If you’re an avid runner, you’ve most likely have heard the term Shin Splints, if not have suffered from this painful and frustrating condition, yourself. Runners are typically the group that suffers from this painful syndrome but it really anyone involved in a sports-related activity performed on hard or, unforgiving surfaces. Shin Splints fall under the over-use or repetitive injury syndrome category.

Shin splints, in spite of the name, is not really a “splintering” of your shin bone. Although, if you’ve had them, you’d swear that’s exactly what’s happening to your leg and you know how frustrating that can be. Shin Splints are an inflammatory reaction to stress on the bone and is called periostitis. It is also called Medial Tibial Stress Syndrome, or MTSS.

Shin Splints can be described as a moderate to severe pain in the front of the lower leg. It’s not a stress fracture of the lower leg but can lead to one if care isn’t taken. The constant stress and strain on the bone due to muscle pull over a period of time has it’s effects. This, of course, does not happen to everyone who exercises but can happen when there are certain problems that are allowed to go unchecked over time. Poor alignment of your wheels in the car may not be a problem over the short term but allow it to continue and it will certainly cause problems elsewhere in the auto.

Pain is pronounced more upon the beginning of activity, then eases slightly only to return afterwards. It can be most painful a few hours after exercise or even the next morning. Climbing or descending stairs, for me, was the worst since it placed increased stress on the muscles that pull on the bone.

The causes of shin splints can be boiled down to 3 issues:

1. Biomechanics:

This has to do with the ‘mechanics’ of your body, specifically the lower extremity in this case. When undergoing an evaluation, we look at how much flexibility you have, or don’t, in your joints, muscles and tendons. This allows us to predict how much your foot adapts to the uneven surface of the ground when running or during an activity.

2. Shoewear:

Inappropriate, well-worn or the wrong type can exacerbate biomechanical abnormalities ten fold.

3. Training errors:

I have found that the most problematic of the three. I, myself, have fallen into this category more times than I’d like to admit. Usually the case more times than not. Whether it’s the terrain, over training, too much too soon, increasing the intensity or type of training has an additive effect on the previous two problems.

X-rays, MRI’s and CT scans can be utilized to diagnose, treat and track the course of the condition. It can also, when performed early, curtail the inevitable as long as you heed the warning signs and advice of your trainer, coach or physician. What is the inevitable, you ask, if you don’t take care of Shin Splints early? Let’s see, a stress fracture of the lower leg, a serving of pain, quite a bit of time off from your favorite activity and a nice dose of frustration of your lack of progress to normalcy.

The two most important treatments after being diagnosed is rest from that particular activity which brought on the shin splints, and cross-training. Although most athletes, especially runners, are not interested in doing anything else other than running. It’s what we love and to do anything else is heresy. Cross-training will allow you to continue your training and strengthen other muscle groups in the mean time.

Like any treatment, finding the cause of the problem is paramount. Being evaluated by a Podiatrist for biomechanical concerns- i.e. flat feet, high arch, over-pronation, supination, leg length difference, etc is also at the top of this list.

If it’s a matter of purchasing new shoes, that’s easy enough. If, on the other hand, your training is consistent and appropriate and you’re still having problems, see a Podiatrist who has experience in evaluating for these concerns. He or she should include weight-bearing and non weight-bearing exams and gait evaluations, as well as other areas to investigate.

Treatments:

NSAID’s-oral or topical
Applying ice during the early stages and heat later on
Change in shoe wear
Change in training methods or surfaces
Stretching
Cross-training-avoiding weight-bearing exercises
Taping or use of a compressive wrap
Medications
Pool running
Evaluation by a trained Podiatrist