Keeping healthy shins
by: Brian Gajafsky, PT, CSCS
The term "shin splints" is typically used to describe pain in the front or inside of the lower leg. This condition usually affects individuals who participate in repetitive running or jumping activities resulting in micro trauma to the muscle, tendon and bone tissue. The repeated stress or overuse associated with this type of movement is thought to be one of the major causes of shin pain.
For example, in just 1 mile, a runner will take more than 1,500 strides. With each stride, the leg absorbs two to three times the body's weight. Knowing this, it's easy to understand why shin splints are the most common running injury (13% to 19.5%) among runners.
The initial signs of shin splints may include lower leg aching during or after a workout. As is common with many overuse injuries, these symptoms may disappear after warming up or during the workout. However as the injury progresses, these symptoms may remain throughout the workout, into the cool down, and even while walking or sleeping. Initial conservative treatment of shin splints can be summarized with the term RICE:
- Rest the injury to allow damaged and inflamed tissue to heal. Resting doesn't always mean putting a complete stop to activity. Decreasing the intensity (mileage and or pace), along with adjusting the frequency of your running schedule (everyday to three times a week) can aid in healing. Another good option is to alternate between running and low impact exercises such as swimming or cycling.
- Ice over the painful area for 10-15 minutes several times a day will provide pain relief while decreasing the inflammation.
- Compression and elevation will decrease swelling. Minimizing the amount of swelling to an area will help maintain good blood flow while facilitating the healing process.
Warming up, stretching and cooling down
Your pre-workout routine should consist of 10-15 minutes of easy running followed by a thorough stretching program. A warm-up gradually increases your blood flow and body's core temperature to prepare your muscles and tendons for stretching. It's important that your warm-up includes a comprehensive lower extremity stretching routine with the following muscle groups:
- gastrocnemius, soleus and tibialis posterior (calf muscles)
- peroneus brevis and longus, tibialis anterior (side and front of shin muscles)
Be sure to end your run with 10-15 minutes of easy running to ensure an adequate cool down.
The terrain you choose to run on affects the amount and types of stress put on your body. Consistently training on hard surfaces, always using the same side of the street or running up and down steep terrain may increase the risk of developing an overuse injury. The use of a variety of routes consisting of different surfaces and terrain is a good training tip.
The life of a running shoe varies among individuals. Training with worn-out shoes that have less shock absorbing capacity or support can cause increased stress on your body. One suggestion is to alternate workouts between two different brands of shoes. It's also a good idea to purchase and gradually break-in new shoes prior to the existing pair(s) breaking down.
Get into the habit of periodically examining the bottom of your shoes for excessive wear. Increased wear on the medial portion (inside or instep) of the sole may be a sign that your foot and ankle alignment could be the source of an injury. Foot orthotics, also known as shoe inserts prescribed by your doctor, can help to correct this problem.
Even when practicing good training strategies, shin splints or other overuse injuries may still occur. Lower extremity strength and/or flexibility deficits can result in poor running form, which could contribute to injuries.
Increasing the intensity of your workout after recovering from an injury should be gradual and pain-free. Boosting running speed and distance too quickly can cause shin splint symptoms to reoccur. The ideal recovery to prevent re-injury is to build up one element at a time (speed or distance).
In addition, the more variety you incorporate into your training – whether through what you wear or how you train, the less chance there will be for an injury to occur due to repetitive stress. Individuals experiencing persistent pain or discomfort during exercise and/or normal daily activities should seek professional medical advice.
For more information on this topic or to schedule a Free Injury Evaluation, call the Sports Medicine Hotline™ at 414-219-7776, or toll free at 800-219-7776.