Shin Splints

Shin splints also referred to as Medial Tibial Stress Syndrome (MTSS) is a name often given to any pain at the front of the lower leg. However, true shin splints symptoms occur at the front inside of the shin bone and can arise from a number of causes. You may have shin splints when you feel throbbing and aching in your shins. While they often heal on their own with reduced running and extra rest days, severe shin splints can ruin your game. It is generally understood that shin splints are not a single condition but rather symptoms of several problems in the shin area. One common cause is inflammation of the periostium of the tibia which is the sheath surrounding the bone. Stress fractures can be another cause. Over-training, excessive pronation, worn shoes, hard or canted running surface could lead to inflammation or stress fractures.

Symptoms of Shin Splints

During the early stage of shin splints a runner will experience a pain that is present when the training run first begins, but then disappears as running continues. It is often observed that the pain will often return after exercise or the following morning. As the injury progresses runners will experience more time with the pain, and less time without it. Depending on the exact cause, the pain may be located along the medial part of the shinbone, anterior area of the shinbone or in the muscles of the forefoot. The area may be painful to the touch. Swollen muscles can sometimes irritate the nerves in the feet, causing them to feel weak or numb.

Causes of shin splints

The cause need to be identified before shin splints can be eliminated. Possible causes are:

  • Too tight achilles and calf muscles.
  • Running on uneven terrain causes the foot to twist and turn in order to stabilize the foot which increases friction.
  • Increased amount of faster running (speed work).
  • Changing from soft to hard running surfaces increases impact absorbtion effort.
  • Running in old shoes.
  • Excessive uphill running.
  • Poor running mechanics including an excessive forward lean.

Shin Splints Prevention

Let's have a look at prevention before we move on to treatment. Preventing shin splints will save any runner the accompanied pain and will allow him or her to happily continue with the training schedule. The first thing a serious runner should do is make a visit to a podiatrist to analyze their foot strike and running mechanics. As with running you make the same movements many times, this repeated strain on the same areas could cause an overload especially if running mechanics are not perfect. Running in shoes which fit your foot shape with impact absorbing cushioning is a good preventive measure. Buying a new pair of running shoes is money well spend because they are the first line of defense against a long list of injuries. Visit a podiatrist who can suggest certain foot stabilizing shoes or insoles to correct over-pronation or under-pronation.

A good warming-up can make a big difference in preventing shin splints. Warming-up your muscles by increasing the blood and oxygen flow will prepare the muscles for intense activities. Warm-up by jogging for five minutes and then doing some stretches. Make this a fixed routine for the rest of your running life. Some runners would do this one more time by running another easy mile and doing some more rigorous stretching. It is time well spent and take our word for it, it is much better than wasting time at home being injured.

Cooling-down after a run will prevent blood from pooling in your legs and will remove harmful waste from your muscles as well. Cool down by jogging or briskly walking and then do an extensive stretching routine when your breathing and heart rate have slowed down to near normal conditions.

Stretching after any run should be done without exeption. Loose and relaxed muscles are less prone to friction related injuries.

Preventive Strengthening Excercises
  • Standing up, have a partner hold down your feet which are flat on the ground. Your partner places resistance on your toes while you try to lift them up.
  • Sitting down, place your left ankle on right knee, apply pressure to inside of your foot (near large toe) with either hand, push your foot up and in using your leg muscles. Start with three sets of 10 repetitions building up the number of repetitions every week. Repeat with other foot.
  • Same position as above, apply pressure to outside your foot (near small toe) with either hand, and push your foot down and out using your leg muscles. Start with three sets of 10 repetitions building up the number of repetitions every week. Repeat with other foot.
  • Same position as above, apply pressure to top of foot (near toes) with either hand, and lift foot using leg muscles. Start with three sets of 10 repetitions building up the number of repetitions every week. Repeat with other foot.
  • Sitting on a table or chair attach a weight around your foot. Without bending your knee, lift your foot up and down from the ankle.
  • Anchor an elastic band to the leg of a table or sofa. Stretch the band, and then loop it around the end of your foot. Move the foot up and down and side to side against the bands resistance.
  • While standing erect raise up and down onto your toes several times. If that is too easy you can make it more challenging by performing the same exercise while standing on a step and allow your calves to stretch over the edge of the step.
  • While sitting, lower and raise the feet with the heels on the ground as high and quickly as possible for 60 seconds.
  • Walking down steep hills.
  • Walking on toes.
  • Walking on heels.
  • Walking with feet turned inward and outward.
  • With socks off, gather up a towel that is flat on the floor, using only your toes.

Strengthening your lower legs to prevent shin splints should be approached as any other strenth exercise, meaning that they should be build up with small increments to prevent overworking the muscles which would cause shin splints in the first place.

Shin Splints Treatment

For any injury involving soft tissue the R.I.C.E.R.(Rest, Ice, Compression, Elevation, and Referral to an appropriate professional for an accurate diagnosis) regime should be followed. For best result follow R.I.C.E. regime for two or three days. To complement this you could also take non steroid anti-inflammatory drugs like: Ibuprofen/ Voltaren/ Cataflam/ Mobic. Further treatment of shin splints would involve the strengthening of the lower legs with the previously mentioned preventive strengthening exercises.


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