Shin Splints – A Runner’s Handbook to Causes, Treatment & Prevention

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Shin Splints also known as Medial Tibial Stress Syndrome (MTSS)  + The differences.

It happens to every runner sooner or later. After prolonged jogging or running, unfamiliar amounts of stress on your legs can result in a phenomenon commonly referred to as shin splints. These are shooting pains experienced on the lower leg, focused around your bone or tibia. Untreated, these can develop into very painful injuries such as stress fractures. There is a great deal of misinformation being spread about this condition, so it is important to be informed.

Having this condition can be very painful and make life difficult, but they are easily treated and even more easily avoided. The pain can be soothed, and you can change the conditions in order to prevent this pain from happening in the future. Even better, this can be done while still exercising, meaning you won’t lose too much progress. Take a look at this full breakdown to understand what they are, how you get them, how to treat them, and how to prevent them. This way, you can work around them if necessary, and continue training towards your goals.

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What are shin splints?

They are micro-sized tears in lower leg bones. These can cause a mild to severe level of lingering pain, and can be confused with regular soreness at first. If these muscles experience an unfamiliar amount of stress or a higher than usual amount of activity, they tend to become swollen and irritated. The bone fracturing occurs mainly in the tibia and the primary muscles affected are the ones surrounding it. It’s for this reason that medical professionals refer to this injury as medial tibial stress syndrome. They do not cause permanent damage. However, they may lead to permanent damage if treated poorly or not given adequate recovery time.

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The stages of shin splints

Stage One
The first major symptom of the first stage of Shin Splints is pain that fades away while you are warming up, so the physical activity may be continued without a lot of trouble.

Stage Two
At this stage, you can feel a pain that fades away during activity but comes back once you have ceased that activity. At this stage, you can continue training.

Stage Three
At this stage, the pain is quite intense and the activity has to be stopped in order to stop aching. Seek medical advice at this stage.

Stage Four
This is the most advanced stage in which pain is perpetual and you should seek medical support as quickly as possible.

Symptoms

Swelling of the lower leg or pain & tenderness along the tibia are usually tell-tale signs. The pain will usually be present when exercising at its first stage of development, but if it progresses, it can become a constant pain. You must always diagnose the complication at the first signs and start treatment immediately so as not to let it worsen.

To break it down, this is what you want to watch out for, especially during exercise.:

Some more serious symptoms may include:

  • Severe pains when moving, or exercising
  • Hot area
  • Inflammation
  • Worsening swelling
  • Even when not doing any physical exercise, you still feel pain

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Causes

This is one of the most common injuries runners experience, affecting up to a third of runners on average.

They have many possible causes, but the most common ones are extended stress put on the shin and lower leg. Many athletes engaging in extensive physical training for the first time, such as for track and field related sports, find themselves suffering from pain a few weeks into their workout regimen. If this is the case for you, you’ll need to adequately manage this injury so that it doesn’t negatively affect your routine.

Pain and soreness are instrumental to any physical training process. When you exert force on your body to perform physical activities, muscles will often tear and swell up as a result. This can be seen most often with weightlifters, who train their bodies to lift heavy weights in order to ‘pump’ up their muscles and sculpt their bodies into an aesthetic form.

However, the pain that results from this activity is dull and fades after 48 hours of rest and proper nutrition. If you experience sharper pain that lingers for a longer period of time than this, something’s wrong.

Women are more likely to develop this condition than men, mainly due to their increased hip rotation when walking.

Because of this, men who tend to walk more with their hips are also more likely to develop this injury. Other causes are flat feet, wearing foot protection with inadequate shock absorption, muscle imbalances, and low bone density. In general, working the legs too hard when they aren’t accustomed to a high level of physical activity is the main cause of this injury. The result of this is a lingering pain that can impede progress in training.

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Risk Factors

Anyone who is involved in intense physical activity and constantly puts a high amount of pressure on their legs is susceptible to development. There are many ways for it to occur and certain things can raise the chance of them occurring. These include:

  • Being unfit, smoking and having a lack of cardio – This leads to higher impact on exercises, and the area takes more or a beating.
  • Spike in level of exercising done – You may still be adjusting to the jump of routing.
  • Activities that require quick stops, and change of direction, especially on hard surfaces.
  • Running, exercising or taking part in any physically demanding activity on uneven surfaces
  • Lack of solid muscle structure – weak, flimsy, undeveloped muscles
  • Bad choice of footwear – especially old shoes, or shoes with poor cushioning
  • Ankles are weak, or weakening
  • Lack of stretching – causing tight muscles or tight Achilles tendon
  • Pronation complications, flat feet complications, and high arches can also be a problem.

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Diagnosis

Examinations by a Doctor will usually lead to a proper diagnosis. You will need to go forth with a physical, and may even need to get an X-ray done in order to see bone structure and overall condition.

There are some conditions that can fool you into thinking you have shin Splints. It’s not always easy to tell the difference, so you need to go through the proper processes, and really pay attention. Some of these conditions include lack of blood circulation in the lower leg, muscle hernia, compartment syndrome, radiculopathy, stress fractures, tendonitis, exertion caused blood clots, and popliteal artery entrapment syndrome.

Magnetic resonance

Medial tibial pain in athletes is usually diagnosed as shin splint syndrome or as a stress fracture. The evolution of the injury, from the stage of periosteal edema to the following marrow involvement to the eventual stress fracture, can be recognized by magnetic resonance imaging. In one study, 14 runners have been observed in a period of ten days. The total of 18 legs that presented symptoms has been scanned through radiography, a technetium bone scan, and a magnetic resonance imaging scan.
The extent of the injury and the anatomic location of the injury have been defined in a very precise way through the use of magnetic resonance imaging that has been associated with the technetium bone scan grading system. Some medical professionals recommend magnetic resonance imaging to bone scan for grading tibial stress, because the magnetic resonance imaging is more precise and equating the amount of bone involvement along with the clinical symptoms. This helps the medical professionals prescribe the most effective and proper treatment and it helps them determine the best rehabilitative program for the patient affected by the condition.
It is also quite good for the patient because it does not expose one to the ionizing radiation and to the three-phase bone scintigraphy.

X-ray

The X-ray is a quick and painless imaging method that produces images of your body’s structure specifically the bones.
Depending on the density of the material of different parts of your body’s internal structure, the X-ray emissions are absorbed. On the X-ray image, the bones will show up as white because they are denser than other things in your body. The air, for example, in your lungs shows up as black on the image. Fat and muscle show up as shades of gray.

Physical examination

The physical examination is performed by a professional physical therapist who will most presumably feel your leg. They will look for tenderness of the medial tibia, the spot where the tibialis posterior and soleus muscle starts. The physician will take into consideration some aspects of:

  • The upper leg such as any anomalies of the knee (genu varus or valgus), femoral malformations or leg-length inconsistencies
  • The lower leg such as movements of the ankle or deformities of the arch of the foot, tibial twisting
  • The muscles such as the inflexibility of the hamstring and quadriceps muscles and the vulnerability of the core and pelvic muscles
  • The shoes, for example, if the shoes are worn-out
  • The gait patterns, for example, while running on a treadmill

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R.I.C.E. First Aid

Let’s say you are in the middle of an intense physical exercise and you feel an acute pain in your lower leg and tibia. What should you do? The answer is R.I.C.E. This is the first ad-hoc procedure you should be doing in this case. Here are the steps:

R stands for rest. Stop performing any kind of activity once you experience pain and don’t go back to it until the injury is recovered.

I stands for ice. Apply some ice on the painful area but be careful to avoid frostbite. The ice will help reduce the inflammation and the pain.

C stands for compression. You can use straps to apply locally or you can gently apply manual pressure to alleviate the pain. You can combine this with the previous step too, but be careful not to cause bruises.

E stands for elevation. Put your leg on a high surface. This will help your blood flow clear the edema fluid and it reduces inflammation and pain.

Treatment

The most important thing to know is that the pain will go away eventually. For many scenarios, simply resting your feet for a long enough period will result in the problem being solved. Additionally, your feet and legs will grow stronger as a result. However, athletes in the middle of a long training period can’t afford the lost time and physical setbacks caused by this. In that case, these treatments should be considered alternatives to resting. For the majority of people reading this, rest is the best cure, but if the pain persists after a few weeks of downtime, consult a medical professional. If you can’t rest and need to mitigate the damage, try some of these methods:

shin-splint-prevention-tools

  1.  MudGear OCR Compression Socks
  2.  Tread-Labs Stride Insole
  3. SpiderTech Kinesiology Tape
  • Method 1: Compression

Compression sleeves, socks or shoes can serve as a great method to prevent shin splints and soothe the pain induced by them. The purpose of a compression sleeve is to provide structure and support for your legs, ensuring blood circulates evenly throughout the area of compression. Additionally, the extra support provided by the sleeve will offset some of the pressure when running. This will decrease the likelihood of developing it in the future. Whether it’s dealing with soreness or trying to prevent pain down the line, compression is a good method to try, although not the most effective one.

  • Method 2: Insoles

Sometimes, the problem that causes the condition is your foot. The shape of its arch or the quality of support on your training shoes can be the cause. In situations like these, a gel insert can give you extra cushion in key areas of your feet. This is useful for runners that have flat feet, and those who have pronated or supinated feet when running. Insoles fix the uneven weight distribution caused by these foot conditions, and are molded to match the shape of your foot. In these conditions, insoles offer pain relief, allowing you to continue exercising while recovering.

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  • Method 3: Kinesiology Tape

Using KT or kinesiology tape, joints can be positioned and held in their proper place. This can aid in the healing process of shin splints, as it helps set the tibia and muscles while restoring these body parts. This is important in the event of damage being caused due to displacement. In fact, because of its highly effective application in treating shin splints, KT can reduce the pain caused by them due to its load-distributing capabilities. Consider using KT to treat an injury like this if you need to continue exercising through the recovery. It may also be helpful if you’re concerned about long-term damage developing as a result of your injury.

KT Step-by-Step

  1. Clean and shave affected leg
  2. Place an underwrap if skin is sensitive
  3. Cut a 12-18 inch length of tape
  4. Flex foot to 45 degree angle and place tape on top of foot
  5. Wrap tape under foot and across arch
  6. Wrap diagonally up to shin
  • Method 4: Massage

This is more of an immediate technique, but if the pain doesn’t stop, consider going to a specialist to check your leg out. Your physical therapist might show you how to massage the injured area, but in some cases, massage is performed by the specialist. This is a procedure you can do at home yourself or with the help of someone.

Lubricants
You will need a lubricant to help the hands slide gently on your skin without any friction. Do not use too much oil otherwise the movement won’t be controlled. Don’t forget to sit on a flat surface, such as the floor or mat or massage table. There are many massage oils you can use and cheap as well:

  • Simple baby oil. It is gentle and designed for sensible, soft skin. It is quite cheap, easy to use, and it often has a great scent.
  • Methyl salicylate-based analgesic heat rub gels. These gels can be used for massaging the painful area and can help reduce the pain significantly because the skin can easily absorb them and they have a quick result.
  • Specialist massage oil. Although the baby oil and heat rub gels are great, a specialist oil is the best choice because it is thicker and better for massaging. The downside is that it is not a cheap as the others.

Massage techniques
When it comes to this sort of condition it is quite fundamental to learn the correct way to massage the injured spot, you can’t just invent the moves because it is a delicate procedure and there is a risk of doing something that doesn’t work or something that might not be beneficial. The whole procedure should not take more than 30 minutes and it should be performed whenever it is necessary.

Here are the best ways to massage the affected area:

  1. Effleurage

This is a massage technique to prepare the tissue of the affected area for deeper massage methods. The key is to hit, very gently, the area of the leg, always towards the heart. Stroking towards the direction of the blood flow is really important to avoid damage to the veins. The patient should not feel any pain at all. The movement should end by bringing the hands down on the outside of the leg, then start all over again and repeat for 10-20 minutes, while progressively applying a bit more pressure at every repetition.

2. Stripping the muscle

This is a deeper technique that is a bit more intense than the previous one, it also requires more skill, but it is not extremely difficult. All you have to do is to apply pressure, using the thumb of one hand, to the muscles in the posterior area of the compartment muscles (at the back of the shin). The important thing is to not apply too much pressure on the bone or unnecessary pain may be caused. Try and massage the muscle for about 10 to 20 times. Don’t apply too much pressure. The patient should not be able to feel pain. Alternate this massage method with the previous one(cross friction).

3. Cross friction massage

This is a massage technique that should be paired with the previous one. The essence of this move is to apply pressure transversely to the muscle while starting from the lower section towards the knee. Here, it is also important not to apply too much pressure on the bone or unnecessary pain may be caused. This move should help stretch the muscles and reduce the pain exerted on them.

  • Method 5: Extracorporeal shockwave therapy

Extracorporeal shockwave therapy (ESWT) or Extracorporeal pulse activation therapy (EPAT) is a medical method used to treat many tendon, joint, and muscle conditions. This is an out-patient setting procedure that can take up to 30 minutes. The patient needs to be under local anesthesia. Nowadays, in modern clinics, this procedure can be done in less than 10 minutes without local anesthesia and the device which is used is often portable. Usually, castor oil (vegetable oil) is used as a lubricant, instead of the ultrasound jelly because it has a cavitation-free quality. After the procedure, the patient can walk out of the clinic but it cannot take any anti-inflammatory medication and the tibia shouldn’t be iced. Acetaminophen/Paracetamol with codeine may be utilized.

Although it is a safe procedure, it has some contraindications. It shouldn’t be performed if the patient has: neurological and vascular disease of the foot, a history of rupture of the plantar fascial ligament, open bone growth plates, pregnancy, implanted metal in the area (bone screws and pins), and people on medication that interposes with blood clotting, such as coumadin and prophylactic aspirin.

  • Method 6: Surgery

In very rare and extreme cases, the only cure for shin splints is a surgical procedure. These will cost you an exorbitant amount of time and money, so it’s more of a last resort. However, if you tried all other options and are still experiencing pain, this may be the only thing that stops it. A fasciotomy, or series of small cuts in the fascia that connects to the shin, is often implemented. In other cases, periosteal stripping, or removing some of the tibia’s connecting tissue, is a procedure done to ease the pain of shin splints. After an extended period of rest, these procedures should take care of any aches and pains in the tibia.

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While you are trying to recover, you can reduce pain by taking anti-inflammatory painkillers, nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants.

Drugs
  • Ibuprofen is also sold under the trade names of Nurofen, Brufen, Motrin, Advil, and so on.
    Eating a fiber-rich meal is highly recommended before taking Ibuprofen since it might cause, in some rare cases, bleeding of the gastrointestinal apparatus, so carefully read the leaflet and eat a full meal before administering.
  • Naproxen is also sold under the trade names of Flanax, Anaprox, Aleve, Naprelan, Naprosyn, and so on. Naproxen can increase the probability of stomach ulcers, that’s why it’s highly recommended you eat a fiber-rich meal before administering the meds. Some patients may also need an auxiliary proton-pump inhibitor to help protect the stomach by reducing acid production in the stomach. Avoid or consult your doctor if you have gastric, duodenal ulcer, or any stomach-related health problems.
  • Steroid medication and local anesthetic: if the pain progresses, your doctor may prescribe you some injections to reduce inflammation and stimulate tissue growth and repair.
  • Methyl salicylate-based analgesics are also sold under the trade names of Flexpower, Deep Heat, IcyHot, Ben-gay, RUB A535, and so on. These wintergreen oils are intended for topic use and can provide some symptom relief. Just massage an adequate dose on the affected area, let it absorb, and monitor your symptoms. Carefully read the package insert and keep away from children as it’s is usually toxic when ingested.
Choosing a physical therapist

We have talked about the ways to treat Shin Splints, but what do you need to know about the medical professional that is supposed to supervise you and guide you through your treatment? Although all physical therapists are usually prepared and have experience in treating shin splints, here are some tips to find the perfect physical therapist:

1. Experience. Find a physical therapist who has experience with treating people with this condition, specifically people who participate in your sport. Don’t be shy and ask your professional about their experiences in the field, after all, you are putting your health in his hands and he should happy to provide you with information.

2. Specialization. Find a professional who is a board-certified clinical specialist in orthopedic or sports physical therapy.
This type of professional has superior knowledge and skills that might be advantageous for treating your condition.

3. Recommendations. Ask your family and friends if they know a good physical therapist. It is easier to go to a professional who has helped one of your relatives and friends instead of searching for one. If you don’t have any recommendations, you can use online tools on specialized sites such as the American Physical Therapy Association to find a professional in your area.

4. Plans for the treatment. If you consider going to a certain physical therapist first ask him about his treatment plan, what kind of program he could create for you. He should mention the methods described in this article: ice, rest, exercises and stretch, massage, taping, etc. Even if he mentions a new method, ask him about it.

Prevention

Treating shin splints is one thing, but what about preventing them from happening in the future? Once you’ve recovered from an injury like this, it’s important to take measures to avoid it happening later on. Frequent shin splints can cause serious damage down the line. It’s inevitable for athletes to experience this at least once in their career, but future cases are often indicative of bad habits or improper technique. In order to spare yourself the pain and loss of progress, here are some techniques to try:

  • Method 1: Warming up

Warming up before a workout is absolutely fundamental regardless of the physical activity that follows. Starting a
high-impact physical activity without warming up increases the risk of muscle strains. Micro and macro traumas can happen to any muscle, bones, and ligaments. Warming up beforehand a physical activity can lower the risk of injuries by helping the body, particularly the muscles, to slowly slide into the physical activity. Here are some of the best moves to warm up.

1. March on the spot or around for a couple of minutes. This is a great way to get ready for any sport or activity.
2. Dancing is the most effective and fun method to warm up. All you need is a good tune to make you dance. Bounce, slide, turn, spin, etc… Don’t sudden moves, you could injure yourself so be cautious! The first moves should be slow then progressively quicker and more intense.
3. Jump. You get a rope or you can jump. This is a perfect way to accelerate your heartbeat.
4. Swinging your legs, at first slowly then faster and faster can help your body stretch.
5. Exercises that involve balance are important to help your brain get ready for action.

  • Method 2: Incremental training

When starting a strenuous physical routine for the first time, it’s important to ease into the exercise. Shin splints are often caused by adopting a routine that is too intense for someone of their health level. It can be due to a lack of frequent exercise, poor diet, or no sleep. A terrific method to prevent injuries like shin splints and much worse is to train at a lower pace first. Then, work your way up to a more intense level of exertion. Simple changes, like running for shorter periods and cross-training with swimming, are often all that are needed to prevent this injury from happening. Additionally, this can provide relief in the event of an injury, while still allowing you to make progress in your workout plan.

  • Method 3: Ice

Sometimes, your muscles just need to cool down. Inflamed muscles can lead to micro fractures in the tibia if left unchecked, so in some cases it can be beneficial to put ice packs on your lower legs if they become swollen from excessive activity. This helps reduce the swelling, eases the pain, and prevents shin splints from every happening with a bit of foresight. While commonly used in the treatment of this injury after it’s already occurred, the cooling and deflation of sore muscles can be used as a very effective preventative measure. Don’t wait until you feel the pain to add the ice!

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Ice Step-by-Step

  1. Get an ice pack or plastic bag full of ice
  2. Wrap in a towel
  3. Place the towel-wrapped ice on affected area for 15 to 20 minutes
  4. Repeat every hour as needed
  • Method 4: Barefoot running

Barefoot running is an unconventional modern exercise. However, it has been quickly gaining popularity in recent years among fitness enthusiasts and professionals. The knowledge that hard striking of the heel provides support for dull aches has been harnessed by native tribes in Mexico. It is commonly recommended by fitness gurus as a more natural way to run as a result. The justification for this statement is that your ancestors walked in harsh environments without foot protection, and so had to rely on their hardened feet. Based on prevailing scientific thought, this may seem like a logical explanation, but adequate proof from extensive testing has yet to develop. Still, it’s hard to deny the satisfying feeling of striking your heel hard against the ground!

  • Method 5: Foot drills

Your legs perform better if they are stretched first. This is true of any other part of the body. Medical professionals have designed special warm-up routines that target the areas susceptible to shin splints. Performing these exercises before your workout session will prime the muscles you are working and help prevent injuries. Toe curls, heel drops and leg bridges are all effective as warming up exercises. Try implementing these exercises in your warm-ups, and you will cut down on shin splints and other painful conditions.

khourychiropractic.com.au

Foot Drills Step-by-Step

Toe Curls:

  1. Stand with feet hip-width apart
  2. Place foot on the edge of a towel
  3. Curl toes, gathering towel toward you
  4. Repeat with other foot

Monster Walks:

  1. Stand with feet shoulder-width apart
  2. Place resistance band around thighs
  3. Extend right leg and step out toward the right
  4. Repeat with left leg
  5. Take two steps backwards in similar fashion
  6. Repeat a few more times

Heel Drops:

  1. Stand on your toes at the edge of a step
  2. Shift weight to one leg
  3. Lift other leg
  4. Lower heel of leg with weight placed on it
  5. Raise heel and return to starting position
  6. Repeat with other leg

One-Legged Bridges:

  1. Lie on back with arms on the side
  2. Bend knees
  3. Use glutes to lift hips off the floor
  4. Extend one leg in the air for 30 seconds
  5. Lower leg and repeat with other leg
  6. Repeat incrementally, working your way up to 60-second extensions
  • Method 6: Strengthening workout

Adding some strengthening moves can help your muscles reduce the stress exerted over the tibia and can also help you have a better posture and a better distribution of the weight in your legs. It can also help your body to be more prepared for high- impact sports. Here are some moves you can add to your strength routine:

  • Step up raises. Take two dumbells in each hand. Stand tall and step with one the right leg on a bench or some higher surface using one just the right leg to lift your body. Once you’ve lifted your body and you are standing tall on the bench, lift your heel up. Don’t forget to inhale and exhale, don’t hold your breath. Repeat on each leg for about 15 to 20 times. This is a combined move, a calf raise, and a leg lift. You should feel it in your whole leg specifically in your calves and shins, but also in your quadriceps and hamstrings.
  • Wall shin raises. This is an exercise that can be done with just your body weight, but it is more effective if weight is added. Hold some weights in your hands and stand with your back against the wall. Keep your feet a bit distant from the wall, now just lift yourself on the ball of your feet. Repeat 25-50 times in a row. Don’t forget to breathe. This is an awesome exercise to isolate your shins, and it will help them become stronger and resistant to high-impact physical activities.
  • Single wall shin raises. Just like the previous one, this is an exercise that can be done with just your body weight, but it is more effective if weight is added. Hold some weights in your hands and stand with your back against the wall. Keep your feet a bit distant from the wall, now just lift yourself on the ball of your just one foot. The other should make a sole-to-wall contact. Repeat 25-30 times in a row. Don’t forget to breathe. Just as the other one, this is an awesome exercise to isolate your shins, and it will help them become stronger and resistant to high-impact physical activities. The difference between this exercise and the previous is that this one uses just one leg at a time and so it can help you get the same results on each leg. The other one, although easier, can increase the possibility of the prevalence of one leg over the other resulting in unequal results.
  • Method 7: Stretches for shin splints

Stretching your shins and calves is really important to prevent and cure shin splints. The moves can be combined with some yoga moves to maximize the results. The stretch moves work on the muscles and the body while yoga helps to calm down and strengthens the immune system. Here are some important yoga stretches for shin splints:

  • Downward dog: start on all fours, spread your palms on the mat then press the hips towards the ceiling. Your body should resemble a boomerang. While you inhale and exhale, you will stretch your calves, your arms and your back muscles.
  • Child’s pose: sit on your knees, then on your the back of your feet. Try to touch the floor with your chest while elongating your arms in front of you. This is a very relaxing pose, and it stretches so many muscles in the body.
  • Heel step-downs. Stand tall with your feet apart. One leg should be further than the other which should be behind.
    You should next lift the toes of the foot that is forward (so you are now on the ball of that foot) while you are lifting the heel of the other one (calf raise). Repeat for 20 and then switch legs. This is not just a motion to isolate the two muscle groups, but it also requires coordination. You can add some weight if you want.
  • Seated shin stretch. Sit on your knees. Put your feet behind you so that the heels face the ceiling. Lean backward, slowly and gently, using your arms to help you stabilize and then lift your knees. You should be able to feel it in your shins. Hold this position and breathe, if you want close your eyes. It is recommended to do this stretch on a soft surface.
  • Gastrocnemius muscle stretch. All you have to do is to face the wall and lean into it, then push the leg behind you into the floor. Try and touch the floor with the heel. The further leg is slightly bent, but should also touch the floor with the heel and the sole of the foot. Hold the pose for a couple of seconds then switch legs. Repeat for 3 to 5 times. If you don’t feel the stretch then you should move your legs further apart, specifically the leg that is behind. You should feel it in your calves and shins.
  • Soleus muscle stretch. Face the wall and lean into it, then the leg that is behind should have the knee bent towards the wall. Don’t forget to keep the sole of the foot in contact with the floor. The other should be quite straight and in front. You should be able to feel it in your lower calf. This position is meant to be held for a couple of seconds, then switch legs. Repeat for 3 to 5 times.
  • Calf stretch. Sit on the floor with your legs straight in front of you. Wrap a towel or an elastic exercise band around your foot, then pull towards you. You should feel it in your calves and in your shin too. This stretch strengthens the shins too. Don’t forget to hold for a couple of seconds, to breathe, and to repeat on the other side.
  • Shin resistance exercise. Sit on the floor. You will need an exercise elastic band. Wrap it around a table leg and around your foot. Pull the band with your foot towards you. You should repeat it on the other side for another 20 reps. You should be able to feel it in your shins. Don’t forget to breathe.
  • Method 8: Vitamins

Since shin splints are a result of tears in your tibia, an effective preventative measure is to strengthen your bones. Some effective vitamins for promoting bone strength and density are calcium and Vitamin D. These nutritional supplements are connected to increased bone density in medical studies. Consider altering your diet to include foods with higher concentrations of these nutrients. Orange juice, milk, tuna, mackerel, and egg yolks are great sources for these vitamins. Taking this step will not only prevent shin splints, but can even stop the development of osteoporosis!

Foods with High Vitamin D:

  • Mackerel
  • Salmon
  • Tuna
  • Beef Liver
  • Egg yolks
  • Cheese
  • Vitamin D enriched milk

Drink lots of water! The adequate quantity is about 1.5 – 3 liters a day. Sun is also important because it is a viable source of Vitamin D that is fundamental for the absorption of Calcium and other minerals and vitamins.

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Signs that your Shin Splints have healed

In this article, we have listed and described the ways to prevent and cure the Shin Splints, but how do you know that your body has healed, particularly the shins, the tibia. Here are the signs that your Shin Splints have healed:

1. Flexibility. If your injured leg has become just as flexible as the other, meaning you can move in a million ways and it doesn’t hurt, then this might be a sign of the healed Shin Splints. It should be a natural result of the stretching and rehabilitation.

2. Strength. If your injured leg feels just as strong as the other, meaning you can workout and it doesn’t hurt, then this might be a valid indicator of the healing. This should also be a natural result of the rehabilitation and stretch.

3. Absent pain. If you can step and use (without having pain) the parts of the leg or foot that were painful, then your shin splints might be healed. This should also be a natural result of the rehabilitation and stretch.

4. Normal activities. If you can jog, sprint, and jump without feeling pain then you should have healed Shin Splints.

5. X-rays. If your X-ray does not present fractures or signs of Shin Splints then, congratulations, your shins are healed.

Even if you do not have all these signs, but only partially, then it means you are healing, you just have to keep being patient and keep going with the rehabilitation.
Most people heal within 3 to 6 months, it depends on the case. The most important thing is not to rush too soon into high-intensity physical activities, or there is an increased risk of hurting perpetually.

Muscle balance and bone density

Muscle imbalances occur when one muscle group on the body is neglected for another. This is possible by exercising one leg more than the other, or by focusing more on biceps than triceps when lifting weights. These imbalances can cause tightening and swelling, which affects the underlying bones and may even cause fractures. In addition, weaker tibia can bend slightly when running, due to the high strain put on them from impact with the ground and weight of the entire body focused on them.

These factors working in tandem are often the cause of shin splints in less experienced runners. Over time, these pains will occur less, due to improved muscle definition and bone density.

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Arches, Feet, and Gait

When assessing the cause of shin splints, there are times when the cause is how you walk, rather than how much. If you’re flat-footed, pronated or supinated when walking or running, this can be the cause of your injury.

If your feet walk in an abnormal position and don’t evenly distribute your body weight, more pressure is exerted on your tibia, increasing the likelihood of shin splints. Examine the way your feet move when walking, and consider investing in orthotics if you have a chronic condition. Sometimes, these irregular walking habits can only be treated with extensive physical therapy, but the pain relief that comes with proper walking habits is worth the effort.

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Stress fractures

Shin splints are a common injury among runners, but it’s still very important to treat them when they sprout up. In the event that you don’t adequately manage this injury (either through rest or through other methods), you increase the likelihood of a more painful condition, such as a stress fracture. With a stress fracture, the pain in your foot increases dramatically. It can even cause permanent physical damage if not treated properly and in a timely manner.

Don’t leave this injury untreated and continue to exercise in the manner that resulted in the condition in the first place. Further stress on the tibia can result in a stress fracture. These happen most commonly to runners who work too hard without proper diet, form, or health necessary to run so much for so long.

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Recovery takes several weeks of inactivity, meaning any progress gained through training will most likely be lost afterward. It’s for this reason that athletes make sure to take steps to prevent this injury, or in the unfortunate case of getting shin splints, make an effort to mitigate the damage caused.

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False positives

When a shooting pain occurs in your lower feet, near the shin, a common culprit for runners is shin splints. Even though this is a safe bet, there are a few other possibilities you may want to eliminate before coming to the conclusion that you’re actually experiencing this injury. Ruling these out can prevent a waste of your effort trying to treat the symptoms and not the cause. In that case, you may want to have an MRI taken or consult a doctor to rule these other conditions out:

  • False positive 1: Tendonitis

Tendinitis is a condition where the muscles take on more of the pressure than the bone, resulting in tendon pain. This is often a cause of what is classically referred to as shin splints. However, it’s different from these because the damage is located on the muscle, not the bone. Instead of micro-fractures, the tendon experiences unnatural stretching and tearing. Because of this, a more accurate term for this specific condition is acute tibial tendinitis. When dealing with pain in your feet, consider if you are experiencing bone pain or tendon pain, and seek according treatment.

  • False positive 2: Periostitis

Another type of pain that commonly afflicts the lower legs of runners is periostitis. This is similar to tendonitis in that it is caused by tissue rather than bone. However, the affected tissue is the periosteum, a tissue that surrounds both the tibia and fibula. When this is torn, many athletes will improperly refer to it as shin splints. However, it is important to rule out this possibility before coming to that conclusion, because it can impede in your recovery process otherwise.

  • False positive 3: Compartment syndrome

Chronic exertional compartment syndrome, referred to as compartment syndrome for short, is a much rarer condition that afflicts the muscles. It comes as a result of excessive pressure on them and can cause a loss of blood flow. In some extreme cases, debilitating muscle injury can result from this condition, so it is advised to check with a medical professional if this is a possible reason for recent shin pain. The methods required for treating this condition is different from shin splint treatment. Because of that, you should rule this out if you wish to relieve leg pain.

Sports-injury-concept-muscle-tissue

 

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Epidemiology

Most people who are affected by the shin splints and have an increased risk of developing the condition, according to quite a few epidemiologic studies, are of younger age, female gender, people who present anatomical variations such as genu valgus and pes clavus, with excess pronation, smoking, increasing weekly mileage in runners, practice aerobic dance,decreased physical fitness, and previous injury. Some other studies may insinuate that age and gender, warming up, cooling down, or stretching, excess running mileage or joint laxity are not relevant factors that may contribute to the development of the condition. Other factors, such as life stress and psychosocial factors, were not linked to the condition.
A few clinical studies were conducted focusing particularly on the risk factors. Some other factors have been detected such as an increased varus tendency, increased muscular strength of the plantar flexor muscles, increased double heel strikes during dance among ballet dancers, increased angular displacement when running due to structural or functional abnormalities in the heel and ankle, and increased external rotation of the femur with the hip extended.

To sum it up

After reading this article, you should now be adequately informed on the causes of and solutions for shin splints. Refer back to this article in the future if you need a refresher on this condition; the information here is comprehensive and can offer aid in the event that you find yourself suffering from it. If you’re worried about shin splints, or if you have the condition and want to treat it, this article will provide adequate working knowledge of it.

With a bit of forethought and some common sense, most cases of shin splints can be avoided. The implementation of knowledge from experienced professionals will also aid in the treatment process. If you’re serious about your training, you’ll want to leave nothing in the way of you and your fitness goals. Now get back out there and start running!

Co-written by Edy Mihai

Curated by Diana Rangaves, PharmD, RPh

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Here are some of the sources used while conducting our research

The sources listed below back up several health claims made in this article. They are pulled from scientific studies and online posts written by medical professionals. Regardless of the amount and quality of the research put in, this article is only meant to inform. Do not treat the contents of this article as professional medical advice. You should always talk to a doctor if you are experiencing unfamiliar pain in order to get an accurate diagnosis.

Sources

  1. Open Access Journal of Sports Medicine, Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis, Online sports medicine journal,
  2. Journal of Orthopaedic & Sports Physical Therapy, Medial tibial stress syndrome in high school cross-country runners: incidence and risk factors., Online Library of Health Topics & Information,
  3. Clinics In Sports Medicine, Medial tibial stress syndrome., Online Library of Health Topics & Information,
  4. Dr. David Ryan, Shin Splints: Learn To Run Pain Free!, Fitness Information Website,
  5. Brian Fullem, A Stress Fracture Primer, Runners General Information Source,
  6. Dr. Marybeth Crane, Shin Splints Can be Anterior Tibial Tendonitis, Injury & Complications Information Database,
  7. Ortho Info, Compartment Syndrome, Orthopaedics Information Database,
  8. Physical Therapy In Sports, Lower-leg Kinesio tape reduces rate of loading in participants with medial tibial stress syndrome., Online Library of Health Topics & Information,
  9. Robert P. Wilder, MD, Surgery for Shin Splints, Sports Injuries and Health information Database,
  10. Caitlin Carlson, 4 Exercises to Prevent Shin Splints, Runners General Information Source,
  11. Drugs.com, Shin Splints, Online Database of Complications & Treatments,
  12. Daniel E. Lieberman, Strike type variation among Tarahumara Indians in minimal sandals versus conventional running shoes, Online Database and Journals of Scientific Research,
  13. The Journal Of Nutrition, Vitamin D and bone health., Online Library of Health Topics & Information,
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