Injury Prevention and Treatment

INJURY PREVENTION AND TREATMENT: SHIN SPLINTS

 

The dreaded shin splints…that familiar sharp, shooting pain up the front of your legs leaving you wincing in agony with every step. Typically beginning runners will feel the pang of shin splints, but they can afflict all different levels of athletes depending on your workout intensity, mileage, and foot support needs.

Symptoms and Why It Hurts:

The term “shin splits” is often used as a catch-all for lower leg pain that occurs below the knee, says Runner’s World, so it is important to distinguish where exactly your pain is located and describe what it feels like.

So what are shin splints exactly? What’s happening in the body that’s causing my misery? According to Runner’s World there are a few different things that could be going on. It could be micro tears of the muscle as it pulls away from the bone (not as intense as it sounds I promise), inflammation of the periosteum (a sheath that covers your bone), or inflammation of the muscle itself.

Causes:

Not everyone will have the displeasure of knowing the pain of shin splints, but those who do understand just how irritating they can be. Let’s first take a look at the causes for this particular brand of lower leg pain, then we can examine possible treatment options.

  1. Pronation

    Pronation 

Probably the most common cause of shin splints, like many other injuries associated with running, is foot pronation (or collapsing arches). When arches collapse there is a domino effect that throws the lower legs out of alignment and draws everything down medially (inward). This puts excess stress on the medial side of the ankles, shins, knees, etc. In order for your body to properly absorb shock, everything needs to be pretty much in line, or neutral. So if your arches are not doing their job in the shock department, then everything north (ergo, your shins) subsequently has to shoulder the burden.

2.    Overuse

Another likely culprit for the onset of shin splints is overuse. Have you increased your mileage recently? Have you increased the intensity of your workouts? Even if you do everything else right in your training with regards to injury prevention, you can still earn yourself some shin pain if you make an attempt to increase your workout duration or intensity before your body is ready. Getting too ambitious with your training can spell disaster and leave you laid up with shin issues. Also, excessive hill workouts or running on inclined surfaces can stress the muscles surrounding the shins too.

3.     Running Surface

Camber 

Something you may not have considered is the “where.” Are you running the same routes frequently? Do you spend a good portion of your time running on sidewalks? Here are some insider secrets that often go over looked. Roads are cambered, so if you run the same route, the same direction, on the same road every day you are probably running off-kilter and stressing your body unevenly. So run the route the opposite way or just switch it up all together. Be creative with your route choices! Furthermore, avoid running on sidewalk. Concrete is the worst on your body, offering no give. Choose asphalt over sidewalk, and choose dirt or grass over asphalt when available. This will help lessen the blow that your body takes pounding the pavement mile after mile.

Treatment:

Rest. Ice. Compression. Elevation. These are all important to a speedy recovery!

Rest: Taking time off is a pain, but often necessary. Shin splints can resolve in only a couple days or they could even take as long as a couple weeks. Trust me when I say that it is better to stop and take time off now in the early onset then it is to push through your training and be laid up for months with a stress fracture. Refer to my previous blog regarding cross training ideas.

Ice: Making sure to ice on a regular basis is critical! You can opt for a handy bag of frozen peas if you’d like, but there are more effective ways to ice. If you can, try to fill your bath tub (or a big *clean* trash can) with water and ice. Let chill to about 55 degrees and hop in! I assure you this polar bear plunge is for good reason. Since there are a few different origins for shin splints, your best bet is to ice everything from the knee down to cover all your bases. Going beyond superficial icing will encourage your body to circulate pooling blood in the legs (associated with inflammation) back up to the heart and rush new, freshly oxygenated blood in to help heal tissues.

 Ice baths

*Ice for 12-15 minutes at a time, no longer! Too long and you will be looking at problems far worse than shin splints.*

Compression: If you still are not feeling any relief, look into some form of compression. Calf sleeves and calf socks – we carry the brand CEP – are made with a graduated compression designed to increase efficiency in circulation thereby decreasing recovery time and encouraging proper blood flow to your needy tissues. Also, the added compression to keep your tendons close to the bone to prevent stress (Runner’s World).

Stretching: Making sure to stretch the Achilles and calves can help ease tight muscles that could be pulling and aggravating your shins. Developing a thorough stretching routine after your run is important for overall health and fitness. We do sell books which focus on proper stretching that may be worth your time, and you can also do a search online for examples.

Proper Shoes: Need I say more? This is a reoccurring theme with each blog post and frankly the reason Sierra Running Company exists. We want to help you find the right shoe so we can limit your chances of injury. The proper shoe is a worthy investment.

Strengthening

Taking some extra time to do some strengthening exercises can help shorten your recovery time and greatly decrease your chances of having shin splints reappear. Strength discrepancies are often the culprit for shin splints, occurring when the calves too strong and begin pulling on the muscles surrounding the shins. The body is built on opposing muscles groups and when there is an imbalance it usually means an injury is on the horizon.

Note: Strengthening exercises should not be done while the shins are still highly inflamed as this will most likely increase irritation, doing more harm than good. You are better off waiting until most of the tenderness and inflammation has subsided.

The Catwalk

Get your inner model on! This exercise works all your lower leg muscles which will help even out any strength discrepancies you may have that could be contributing to your shin pain. For about 10 meters, walk high on your toes with feet slightly flared to the outside (like a duck). Then walk 10 meters on your toes with feet pointed inward (pigeon toed). Switch it up by then walking on your heels, toes raised as high as possible, with toes flared out again. And finally, finish up by walking on your heels with toes up and pointed inward.

Toe Crunches

Crunches aren’t just for abs anymore! For this exercise, sit in a chair that allows you to place both feet flat on the floor. Lay a towel down lengthwise so the towel extends out about 4 feet in front of you. Place your feet on the towel, heels lined up at the back edge. Now, scrunch your toes and slowly pull sections of the towel toward you. The towel should slowly start to fold up underneath and around your toes, and just continue until you reach the other end. Repeat 3 or 4 times. This works the tendons and muscles around your toes and shins to help strengthen them. Does it seem a little ridiculous? Yes, but it’ll help, I promise.

What else could it be?

If you try various treatment and strengthening options and still don’t see any relief from your pain, it is possible that you may be looking at an injury more serious than shin splints. Here are some other injuries that may explain your pain.

Compartment Syndrome:

Intense pain localized on the outside of the shins may not be shin splits after all, but could possibly be compartment syndrome. This injury is a result of increased pressure within the muscles. Symptoms include lower leg pain on the outside of the leg below the knee (specifically the anterior tibialis muscle), unusual nerve sensations, and muscle weakness (Runner’s World). As a coach, I would see this condition occurring in younger runners between middle school and college age. This is a more serious condition that will need the attention of a physician. Sometimes surgery is required to release the built up pressure.

Stress Fracture:

Another condition that can masquerade as a shin splint is the dreaded stress fracture… A stress fracture is an incomplete crack in the bone resulting in highly localized pain. Shin splints are more general, whereas a stress fracture usually presents as a “hot spot” along the bone. The only definitive way to determine a fracture is with a bone scan (X-rays typically won’t reveal them). Unfortunately the only cure for a fracture is rest.

I hope that this will help you win the battle against shin splints, and perhaps offer you some insight into preventing them. Happy running!

Best wishes,

Amanda

 

References

“Shin Splints.” Runner’s World.

“Shin Splints.” American Academy of Orthopedic Surgeons. May 2012.

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