Do you suffer from Shin Splints?

We’re a few weeks into the new year. If your New Year’s resolutions included taking up running, training for a race, or starting a new activity altogether, you may be experiencing some pain in your lower legs. If you have ever been a runner, a dancer, or played sports, you’ve likely encountered this pain in your shins and perhaps been diagnosed with shin splints. In the sport of running alone, up to 20% of runners experience them at some point. Shin splints, or Medial Tibias Stress Syndrome (MTSS), can be frustrating for athletes at all levels as they can be quite painful and cause considerable downtime. 

At the onset, people often start to feel a dull, aching pain along their shin bone. Shin splint symptoms usually begin with physical activity and are relieved with rest. Early in the injury, you may notice the pain at the beginning of training, it might decrease throughout the activity, then increase again as you begin to cool down. As the condition progresses, though, the pain may become more constant. Often the pain goes away with rest until the activity resumes at your next training session. Rarely is there swelling, though if there is, it could be the symptom of a more serious condition. 

While shin splints are not typically considered a serious injury, they can progress to a stress fracture if not treated appropriately. Pain-wise, a tibial stress fracture will have pain that is more localized and constant rather than running along the length of the shin bone mainly during periods of activity. In either case, it is not wise to continue running or training through the pain. 

Shin Splint Causes

Shin splints are caused by repetitive stress on the shinbone and the connective tissues that attach your muscles to the bone. There are several reasons a person can suddenly develop them. 

• You’re a runner. If you’re just beginning a running program, or you’ve suddenly increased the duration, frequency, and intensity of your training, whether that looks like longer runs in preparation for a race, starting a new training program, or picking up running again after an extended break you could be at increased risk.
• You play a sport that requires cleats. Cleats are notorious for their lack of support and cushioning. The lack of shock absorption means your legs are required to absorb the pressure each time your foot hits the turf, grass, or dirt.
• You have flat feet or high arches. 

The reality is that any person who engages in a sport or activity that involves frequent running or jumping can be at risk for developing painful shin splints. That being said, as with most things, some people are simply prone to developing shin splints more than others. Biomechanically speaking, if you tend to roll your foot inward when you walk, you may be overpronating. The repeated stress caused by excessive pronation can not only cause shin splints, but also runner’s knee, plantar fasciitis, and Achilles tendonitis. People with high arches or flat feet are also more likely to develop shin splints because their feet are not optimally shaped to absorb the repeated stress that occurs during any activity requiring running. Luckily, custom-made orthotics can rectify that tendency, add a layer of protective cushioning where your feet need it most, and alleviate the pain fairly quickly.

Diagnosing Shin Splints

Because shin splints are soft tissue injuries, X-rays are not reliable for diagnosing them and are more frequently used to rule out a stress fracture. In some cases, a bone scan may be used. An MRI is the best way to confirm if you’re suffering from shin splints or a more serious stress fracture.

Treatment and Prevention of Shin Splints

Stretching, proper footwear, or orthotics are your best defense against developing shin splints. Exercises that help stretch and strengthen your calf and shin muscles specifically will go a long way to keeping you moving, but, again, sometimes, shin splints still happen.

There are several good stretches to do. A good one to help stretch and strengthen the calves and help you avoid shin splints is the seated calf stretch.

To stretch the calf muscles:
–  Sit on the floor with your legs straight out in front of you.
–  Loop an exercise band, towel, or rope around the ball (front) of your foot.
–  Gently pull the band to pull your toes towards you.
–  Hold this for 15 – 30 seconds.
Repeat this exercise two to four times on each foot.

If it’s difficult for you to sit on the floor, this exercise can be done while sitting in a chair. Just be sure to keep the leg you’re stretching straight and your heel on the floor.

If you already have shin splints, the best way to treat them is to rest. Unfortunately, it’s not always possible for athletes to take time off from their training. In these cases, cross-training is a recommended option. By engaging in exercises that limit the tibial stress, the connective tissue and muscles around the shins can heal while allowing the athlete to continue their training. Ice and ice massage may also help reduce the swelling and inflammation, while NSAIDs are recommended to help with the pain. Physical therapy in the form of ultrasound, electrical stimulation, localized massage, and bracing may also be beneficial. Since we treat a number of athletes in our office, we also use radial pulse therapy. We find that four to five radial pulse therapy treatments will substantially improve or resolve about 80% of the soft tissue injuries we treat.  

As stated earlier, custom-made sports orthotics are also an extremely effective tool in resolving and preventing shin splints as they keep the foot in optimal alignment to absorb shock and prevent the feet from repeatedly over pronating, or rolling inward. In my practice, we use a very specific orthotic prescription, and a high-quality orthotics manufacturer, which makes a huge difference in the resolution and healing of shin splints. A “one size fits all” orthotic may not offer the same benefits. When the orthotics are used in conjunction with massage, ice, and a compression sleeve, you should be able to heal from shin splints and get back to your favorite activities quickly and safely.  Give us a call at (720) 600-3380 if you have any questions or would like to make an appointment.