Your Guide to Shin Splints (And how to avoid, identify and treat them!)

Your Guide to Shin Splints

(And how to avoid, identify and treat them!)

    The bane of those from all walks of active life – runners, tennis players, even dancers – shin splints causes severe pain in the lower leg below the knee, either on the front side of the shin (anterior shin splints) or inside the leg (medial shin splints). They often afflict beginning runners who do not build their mileage gradually enough, but can similarly affect seasoned runners who abruptly change their regime, adding a sudden increase of mileage, for example.

    The root cause of this debilitating syndrome can most often be whittled down to four little words: too much, too soon.

Identifying symptoms of shin splints:

“Shin splints” is the umbrella term for any non-specific posteromedial leg pain, and the primary symptom is severe pain down the front part of the leg (or inside the leg with medial shin splints), usually starting during physical activity.

This pain does not necessarily indicate that anything more serious like tibial stress syndrome is present though, as it is often misdiagnosed with a few other problems like compartment syndrome - the swelling of muscles within a closed compartment, as with the lower leg - or with a stress fracture - a more serious injury wherein the bone is incompletely cracked. Both of these syndromes can be specially diagnosed and definitively blamed as a cause for shin splints.*

Shin splints is more generally felt as painful tenderness down the front side of the shins and, unlike a stress fracture, the pain will worsen over night as the soft tissue has had a chance to tighten. It may also be at its worst when you try to flex your foot upwards from the toes.

*If you run your fingers down your shin over the sensitive part(s), tenderness and pain should run more or less evenly along the entire shin front. If, however, you reach a sharp pain at a certain point, this may be a sign and symptom of a stress fracture. Always visit your physician should you experience this.

Common causes of shin splints:

There are many known causes of shin splints such as over-pronation (a frequent cause of medial shin splints), inadequate stretching before or after physical activities, worn-out shoes, excessive stress placed on one leg or one hip from running on cambered surfaces such as roads, or always running in the same direction on a track.

Although there is no ultimate consensus on what shin splints is exactly, some hypothesis include small tears in the muscle that's pulled off the bone, an inflammation of the periosteum [a thin covering of tissue that wraps around the tibia bone, or shin bone], inflammation of the muscles, or a  combination of any of these.

Thankfully, there is an agreement on the best treatment.

Treatment of shin splints:

• Experts agree that as soon as shin splints occur, training is to cease immediately, or at very least scaled right back. Rest is the single most important means of treatment, usually for 2-3 weeks.

• Ice packs should be applied directly the site to reduce inflammation.

• Non-steroidal anti-inflammatory drugs (NSAIDs) may be administered.

• Physiotherapy and electrical stimulation treatments may be prescribed in more severe cases.

• Rest for a short period of 2-3 weeks may be curative with no further treatment. ‘Cardiovascular conditioning may be maintained during this period with swimming, upper-body weightlifting and deep-water running’ (Baxter, Donald E. - Baxter’s the Foot and Ankle in Sport 2008). 

Prevention:

    Prevention is multimodal. In simple terms, the easiest way to avoid shin splints is to build intensity and mileage gradually. A gradual increase over a period of weeks or even months is the best approach.

    Being sensibly shod is key, also. The right running apparel matters to a lot of runners, but the most important item of clothing is often the most overlooked in terms of necessity – the shoes!
Supportive running shoes (and I mean shoes that are specifically designed for running, if that’s what you do!) are so important, it’s a make-or- break situation. Arch support, perhaps through orthotic in-soles, is a must. Which leads us on to…

    Surface – running the same direction on a track continuously puts you at risk of muscle imbalance on one side of the body, through the hip down to the ankle and foot. Similarly, cambered roads should be avoided, as the slope puts similar strain down one side of the body, which all may lead to shin splints. Instead, try and run on level track, or change direction occasionally to avoid repetitive negative influence on one side.

    Stretching - dynamically pre-run, statically post-run, is a simplistic guide. Consult your coach or other relevant professionals for a tailored stretching complex.

    Consulting professionals – approach a professional such as a podiatrist, a personal trainer, or a well-trained sales assistant at a reputable shoe store. They can provide you with a running gait analysis and determine what shoes are suitable for you, but also advise you on what to do about any running gait issues you may have (which may be causing your shin splints).

These are just a few of the most effective prevention methods. Always consult a physician or other specialists if you have any concerns, or if the pain lasts longer than a couple of weeks or gradually increases, even with rest.

Overcoming shin splints (or better, avoiding them) will aid you in your path to success.

Remember, always do your best and the best will be done by you!

Good luck!

Dom