Shin Splints - What are they? How do I treat them?

As more of us find the motivation to actually do something about our fitness, we are seeing an increase in the number of complaints of shin soreness.  This is particularly the case in people who have had a long layoff from running and attempt to run as far and as fast as they once did.  There are any number of reasons why you should increase your daily exercise and running is one of the best ways to do that .  However, shin soreness, or shin splints as it is also known, should not be the reason to stop.  The condition is treatable and preventable.

Symptoms: 

Shin splints are generally characterised by aches, general soreness or burning sensations over the front and sides of the lower leg, especially the inner side.  The pain may be just a nagging ache, usually associated with running or aerobics.  It may start gradually but develop into a noticeable pain over a period of time.  It is often difficult to remember how the pain began, as it seems to just creep up on you.  The shins may occasionally be swollen and the pain worsens with activity.

Causes:

1. The feet are not correctly aligned.
2. Footwear is worn, loose or of the wrong type for the exercise, e.g running in basketball shoes.
3. Habitual wearing of high heels.
4. Inadequate warm-up before exercise.
5. A change in the ground surface, e.g. from road running to treadmill running.

Treatment:

As with any sports injury, the principles of First Aid must be followed to ensure the effects of the injury are minimised and that a full recovery can be achieved.  The general method of treating non-serious injuries such as shin splints, muscle stiffness or soreness, etc is called:
“R.I.C.E”

R – Rest: Reduce or eliminate your exercise program until the pain and/or swelling disappears.  It might be possible to switch to an alternate form of exercise that doesn’t affect the injury.  For example, walking or cycling are excellent substitutes for a high impact activity, although in extreme circumstances, even walking causes some pain.  Therefore, moving to non-weight bearing exercises such as stretches, swimming or cycling combined with your regular upper body and abdominal work would be recommended.

I – Ice: Apply ice to reduce the swelling.  It should be applied for 10 to 20 minutes several times per day, but especially, directly after exercise.  This also helps to reduce pain.  Use a thin dampened towel between your skin and the ice, as direct application may cause “ice burn”!

C – Compression: While not absolutely necessary, applying a compression bandage around the lower leg at night will help minimise bleeding into the soft tissues and reduce swelling.

E – Elevation: Elevate your legs.  If possible, keep them above the level of your heart.  Sleeping on your back with pillows under your lower legs will work.

Prevention and Management:

Warm up and stretch the shins thoroughly before beginning your exercise and Rest, Ice, Compression and Elevation immediately after exercise.

The muscle that runs the length of the shin is the Tibialis Major and is responsible for flexing the ankle, that is lifting the foot upwards.  Keeping this muscle strong and flexible is a key factor in shin splint prevention.  Kneel on the floor with your feet extended and your butt resting lightly on your heels and soles of the feet.  Gently lean back until you can feel the Tibialis Major beginning to stretch and stop before it becomes painful.  Hold the stretch for a count of 10 and return to the starting position.  Repeat the stretch 3 or 4 times before your begin your run and again during your cool down.

More often than not, the cause of the shin pain is the age and condition of your running shoes.  Yes, I know that old shoes are comfortable but with modern technology, shoe fitting techniques and manufacturing processes there is absolutely no reason why you cannot replace your running shoes every year.  In fact, that should happen regardless.

If you have properly fitted shoes and you stretch consistently but still suffer from shin splints, it may be time to consult with a good podiatrist.  They will analyse your foot structure, biomechanical movement and, if needed, can prescribe orthotics to correct any structural anomalies that may be causing the problem.

Whatever your do, do not ignore the pain.  It is your body's way of telling you that something is not quite right.  Equally, do not allow the pain stop you from becoming a fitter, stronger and healthier you.