Behind IT band syndrome and stress fractures, shin splints are high on the list of dreaded conditions in running. Shin splints are a common name for “tibial stress syndrome”, a diagnostic term used to describe a condition with many causes. Most runners have encountered this at some point in their life, as do many other running athletes. Characterized by aching and soreness in the shin itself, most commonly on the inner part of the shin, though sometimes on the outer or back portion. Shin splints are most often a product of poor body mechanics coupled with changes in training intensity.
More often than not, the presence of pain in the shins arises with what physical therapists call the “Too Factor” which involves running too far, too fast, too soon. When a person increases speed and distance by greater than 10% in one week, the result is significant fatigue in the calf and knee muscles which places greater strain on the bones in the leg. Often the tibia, the long bone in the lower leg responds with micro tears, which is cause for pain in the shin. It is recommended that when increasing intensity of your workout, you only increase one factor per week (distance or speed), and increase only 10% of your current program per week.
Body mechanics that contribute to shin pain are:
- Flat feet: when the feet are overly flattened, they are referred to as pronated. Pronation can lead to increased strain not only in the feet, but in the lower leg, and the knee. Foot strengthening exercises are a great way to manage this, particularly a towel scrunching exercise in which you grasp your toes around a towel, hold 5 sec, relax, and repeat 10x. Orthotics are sometimes prescribed to treat this condition, though I am always very hesitant to recommend orthotics or motion control shoes to people without first strengthening the feet. The reason for this is that if you can actually fix the mechanical problem, it is preferable to masking the issue with orthotic or shoe restraints. If you have chronic instability in the foot due to fractures or ankle sprains, an orthotic may be indicated. See a physical therapist that specializes in running or orthopedics for recommendations for your specific condition.
- Heavy Foot contact: if you are a “noisy” runner you may be introducing unnceccesary forces through your legs, thus irritating your lower legs, knees, hips, and IT bands. Try to contact the ground softly. You may improve this by focusing on a point approximately 40 feet away, and try to stabilize your gaze on this point as you run towards it, not allowing your head to bob above or below it.
- Improper footwear: Running in a shoe that fits improperly can result in increased forces into the lower leg. Furthermore, running in the wrong type of shoe can also lead to poor running form and increased force in the leg and knee.
- Weak calves: poor calf strength lends to increased stress in the leg as well. An easy method to strengthen the calves is to stand on one leg and raise up onto your toe. Repeat this 20 times, and do 3 sets per day.
The best management for shin splints:
- Ice: frozen peas both on top of the shin and underneath the calf for 20 min. 3-4 times per day will decrease inflammation in the legs, and can decrease pain.
- Decrease intensity of workouts for 2-4 weeks: You may consider swimming, cycling, Pilates, or yoga as good alternatives to running while you heal. It is important to continue to improve strength as you are healing so that your body will adjust more quickly when you return to activity.
- Foam Roll: You can use a foam roller to roll out your shins, similarly to the rolling method of the IT bands: https://runningyourbody.wordpress.com/2013/03/12/on-it-bands/. Instead of placing the side of the leg down onto the foam, you will place the shins themselves on the foam roller, and roll back and forth using your arms.
- Compression or neoprene sleve: this pharmacy or drug store purchase is not meant for long term use, and is not a magic wand, though it will most likely increase comfort during physical activity while you are healing from shin splints. Different taping methods used by physical therapist also serve a similar purpose and while helpful is not a long term solution. Using kinesiotape for prolonged periods is not helpful in the long run to healing shin splints.
- See a physical therapist: a PT will be able to assist in pain management, provide recommendations for improving body mechanics, and give specific strength exercises and stretches to meet your needs.
Above all, care of your body and it will afford you many happy days of physical activity in the long run.
Make your day great,