lower compartment, etc.). What are your thoughts on this?”
This surgery was quite the rage a few years ago. I actually thought it had gone out of favor. This is a classic example of reductionist medicine – focusing on the symptom rather taking a giant step back and looking at the big picture. Because there is pain and swelling there then you operate. Bottom line is that 9 times out of 10 the operation does not work. Think global, look above and below the problem. I am of the opinion that the problem really stems from the inability to properly shock absorb, the big shock absorber that needs to be developed is the butt. Movement mechanics must be addressed – how they stop and change direction. Look at the foot, more specifically is the subtalar joint locked up.If it is then mobilize it.
As far as the shin splint issue it is much the same answer. I know field hockey must play on a very firm and generally unforgiving surface, so look at opportunities to train off the surface for non technical work. Look at foot wear, I have found that rigid shoes often are the culprit. In collegiate and national team environment the players are often forced to wear sponsors shoes and all of one style. That shoe and style may not be correct for the individual athlete. The common solution for “shin splints” is to dorsi flexion exercises which can cause more harm than good because the anterior tibialis main job is to help decelerate the foot. Once again work above and below. Excessive weight is another issue, tough to address with the female athlete. When they are too heavy gravity wins! Not an easy problem to solve, but with work it can be done.
Vern Gambetta
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