All you need to know about shin splints!

Do you suffer from lower leg pain?

Below your knee either on the front outside or inside part of the lower leg?

You might have shin splints!

By Xavier Mc Creanor

Shin splints or medial tibial stress syndrome (MTSS) is a symptom complex seen in people who complain of exercise induce pain along the distal posterior-medial aspect of the tibia. In other words, pain on the front part of your shin.  You might experience pain around the inside of the shin bone, outside of the shin bone or even pain on the shin itself (see image below).

So, what does this mean?

Pain due to overuse along the shinbone, the large front bone in the lower leg. This injury is caused by the excessive amounts of force on the shin bone and tissues attaching the shin bone to the muscles surrounding it. This force causes the muscle to swell and this process increases the pressure against the bone leading to inflammation and pain. Little cracks can also occur in the bone due to overuse.  When the body doesn’t get enough time to repair these miniature cracks it can lead to a complete stress fracture or in severe cases a complete fracture. That’s why we recommend that you see a physiotherapist before tying to treat it your self to rule out more serious problems, like stress fractures or compartment syndrome.

Who can get shin splints?

You don’t have to be a professional athlete to get shin splints.  However, many athletes, runners, squash players, even dancers and gymnasts do get shin splints. Beginner runners who don’t start with a gradually increasing training program or seasoned runners who change their workout routine by suddenly adding too much distance, or switching from running on flat surfaces to hills.

Why do you get shin splints?

Shin splints are usually associated with doing too much too soon. However, sport scientist and medical experts has identified several ways you can obtain a shin splint injury. Here are a few examples;

• A sudden change in your training routine or an intensified training program.                                                                 
• Sport that requires a quick take of or hard landing.                                                                                                               
• Overpronation (excessive range and speed of foot pronation).                                                                                             
• Insufficient stretching.                                                                                                                                                                    
• Worn shoes (incorrect footwear).                                                                                                                                                          
• Poor muscle function around the hip and knee, overloading the shin.                                                                                                             
• Excessive stress placed on one leg or one hip can also cause shin splints. In runners specifically shin splints occur when their dominant leg is involved.  If you’re right-handed, you’re usually right-footed as well, and that’s the leg that’s most likely going to hurt. Beginner runners who have not yet adjusted to the stresses of running usually get anterior shin splints due to the imbalances between the calf muscles and the muscles in the front of their leg.  If you are a beginner runner we suggest that you do several stretches before and especially after your run.

How do you treat shin splints?

Health care professionals agree that when shin splints strike you should stop training completely or decrease your training depending on the degree and duration of pain. Then, as a first step, ice your shin to reduce inflammation. Here are some other treatments you can try;

• Make sure you wear the correct running shoes for your foot type specifically, overpronators should wear motion-control shoes. Severe overpronators may need orthotics. Have two pairs of shoes and alternate wearing them to vary the stresses on your legs.  If you suspect that you are overpronating we recommend that you see a podiatrist for a professional opinion.                                                                                                                                         
• Let a healthcare professional or exercise specialist look at your training programme and make sure any changes in your training are done with a gradual build (volume and pace). Consider cross-training for a while to let your shin heal. Swim, run in the pool or ride a bike. Hills and excessively hard surfaces should be avoided until shin pain goes away completely.                                                                                                                                                                                        
• If there is no more pain after the injury you need to strengthen the necessary muscles. We suggest that you do calf raises, bent leg calf raises, foot raises (with Thera-band resistance), toe taps while seated on swiss ball and pronation control exercises.  These exercises will build strength and endurance in your gastrocnemius, soleus, tibialis anterior and tibialis posterior muscles, essential running. It’s advised to do all four exercises to fatigue. The exercises are technique-based, and you should do as many as possible up to 4 x 12 reps but stop if technique fails. Build up slowly, running them all every day if you already suffer from shin splints. Feel free to contact us if you need help with setting up the best exercise program to manage your shin splints.                                                                                                                                                                                                          
• Stretching is also important. After you complete any exercise program it is important to finish off with stretching the gastrocnemius, soleus and achilles muscles. You can do this by doing a calf stretch or using a foam roller over the calf muscle. 

For more information on shin pain or other injuries don’t hesitate to contact us for a full assessment.