Shin Splints in Runners
MEDIAL TIBIAL STRESS SYNDROME (SHIN SPLINTS) IN RUNNERS
THE INJURY
Shin splints or shin pain is clinically referred to as medial-tibial stress syndrome (MTSS). It is an umbrella term that often refers to a number of issues involving pain in the shin area. At their worst, shin splints can turn into a stress fracture along the tibia, and searing pain will
be felt with every stride. In less severe cases, the muscles and tendons in the shin area may be tender and inflamed, or even develop micro tears near their attachment to the tibia (shin bone); often pain lessens a few miles into the run and builds up again towards the end of
a run or afterwards. Either way, shin pain is a sure-fire way to make your running experience markedly unenjoyable and accounts for approximately 15% of running injuries.
THE SYMPTOMS
1. Pain along the front and medial (inner) side of the tibia (shin bone).
2. Mild cases - pain after running.
3. Moderate cases – pain on impact as foot
strikes the ground.
4. Severe cases - pain standing or just walking
without any impact.
5. Pain on palpation along the inside edge of
the tibia. Pain when squeezing/compressing the calf muscle and anterior shin together.
THE CAUSES
Shin pain can most often be traced back to a sudden spike in training volume and intensity. Recent studies indicate the trauma isn’t caused by the direct contact of muscles attaching to the bone. Instead it happens from the slight bend that occurs during activity in a stress-loaded bone. As your tibia and surrounding muscles strengthen with repeated high-impact activity, the chance of shin splints lessens. Hence why shin splints are more common in those just starting or returning to a running programme. They are also a sign you could be wearing the wrong shoe or worn out shoes. Running on hard surfaces also increases your risk of developing shin splints. A high BMI and being female are added risk factors for shin splints.
THE FIX
When the first twinges of pain strike, reduce your running to a comfortable level for a few days to a week, then slowly increase your mileage using the 5-10% rule (no more than a 10% increase per week). Cross train with cycling, pool running, and swimming.
Include:
1. Rest, ice, and ibuprofen
(non-steroidal anti- inflammatories) to ease the pain.
2. Taping the shin can
relieve pain and speed healing. Taping or bracing provides compression to
aid relief, but also stabilises the ankle so the shin muscles don’t have to work so hard to support your leg.
3. Physical therapy including mobilisation,
massage, and acupuncture can
all promote tissue
healing and mobilise surrounding tight structures.
4. Provided you are pain free when performing exercises, you should do flexibility/mobility activities for your ankle, calf and hip. Followed by strengthening exercises for the entire leg which may include squats, bridging and balance activities.
THE PREVENTION
The easiest and best way to avoid shin splints is to increase mileage gradually, and mix your training surfaces from concrete or asphalt to grass or trails. If you have high arches and a rigid foot then you may need shoes with added support and cushioning. Work towards having good mobility and stability, not just throughout your ankle and lower leg, but in your entire body. Strength with mobility means the entire kinetic chain can work together for maximum running efficiency, so take the time to do strengthening exercises daily. Remember a dynamic warm up before a run may prepare better your body for the impact of running.
