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Whether you're running after a soccer ball, jogging around the neighborhood park or training for a marathon, you're at risk of running-related injuries. One of the most common injuries is "shin splints", or medial tibial stress syndrome. The term shin splints refers to pain along the shinbone (tibia) - the large bone in the front of your lower leg. The pain is usually the result of an overload of the muscles and connective tissues that attach to the tibia.
Shin splints are common among runners and other athletes, and often cause symptoms such as tenderness and pain along the inner part of your lower leg. Some swelling in the area may also be present. In the early stages of the condition, the pain may only occur after exercise, but as the condition progresses the pain is often continuous.
The exact cause of shin splints can vary, but this condition often occurs in people as they begin a running program. Running on hard, uneven, or hilly terrain can be a trigger for the symptoms to begin. Improper or worn-out footwear can also cause shin pain, due to a lack of support for the musculature of the foot and ankle. If you have flat arches, your feet may have a tendency to roll too far inward, or pronate. Excessive pronation stresses the musculature of the lower leg during running, making it difficult for the body to disperse shock.
When symptoms appear, there are several self-care steps that are recommended:
- Rest. Avoid activities that cause pain, swelling or discomfort - but don't give up all physical activity. While you're healing, try low-impact exercises, such as swimming, bicycling or water running. If your shin pain causes you to limp, consider using crutches until you can walk normally without pain.
- Ice the affected area. Apply ice packs to the affected shin for 15 to 20 minutes at a time, four times a day for several days. To protect your skin, wrap the ice packs in a thin towel.
- Reduce swelling. Elevate the affected shin above the level of your heart, especially at night. It may also help to compress the area with an elastic bandage or compression sleeve. Loosen the wrap if the pain increases, the area becomes numb or swelling occurs below the wrapped area.
- Take an over-the-counter pain reliever. Try ibuprofen (Advil, Motrin, others), naproxen (Aleve) or aspirin to reduce pain and inflammation.
- Wear proper shoes. Your doctor may recommend a shoe that's especially suited for your foot type, your stride and your particular sport.
- Consider arch supports. Arch supports can help cushion and disperse stress on your shinbones. Off-the-shelf arch supports come in various sizes and can be fitted immediately. More durable custom arch supports are also available for more chronic conditions.
Consult your doctor if rest, ice and over-the-counter pain relievers don't ease your shin pain. Seek prompt medical care if:
If you would like to learn more about the profession of athletic training, visit the National Athletic Trainers Association (NATA) website at www.nata.org.
- Severe pain in your shin results from a fall or accident
- Your shin is hot and inflamed
- Swelling in your shin seems to be getting worse
- Shin pain persists during rest
- Numbness or tingling in the foot or ankle occurs
Usually a physician will evaluate your symptoms based on your medical history and a physical exam. In some cases, and X-ray or other imaging studies can help the doctor rule out other conditions, such as a stress fracture. A stress fracture is a weakening of the bone due to excessive stress. If a stress fracture is found, several weeks of rest is usually recommended to allow for adequate bone healing. Physical therapy may be recommended to decrease pain and address flexibility or strength deficits that might accompany the condition. Cross-training using non-impact exercise equipment may also allow the athlete to maintain fitness while decreasing the stress to the lower legs.
Prevention of shin splints is possible with a few simple steps:
- Choose the right shoes. Wear footwear that suits your sport. If you're a runner, replace your shoes about every 350 to 500 miles.
- Consider arch supports. Arch supports can help prevent the pain of shin splints, especially if you have flat arches.
- Lessen the impact. Cross-train with a sport that places less impact on your shins, such as swimming, walking or biking. Remember to start new activities slowly. Increase time and intensity gradually.
- Add strength training to your workout. To strengthen your shins, try toe raises. Stand up. Slowly rise up on your toes, then slowly lower your heels to the floor. Repeat 10 times. When this becomes easy, do the exercise holding progressively heavier weights. Leg presses and other exercises for your lower legs can be helpful, too.
- Stretch your calves. Be sure to maintain your flexibility so that the muscles of the lower leg are not overstressed. Tight calf muscles can change the biomechanics of the foot during exercise, and predispose the lower leg to injury.
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It's important to be proactive when shin pain develops, so that the condition does not worsen and result in a significant period of inactivity. Once you are able to resume your usual activities, it is recommended that you do so gradually to give the healing tissue time to adapt. Physical therapists can help guide the slow progression back to the athlete's previous level of activity, and can help alleviate any unnecessary set-backs as a result of training errors.
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