Shin Splints

If you’ve ever felt a sharp searing pain in your shin, between your knee and your ankle, you may have experienced the dreaded Shin Splints. Maybe you were running for the bus, training for a 10k, playing basketball, dancing your heart out, or just walking down the street. Shin splints can affect anyone, and can be especially debilitating when starting a new running routine. If you develop pain, and think it might be shin splints, it’s important to check with a doctor or other medical professional to diagnose and treat the issue.

What Are Shin Splints?

Symptoms

Shin splints are a general term for pain in your shins that can actually refer to a few different issues, and can be confused with other more serious conditions. Also known as Medial Tibial Stress Syndrome (MTSS), shin splints occur when the muscles, tendons, and bones become overworked due to increased activity levels. This can cause soreness, swelling, and pain, and make continued exercise very difficult.

Most people get shin splints on their dominant leg, the same side as the dominant hand. The pain usually appears on the front or inside of the shin, also known as the anterior and medial, respectively. This pain affects people in different ways, going away for some when stopping activity, but for others it continues no matter the activity level.

Causes

Shin splints usually presents itself after a sudden change in activity level which can cause overuse of the legs. You may be more likely to experience shin splints from running, but it has the potential of occurring from any increase in activity involving the legs. Shin splints happens most commonly when starting a new running routine, or when modifying an existing running plan too quickly. The body needs time to adapt to changes and forces acting on it, and does not react well when rushed. Changing your routine too quickly, such as starting too quickly without getting adjusted to running, running on a new surface like harder pavement or hills, increasing speed or distance without properly training, or trying new shoes which can change your form, all have the potential of triggering shin splints. To prevent negative reactions to changes in exercise plans, these modifications should be implemented slowly and one at a time

High impact activities like running and sports with sudden stops can cause strong repetitive stress on the bones in the shin and their connective tissues which can contribute to shin splints. The pain associated with shin splints may be caused by inflammation of the muscles, tears in the muscle, damage to the connective tissue between the bone and muscle, or some combination of those. The pain felt with shin splints is similar to a few other conditions, which makes diagnosing the issue more difficult. One condition often mistaken for shin splints is stress fractures, where small cracks form in the bone as a result of high stress and impact. With either one, the management and prevention strategies are very similar, but consulting with a medical professional is key to quick recovery.

Another contributor to shin splints is imbalances throughout the body, and especially the legs. Muscle imbalances can lead to unequal forces acting on different parts on the body, leading to pain and overcompensation which perpetuates the problem. Weak stabilizing muscles in the hips and core, as well as tight hip flexors, can cause dysfunction and ineffective movement while running, triggering pain. Imbalances in strength between the muscles in the calf, the gastrocnemius and the soleus, and the muscle in front of the shin, the anterior tibialis, can also cause exacerbate shin splints. Issues in the feet like high arches, also known as overpronation, and flat feet or overpronation, can add unwanted tension throughout the body. Choosing the right footwear for your activity and anatomy is also important for this reason. Shoes that have been worn down unevenly can affect the way you land, and contribute to bad running form and muscle imbalances. Furthermore, exercises that place excessive stress on one leg or hip, such as running laps in same direction on a track, can also lead to overcompensation and imbalance.

Management & Prevention

So what should you do if you start feeling pain in your lower legs, and you think it might be shin splints? STOP! Based on the level of pain you experience, you should either stop completely or decrease activity to avoid further harm.

The next step is managing the symptoms of shin splints, and preventing further harm and injury. A good acronym to remember is R.I.C.E., which stands for Rest, Immobilize, Cold, Elevation. This works for many injuries and issues, including shin splints. First Rest the legs and take a break from activity by Immobilizing the leg and sitting or lying down while Elevating it to partially reduce blood flow. Then apply a Cold compress or ice wrapped in thin fabric to the area to reduce inflammation, alternating 15 minutes on and 15 off for 3 hours. Orthotic shoe inserts to help arches may relieve some of the pain by supporting positioning your foot at the proper angle. However, foot issues like flat feet or high arches should be addressed at the source through corrective exercises to improve the issue rather than just the symptoms.

Utilizing corrective exercise to reduce muscle imbalances and increase range of motion can help balance things off and encourage the body to function smoothly.  Some great exercises include alternating gently walking on your heels and your toes, as well as writing alphabet on the floor with your toes while sitting. If needed, starting a physical therapy regimen, or at least going in for a consultation or screening, can be extremely beneficial in identifying and remedying underlying issues.

Building up your exercise routine to include lasting beneficial habits can help improve your overall fitness and wellness, and prevent issues like shin splints from occurring in the future. Working in cross training with activities such as swimming and bike riding, can help relieve some of the impact and keep you active while resting from running. Additionally, making sure to include some form of strength training will keep your muscles and joints functioning effectively. It's also important to remember to stretch the muscles in the calves and shin, the achilles tendon above the heel, as well as the hamstrings and hip flexors, and to use myofascial release wherever you feel tightness and soreness.

Shin splints can take anywhere from 3 to 6 months to fully heal. Even after you have recovered and the pain is gone, don’t rush back into things. Start up slowly by creating and following a solid training plan, giving enough time and patience for adequate progression to avoid starting the cycle again. In order to prevent future occurrences of shin splints and other injuries, remember to: stretch, perform range of motion exercises, warm up before activity, follow safe progressions, and always stop when you feel pain.