SHIN SPLINTS
Ok, I am finally getting this post done. I am finally going to talk about the dreaded shin splints. Luckily, I am not someone that gets shin splints. I have had them one time when I was in my early 20’s but otherwise I have not had to deal with them thank goodness!
What are Shin Splints?
Shin splints are also frequently referred to as Medial Tibial Stress Syndrome because the pain is often on the medial side of the tibia bone. The American Academy of Orthopedic Surgeons (AAOS) states that shin splints are when the muscles and bone of the shin become inflamed from being overworked by repetitive activity. They are said to be caused by doing the activity (usually running) too much, too soon or with too much intensity before the tissues are ready. The AAOS also states that it can be caused by high arches, low arches or improper or worn out footwear. Other sources report that it is not really a soft tissue issue but only a bony one. The tibia is affected by the repeated stresses on it and gets a slight bending effect. Over time as runners get more used to running and more regularity with running, their bones and soft tissues get stronger and no longer undergo this bending effect thus, more experienced runners do not get shin splints as often as less experienced runners. It is thought that the tibia remodels over time and becomes stronger and more used to the impact.
Who Gets Shin Splints?
The people most at risk are those participating in running or dancing, or military recruits. Others that may experience shin splints are those just starting plyometrics and doing too much too soon. For instance, someone who recently started Boot Camp classes at their gym.
Signs and Symptoms
Pain along the inside border of the shin bone
Mild swelling may sometimes occur in the area
The pain may be sharp and razor-like or dull and throbbing
It may hurt to touch the area of pain
It hurts during and after exercise
Image retrieved from: http://www.runningstats.com/shin-splints-causes-symptoms-treatments/
What is the Treatment?
First and foremost, be sure shin splints is what you have and not something more serious such as Exertional Compartment Syndrome or a stress fracture of the tibia.
The most common treatment is to stop the aggravating activity. When you first feel the symptoms you should stop running for a few days and see if the symptoms resolve. When you return to running keep the intensity low and your mileage low. You should build your mileage slowly and do not add speedwork until you can run consistently each week at an easy pace without the pain.
Many people advise the use of ice after running, kinesiotaping, or anti-inflammatories. Most everyone agrees on the cause and what you can do to get rid of them. The problem is that just because it is supposed to work to rid you of shin splints it does not always mean it will work for you.
There are other treatments mentioned in the literature and on different running sites. Some of these include 1. Add cross-training such as cycling and swimming; 2. Try orthotics; 3. Get a supportive shoe; 4. Shortening your stride; 5. Increasing your cadence; 6. Striking mid-foot; 7. Running in more cushioned shoes, zero-drop shoes or on softer surfaces.
Different things work for different people. For example, Michelle had shin splints and changing her shoe to a zero-drop, cushion shoe really helped her. My husband used to struggle with them as well and he used a neoprene wrap and switched to doing some runs in minimalist shoes (building up properly of course), and that took care of his shin splints. So, you never know what will work for you because we are all different and our shin splints may be caused by something different than another runner. Just because it worked for them does not mean it will work for you, do your own trial and error. Fix the obvious things first of course.
Runners Connect reports that using a less supportive shoe and running on harder surfaces may actually decrease the stiffness in the lower leg as it will adapt to the surface it is running on. In theory, this adaptation is what you are looking for to improve the ability of the tissues to handle the stresses of running.
Most agree that you should stretch and strengthen the calf and foot to help decrease the risk of shin splints and to treat them once they are present. I also think you should address any hip or core weaknesses as poor-firing glutes may cause you to overuse other muscles of the lower leg. This could cause abnormal pull around the bone inflaming the bone and also not providing the muscle force and shock absorption they should be, causing the bone to take more impact.
Should I Stop Running?
Many people can continue running with mild shin splint pain if they begin to make a few changes mentioned above. You may have to do some trial and error to figure out what is causing your shin splint pain. If you are having pain when you are not running (not just right after your run) then you need to stop running until you do not have the pain. Spend your time doing strengthening, stretching and foam rolling until you are ready to run again.
If you continue to have pain and swelling that occurs when you run and rest from running or icing does not help you should see a healthcare provider to be sure you do not have one of the other above-mentioned issues.
Just to summarize, if you do get shin splints remember to begin some of the trial and error treatments mentioned. If the pain returns on the next run then take a few days off from running, foam roll, stretch and make sure you have been doing your strengthening. If the pain continues then you may need to take more time off running. Because you likely will need some trial and error to figure out what is causing your shin splints if you are not having pain when you are not running then I would suggest you continue running but shorten your stride, increase the cadence and begin the trial and error with shoes, running surface, taping, etc. Do not do speedwork during this time frame as it is likely to bring on the pain. Remember that if you have pain when you are not running and it is not being relieved by rest then you should see a healthcare provider. You should not continue to run with this kind of pain as you may cause a stress fracture.
Here is a YouTube video about foam rolling for shin splints: https://www.youtube.com/watch?v=_hCfnuSdmk8
Happy Running and here's hoping you never get shin splints. Remember, they are almost always preventable!!
Kristi