What to do about shin splints

As a runner and physiotherapist, I often get approached my fellow runners to consult about their latest ache or pain.

The most common query (by a long shot) is “What can I do about my shin splints?”

The term “shin splints” is a common title for the pain felt by runners on the inside of the tibia, or lower leg bone.

Shin splints can be caused by three different conditions: Medial tibial stress syndrome, compartment syndrome, or tibial stress fracture

Medial tibial stress syndrome, or MTSS, is the most common diagnosis leading to shin splints. This occurs when there is repetitive micro-trauma – which means the damage and pain occurs slowly over time with continuous bouts of exercise – to the muscles attaching to the inside of the shin.

These muscles most commonly include the tibialis posterior and the soleus. Usually MTSS occurs when one or more of the following factors are present:

High impact activity, such as running or jumping

Training on a hard surface, like concrete or pavement

Old or improper footwear

Rapidly increasing intensity and/or duration of training

Pronation or over-pronation – when the arch of the foot flattens with weight bearing exercise

It is a common understanding that MTSS can lead to stress fracture if activity is not modified and the condition is not treated properly.

So, the next obvious question is “I think I have MTSS, what can I do about it?”

You can try these suggestions if you already have symptoms:

Make sure you are in the correct running/training shoe.

Avoid having bare feet when on hard surfaces (including in your home or by the pool).

Avoid wearing ‘flip-flop’s’ or ‘slippers’, use footwear that provide support and cushioning.

Make sure you throw your running or training shoes away after 500 miles.

Use the 10 per cent rule in training – never increase by more than 10 per cent milage each week.

Try reducing the duration and intensity of training.

Try training on softer surfaces, like grass instead of pavement.

Cross train to maintain fitness while reducing weight bearing load – try biking, swimming or pool running.

If you are experiencing pain, try RICE – rest, ice, compression and elevation.

If you have a history of always getting shin pain when you try to start a running or exercise programme, you can use these concepts for prevention as well.

Try these suggestions for seven to 10 days.

If your symptoms do not clear up, you may need to see a physiotherapist. A detailed examination of biomechanics may be required to identify if you require further intervention.

Some individuals require further intervention such as orthotics, physiotherapy electro-modalities, massage and a stretching/strengthening programme.

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