Anyone who has ever experienced shin splints knows that this is a very frustrating and painful condition. If a person suffers from this, he would feel a nagging pain mainly in the front of his leg along his tibia. Usually, the person would experience the pain while exercising and after the workout. He would also feel the pain if he presses on the affected area. Sometimes though, a person would feel a tightening pain in the outside muscular area of the shin which is soft. The pain could get so bad that running would become an impossible task. Then when the person stops running, the pain subsides.
This condition affects athletes and, in fact, it has derailed a lot of careers already. It’s a very frustrating condition which doesn’t just involve the lower leg. If the shin pain is bone-related, this is known as medial tibial stress syndrome and this can cover different types of ailments from a simple stress injury to a bone irritation, a stress fracture or even a crack in one of the bones. Shin splints generally occur because of some main variables including how much activity a person does, the mechanics of his body, and even bone density.
A person’s activity can cause the condition in such cases where a person ups his training workload too fast and too soon. Body mechanics, on the other hand, refers to a person’s foot strike, foot type, and how his body is built. Finally, bone density can be a major factor for women. Fortunately, a person can alter all these factors to help alleviate the condition.
When shin splints affect the muscles, this usually indicates a condition known as exertional compartment syndrome or ECS. This condition may happen in any part of a person’s lower leg and is usually characterized by a tightening sensation in a person’s shin which gets aggravated when he exercises. A lot of times, patients would claim that the tightness is so severe that they feel like their legs might explode. To learn more about shin splints and how to treat it, read on!
So, What Are Shin Splints?
The term “shin splints” refers to a pain that a person feels along the front of his lower leg or his shin bone. The pain is usually concentrated on the lower leg between the ankle and the knee. Doctors may refer to this condition as MTSS or medial tibial stress syndrome.
Shin splints typically affect those who engage frequently in moderate to heavy physical activity. Therefore, one is more likely to get the condition if he participates in a lot of strenuous physical activities or sports. These include basketball, tennis, racquetball, soccer, and the like. Sometimes, the pain felt by someone suffering from shin splints can get so severe that he should stop the activity.
Also, shin splints are considered a cumulative stress disorder which means that it can develop over time. One may get shin splints because of repeated stress or pounding on the muscles, joints, and bones of a person’s lower legs. This prevents the body from being able to restore or repair itself naturally.
Some Fast Facts About Shin Splints
When it comes to common leg injuries and conditions, shin splints is one of them. Although it occurs mostly among runners, it can also occur in other types of sports activities such as soccer, basketball, track & field, and more. Here are some fast facts about the condition:
One of the Major Factors of Shin Splints Is Repetitive Stress. Keep in mind that shin splints are usually caused by repetitive stress to the lower leg’s connective tissues, joints, and bones. In the more severe cases, bone irritation may also be part of it.
Not Enough Exercise Variety Can Be Another Factor. If one doesn’t mix up his exercises but keeps the high intensity at all times, this can cause the condition and the pain that comes with it. Usually, people describe the pain as a tenderness or a soreness along the shin bone. It may also come with mild swelling of the person’s lower leg. If one cannot control the symptoms by taking OTC pain relievers, rest or even placing an ice pack, then he should consult with a doctor.
One Doesn’t Need to Have Surgery as a Treatment. If one suffers from shin splints, he should know that surgery isn’t the only option. A person can consult with a physical therapist who can provide treatment which can help reduce the inflammation an pain. Also, therapists can assess the person’s gait, what footwear is the best for him, and his readiness to go back to his activities.
Causes and Risk Factors for Shin Splints
Here’s a situation that’s familiar for a lot of people: one goes for a run on an uneven terrain or plays basketball on a hard court made of concrete. After some time, the person notices a dull pain along the inside part of his shin. Everyone who engages in such activities can experience the pain brought about by shin splints. Usually, the pain would ease up as soon as the person stops performing his activities. However, it might linger and, eventually, cause a constant pain. Here are the common causes and risk factors for this condition:
- Starting a training or a sport or intensifying it. Shin splints are very common among people who do this because their tissues are responding to increased use.
- Using unsupportive shoes. If one wears shoes which don’t offer good cushioning or support especially when running and performing physical activities, they might develop the condition.
- Playing sports on running on hard surfaces. This can be especially dangerous if one is performing a lot of jumping, running, and more on such surface. Doing this can also make the person more prone to getting stress fractures.
- Running on a terrain that’s uneven or hilly. Repeated activity makes the feet and legs readjust frequently which, in turn, can increase the risk of developing shin splints.
- Having pre-existing ankle or foot problems. Such problems include hyperpronation, high arches, flat feet, and more.
- Having a poor form while running. This is especially true if the person’s feet hit the ground too forcefully at his heels.
- Having calf muscles which are tight as this can place too much pressure on the person’s shins.
The pain that commonly comes with shin splints comes from too much force on the person’s shin bone or the tissues which attach the bone to the muscles around it. Too much force can cause the muscles to get swollen and it also increases pressure against the person’s bone which can lead to inflammation and pain.
Shin splints may also be caused by a stress reaction to a bone fracture. Constant or repetitive pounding can cause small cracks in a person’s bones. If he rests, then the bones can repair themselves. But if the person keeps at it, the body doesn’t have time to repair itself and in time, this can either result in a stress fracture or a complete fracture. There are different kinds of activities and even physical attributes which can place a person at risk for this condition. Such risk factors include:
- anatomical abnormalities
- muscles weakness in a person’s buttocks or thighs
- poor flexibility
- improper techniques for training
- running on a terrain that’s uneven, slanted, hard or downhill
- using worn-out or improper shoes for working out, playing sports or running
- participating in activities or sports which have a lot of fast stops and starts
There’s also a higher likelihood of shin splints developing when the tendons and leg muscles are tired. The condition is also more prevalent in athletes, women, dancers, military recruits, and those who have rigid arches or flat feet.
Symptoms of Shin Splints
People who have shin splints will experience a number of symptoms including:
- a dull pain in the front portion of the person’s lower leg
- a pain which worsens during exercise or physical activity
- a pain felt on either side of the person’s shin bone
- muscle pain
- a pain along the inner portion of the person’s lower leg
- soreness or tenderness along the inner portion of the person’s lower leg
- swelling (usually mild) in the person’s lower leg
- weakness and numbness of the feet
These are the common symptoms which usually respond to treatments. But if they don’t or if a person experiences other types of symptoms, then he should seek medical help immediately. Such symptoms include:
- a severe pain in the shin after an accident such as a fall
- a shin that feels very hot
- a shin that’s noticeably swollen
- a pain felt in the shin even when the person is resting
Treatment of Shin Splints
Some experts believe that shin splints may be the early stage of stress fractures, therefore, determining the difference between these two can be quite tricky. In any case, shin splints can eventually become complete stress fractures if the person doesn’t have it checked and he keeps on performing his activities. When it comes to shin splints, early diagnosis is vital.
When a person has a stress fracture, he’s bound to experience pinpoint pain which is about the size of a quarter or a dime. This means that if the doctor asks the person to point to the pain, he will be able to point to it right away. Usually, the pain would be very point-specific and it would be around the bony part of the leg. With a shin splint, the person would feel a kind of aching discomfort up and down his entire lower leg.
A doctor will be able to diagnose the condition through a physical exam. He will ask the person about any types of training or physical activities he performs and how often he does them. Doctors may also prescribe some diagnostic tests such as x-rays or imaging scans if they think that the patient suffers from bone fractures or other conditions apart from shin splints.
Shin splints typically require the person to take a rest from his training or physical activities in order to give the legs time to heal. The discomfort felt by the person may go away completely in a matter of hours up to several days with limited activity and rest. Ideally, the person should take about two weeks off if he really wants the condition to heal. At this time, one can still engage in physical activities as long as they don’t cause additional stress or harm to his legs. The doctor may suggest these home remedies:
- keeping the legs elevated
- using ice packs to reduce the swelling
- taking OTC anti-inflammatory medications
- wearing elastic compression bandages
- using a foam roller to massage the shins
It’s also a good idea to check with the doctor first before re-starting any of his usual activities. Also, warming up before performing any exercise is an excellent way to make sure that the legs don’t become sore.
People often believe that one would need surgery as a treatment for shin splints but this isn’t really true. In fact, surgery is rarely used in the treatment of this condition. Normally, a doctor would only recommend surgery if the shin splints are causing severe symptoms and pain for more than a few months. The surgery for shin splints which is called fasciotomy involves making tiny cuts in the fascia tissue around the calf muscles. Potentially, this can ease some of the pain caused by the condition.
Other Treatment Strategies for Shin Splints
It’s quite easy for a person to acquire shin splints. Factors such as fallen arches, poor shoes, insufficient warmups, faulty posture, poor running or walking mechanics, and more can lead to the condition. Shin splints are a very common condition which can be very disabling for some people. Most people would know when they have this condition but very few of them actually know what shin splints are.
Most doctors would call this condition periostitis or tendinitis but even they aren’t sure which of these terms really describes the condition. As we’ve stated earlier, some people believe that shin splints indicate the early stage of a stress fracture. Other people argue that shin splints are nothing but an irritation of the muscles. Others also believe that they’re an irritation of the tendon which attaches the bone to the muscle. Often, the symptoms of this condition are confused with the symptoms of a stress fracture. However, shin splints would usually include a pain felt in the shin of one or both of the person’s leg and he isn’t able to pinpoint the exact area of the pain.
If one has this condition, then he would like to get rid of it right away. To help out, there are some ideas which are designed to help prevent the condition from getting worse. That way, the person will still be able to continue with his lifestyle without causing more harm to the affected area. Consider these treatment strategies:
Take a Short Break. We’ve already discussed the importance of resting when one has shin splints but it’s important to reiterate. If running or walking worsens the condition, then a person should take a short break from such activities in order to give his body some time to heal. Instead, one can stay in shape by performing low-impact exercises such as swimming and cycling. When the person is ready to start running or walking again, he can start gradually. Then he can increase the speed or distance slightly as each week goes by.
Check the Ground. Hard and unyielding surfaces can give a person shin splints right away. Therefore, people should start looking at the ground they’re running or training on. If the person is dancing, running, walking, and more on a surface which doesn’t have any “give,” then he needs to make a change. For instance, people who do a lot of aerobics tend to get a lot of injuries when they exercise on concrete floors which have carpet coverings. So if the floor is non-resilient, the person should only perform low-impact exercises unless he has a high-quality foam to work out on.
For those who enjoy running, they should run on dirt or grass rather than asphalt or concrete, the latter being the most harmful. Depending on when the person lives, the best thing to do is to search for soft sidewalks to run on. Some states in the US have installed sidewalks which are made from old tires of cars and these sidewalks are known as “Rubbersidewalks.”
Wear the Proper Shoes. Unfortunately, most of the time, people can’t change the surfaces where they run on. So the best thing to do is to search for the right shoes. A person should wear a pair with good shock absorption, fit, and arch support. For those who participate in activities which cause a lot of impact on a specific area of the feet, judge the shoes on their ability to absorb the shock in that particular area. Therefore, the best thing for the person can do is try the shoes on before buying them to see if they’re suitable.
For people who run a lot, choosing the proper shoes can be more tedious. According to research, more than 50% of runners who have shin splints pronate excessively too. When choosing a pair of shoes for pronation control, one would realize that this means that the shoes would have less cushioning. If the person is a pronator who also has shin splints, he would probably need a pair of motion-control shoes. This type of shoes is durable, rigid, and limits pronation.
Change Shoes Regularly. One way a person can get all the cushioning he needs from his shoes is to change them regularly. As a matter of fact, runners should change their shoes after every 300 miles of running. For those who participate in other types of sports or activities, they may need to change their shoes 2-3 times yearly or more frequently depending on how often they work out.
Change Shoes Regularly. As soon as the person experiences the pain from shin splints, he should place his shins on RICE. What does this mean? Well, it means that one should practice rest, ice, compression, and elevation for at least half an hour each and every day. A lot of experts believe in this form of treatment, simple as it is.
Try the Contrast Method. This is a variation of the RICE treatment and it seems to be especially effective for those who have pain in the inner part of their leg. This method involves alternating a minute of heat with a minute of ice on the shins. Do this method before any kind of activity which may cause pain from shin splints and continue the method for more than 12 minutes.
Try the Contrast Method. If a person experiences his shin splints at the front part of his leg, then it’s best to massage the part of the shin that’s near the edge and not on the shin directly. If the person massages the bone directly, it might worsen the inflammation. In order to massage away the pain from shin splints, he should sit on the floor with his knee bent and the foot flat on the floor.
Then, the person should start stroking both sides of his bone lightly with his palms. Glide the palms back and forth from the ankle to the knee and keep on doing the stroking motion for a number of times. After that, the person should wrap his hands around his calf then, with the tips of his fingers, stroke each side of the bone deeply from the knee to the ankle. Cover the whole area while using as much pressure as one can handle. The massage aims to restore the length and relieve the tightness felt in the tendons of the shins. Also, a good massage can improve circulation in the area.
Correct Faults in the Feet. High arches or flat feet may cause shin splints. If a person has high arches, he may feel pain on the outside portion of his lower leg. In order to relieve the pain, he should perform various stretching exercises, strengthen his muscles, and also add some orthotics. On the other hand, if a person has flat feet, the muscles inside the calves need to work harder and, therefore, gets tired faster. This makes the bones take more of a pounding. Therefore, if the person is flat-footed, he may require additional arch support or shock-absorbing material in his shoes. Although inserts are available, the person should see a podiatrist first before purchasing such inserts.
Stretch the Calves. Stretching the calf muscles and the Achilles tendon is a great preventive measure for this condition. Women who wear shoes with high heels each day aren’t stretching these parts of their feet at all which is unfortunate because stretching is crucial. Without it, the calf muscles are shortened and, in turn, throw the stress and the weight forward, towards the shins. For a good stretch, place both hands against a wall, stretch one leg behind the other, then press on the back heel gradually to the floor. Do this for about 20 times then repeat using the other leg.
Signs That the Shin Splints Have Already Healed
As aforementioned, shin splints can be very painful and frustrating. But the good news is that they can fully heal. One would know that they’ve healed completely when:
- the affected leg is already as flexible as the unaffected one
- the affected leg is already as strong as the unaffected one
- one can press on the spots which were once painful
- one can already sprint, jog, and even jump without experiencing pain
Although shin splints can fully heal, there’s really no way a person can exactly say that they’ve already gone away. Mainly, it would depend on what caused the shin splints in the first place. Also, people heal at various rates. It’s not unusual for a person to need a number of months for healing. The important thing is for the person not to rush back into his sport or his high-intensity activities. If one goes back to his usual activities, then he might end up hurting himself permanently.
In the meantime, the person can try performing low or no-impact activities which won’t aggravate the condition while he’s healing. For instance, runners can try cycling or swimming for a bit. However, if the shin splints aren’t healing or they recur, the doctor might suggest that the person see a physical therapist. Such a therapist may treat any issues the person is experiencing with his legs or even work with the way the person is moving which might be causing the problem. Then the therapist can also ease the pain so that he can go back to his sport. Finally, the therapist can also make sure that the patient doesn’t have a stress fracture.
Curing and Preventing Shin Splints
Shin splints don’t start out bad all the time. But if left unchecked or untreated, they can quickly transform into one of the worst types of injuries out there that can hinder a person’s daily training or activities. Unfortunately, shin splint can develop for a number of reasons. But one can cure and prevent the condition so that he doesn’t have to suffer as soon as running season begins again.
Build Slowly. Rather than diving right into one’s routine, it’s better to start slow and build gradually. Over time, it’s best for one to increase his distance and speed to avoid shin splints. For new runners, it’s never a good idea to immediately start by running 5 miles. Each and every person needs a break-in period so as not to shock the system and cause any injuries. For instance, a person can start off by having a 20-minute running-walking combo every other day. In terms of building the duration and intensity, the person can increase each week by about 10%.
Try Cross Training. Immediately running might cause shock to a person’s body. That’s why it’s a better idea to do cross training. This means that the person can supplement the running with other types of workouts which aren’t as stressful on the legs and joints such as rowing, cycling or swimming. This will help the body adjust better and help prevent the development of shin splints as well.
Strike the Ground Mid-Foot. When one is running, he should fight the tendency to use a tiptoed dash or a heel strike. This is because hitting the ground heel first causes on to overstride which, in turn, leads to the person’s foot slapping down on the pavement. This stretches the muscles of the shin and forces them to work harder when it’s time to slow down. By contrast, running on the toes places a lot of stress on the calf muscles located in the back of the person’s leg. So if one wants to prevent shin splints, it’s best to strike the ground mid-foot. This can also help to avoid other injuries and strain which are commonly associated with running.
Maintain Short Strides. Every runner out there is pushing for the finish line. But it’s important for them to make a habit out of watching the length of their strides. This is especially true at the end of a high-intensity workout. Although differing leg lengths and biomechanics make it very challenging to recommend an exact distance, shorter strides are typically more ideal. When a person is planning to get back into a sport, he should take the first two weeks to maintain a short stride purposely in order to reduce the risk of developing shin splints.
According to research, as runners increase their speed, their strides shorten too. This means that the key to giving a boost to a person’s mechanical efficiency is to increase the rate of turnover. There is no “magic number” that everyone should follow. Remember that the best turnover rate which might drive a person to failure might not be enough for other people.
Assess the Pain. No matter what type of workout one is doing, he should pay attention to his body. When a person has a classic shin splint, he would feel pain on the front part of his lower leg. But if a person feels an acute pain in a single spot, he may be suffering from a stress fracture which, in time, will worsen and prevent the person from being able to run.
Use an Orthotic. If one notices that he’s overpronating or heel striking, then he should replace the foam liner of his shoes for a plastic orthotic which can provide additional support to the arches. Orthotics can help cure and even prevent the occurrence of shin splints. They can also prevent the development of other types of overuse injuries such as iliotibial band, runner’s knee, plantar fasciitis, and Achilles tendons. Check the local running stores as they would typically have form-fitted orthotics one can choose from.
Lessen the Running. People who have shin splints don’t have to lose hope. Developing the condition doesn’t mean that a person’s running career is over, it just means that he would have to cut back on his running distance and frequency for some time. To help with the treatment, one can massage or ice his calf muscles for a couple of minutes a few times each day. The key is to stay below one’s threshold in order to prevent further irritation. One should also train gently or take a couple of days off while the shins heal. Then as the person gets back to running, he should do so at a gradual pace.
Seek Professional Help. If one suffers from shin splints, he should try his best to search for the cause as well as the proper treatment. And the best way one can do this is by seeking professional help. One should consult with a physical therapist or even a podiatrist who knows all about running, the treatment of shin splints, and how to help the person. Professionals can look at the person’s form, establish the cause of the condition, and prescribe the appropriate treatment.