A Runner’s Bane

Question: I’m a 44 year-old man who recently got back into exercising after my friends encouraged me to work out as a way to lose weight. But after jogging a few times, there was swelling on my left shin. The doctor said it was “shin splints”. Why did this happen and should I stop exercising?

Answer: Shin splints are a common problem in people who take up running. Usually occurring over the inner aspect of your shin, the pain can arise from a number of different problems, ranging from stress reactions in the bone or simply due to your running style. Stopping running will probably help with the symptoms, but it may recur should you decide to take it up later. If you do want to continue with activity, it might be worth seeing a sports physician or podiatrist for their opinion.

Dr Dinesh Sirisena
Sports Medicine
Khoo Teck Puat Hospital

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Sole Uncomfortable

A lady sitting on the couch, massaging her feet

Question: I am a 35-year-old woman who wears track shoes most of the time. For the past month, there has been swelling of the big toe on my left foot, and occasional pain. The lower part of that toenail has also turned black. I do not recall injuring my foot and my shoes are the right size. What could be the cause?

Answer: It sounds like you have two skin problems. The swelling of your left big toe may be due to an ingrown toenail, a common condition that usually affects the big toenails. Pressure on the nail causes the nail edges to cut down into the flesh, causing pain, inflammation and sometimes even skin infections. Common risk factors for ingrown toenail include improper nail trimming, improper footwear (too tight or loose), repetitive pressure on feet such as during jogging or playing football, poor foot hygiene and pincer nails (where the nail edges are naturally curved downwards).

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In mild cases, proper nail trimming, footwear and foot hygiene may suffice. In more severe cases, a simple surgical procedure to remove the ingrown nail edge may be performed under local anaesthesia. In the case of infection, oral antibiotics may be required.

Nails can turn black for several reasons. The most common reasons are fungal nail infections (onychomycosis) and blood collection under the nail (subungual haematoma) due to nail injury. In rare instances, this may be a sign of melanoma of the nail unit (subungual melanoma), a serious and potentially fatal type of skin cancer. You should seek medical advice early if the black area is getting larger, darker, and spreading to your surrounding skin folds, or simply not improving.

Dr Suzanne Cheng
National Skin Centre

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