Any social or professional athlete who has experienced shin splints will tell you … it can really hurt! It can also reduce training and game time. As one of the most common sports injuries, affecting everyone from runners to netballers, footballers and tennis players, here are some tips on preventing and treating this painful injury.

shin splints diagramWhat are shin splints?

Shin splints (or medial tibial stress syndrome) refers to pain felt anywhere along the shin from the knee to the ankle.

The pain you feel down your shin might be because of the tendons and muscles over the length of the shin pulling on the bone and, therefore, creating inflammation. However, recent research suggests the pain is more likely due a stress reaction from the bone.

Pain felt along the inner area of the shinbone is called medial shin splints, while anterior shin splints refers to pain felt along the outer side. While medial shin splints are more common, pain may be felt on both sides of the shin in more severe cases.

The causes

Shin splints are commonly caused by stress and overuse of the area – in other words, exercising beyond your level of fitness, or exercising in ways your body isn’t regularly used to. This could be a change in the amount or type of training/playing you are doing, such as running for a long period on hard (high-impact) or unfamiliar surfaces, which can injure muscles and tendons. The result is irritation and inflammation, causing pain at varying degrees.

Other causes of shin splints include the following.

  • Sudden increase in training frequency, duration or intensity.  When you impact your body with exercise suddenly rather than gradually, you risk many types of injury, including shin splints.
  • Poor technique. Incorrect movements, such as rolling your feet inwards upon impact, can strain muscles and tendons.
  • Flat feet and rigid arches. The shin muscles help to maintain your instep or arch in your foot. Improper biomechanics can cause the impact of stepping/running to be distributed unevenly along the shin.
  • Wearing the wrong shoes. If your shoes don’t properly absorb the shock of impact and support the arch of your foot, this can aggravate muscles and tendons.
  • Running downhill. This causes your feet to hit the ground with your toes pointed downwards, rather than evenly distributing weight throughout the feet, which puts extra stress on your shin muscles.
  • Tightness or weakness in the calf muscles. This puts additional strain on the shin area, especially when exercising.
  • Poor flexibility/strength and muscle imbalance. This affects the leg muscles, causing strain.
  • A history of shin splints. If you’ve had shin splints in the past, you are more likely to get them again.
  • Returning to exercise too soon after injury. If you don’t rehabilitate shin splints properly and return to training too quickly, you may end up with a longer setback.

The symptoms

  • Aches and pains along the shinbone, which may develop gradually over time
  • Tenderness (down the front of, or inner section, of your lower leg)
  • The skin along the shin may be red and inflamed
  • The pain may be felt before, during or after exercise
  • Mild swelling in the shin area
  • Pain that may subside when you finish exercising, however continuous pain is felt later
  • Pain along the shin when the toes are pointed

Note that if your pain is worse when you stand up or exercise, or the pain is worse in one specific place on the shinbone, plus the pain takes a while to improve after exercise, you may have a stress fracture. This is caused by the muscle pulling on the shinbone eventually causing the bone to crack and requires medical attention and rehabilitation before you resume any exercise. Other conditions, such as tendinitis and compartment syndrome, can also cause symptoms similar to shin splints.

Initial treatment

Early assessment and treatment of shin pain can make a significant difference, and can prevent the problem becoming more severe. Follow the RICE method of treatment as soon as you notice the pain – rest, ice, compression, elevation.

  • Rest. The area needs to rest in order to heal properly. Totally avoid exercise that involves high impact, however you may be able to do low-impact activities such as cycling, use the elliptical machine/Cybex ARC Trainer and go swimming.
  • Ice. Place an icepack on the area for 15-20 minutes three times a day.
  • Compression. Use a compression sleeve or wrap to keep swelling at a minimum.
  • Elevation. Prop up your legs on a pillow when resting and overnight.

You may also take anti-inflammatory medication, such as aspirin or Ibuprofen, to ease the pain and inflammation. It’s best to seek advice from your doctor or local chemist before taking any medication. And please see your GP if your pain persists for more than a week.

Ongoing treatment/rehabilitation

If shin splints are a regular concern, you should be overseen by a sports medicine professional. Rehab may take a week in mild cases and several weeks in more severe cases. It may be recommended that you:

  • perform specific stretches to aid flexibility
  • visit a podiatrist to arrange special shoe inserts (orthotics) to correct flat feet and other arch issues
  • see a physiotherapist to correct biomechanical problems, such as tight or imbalanced muscles, which might affect your running style. They can also advise you on how to tape your lower legs and feet before you exercise
  • partake in a strength and muscle-conditioning program

Prevention

Even if you are prone to shin splints you can take precautions to prevent them or reduce their intensity.

  • Warm up. Before and after you exercise, warm up and stretch the muscles.
  • Stretch. Do stretching exercises as part of a regular fitness regimen to lengthen muscles.
  • Watch the intensity. Gradually increase the intensity and duration of your training and avoid sudden changes in intensity.
  • Get play-ready. Ensure you train prior to playing competition games and partake in fitness programs to maintain strength, coordination and flexibility.
  • Be surface aware. If possible, train/play on flatter and softer surfaces such as grass.
  • Wear insoles. Place shock-absorbing insoles into your sports shoes.
  • Wear proper shoes. Select shoes appropriate for your sport and replace them when they are worn.
  • Consider biomechanical screening. This will identify any problems in your gait or landing before they arise.
  • Allow recovery time. Ensure there is enough time between training, play and work-outs to allow your muscles/tendons to heal.

Have you suffered from shin splints? And do you get them regularly? Let us know how you treat them in the comments section below. 

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