Shin splints:
History: This is almost always an overuse injury, beginning slowly and getting worse. Shin splints usually happen after some change in your running program. Ask yourself if you have changed equipment such as your shoes. Or maybe, you have used the same running shoes for 4000 miles. Have you added additional hills (especially downhills) or trail running?
The front of your shin hurts just after the heel hits the ground, as your foot is lowering to the ground. Your shin probably hurts more when you are running downhill than when you are running uphill. The pain starts as soon as you begin running and gets worse as your run progresses. It may take several minutes to several hours before it relieves.
Self-Exam: Here are some things you can look for in yourself.
1) Stand in front of a mirror and look at your shins. One may be larger than the other. Also, have someone look at your calves from the back. There may be a size difference there also. These may be a indicator that one side is stronger than the other or that one muscle has some swelling. PH
2) Hold on to something for balance and then try to pull the toes of both feet up and to the middle. (This is not a balance test.) VID
3) It is really important to check out the tests for stress fracture! The symptoms for stress fracture are very similar to shin splints and you should make absolutely sure you do not have a stress fracture of your tibial.
Treatment:
1) Manage the pain:
a. NSAIDS will help.
b. Kinesiology taping to the shin can relieve some of the stress on the muscle and increase blood flow. LIN
c. Ice or heat can relieve your pain.
i. Ice right after you get done running
ii. Heat on non-running days
d. Continue running but avoid aggressive speed work and hill repeats, especially downhill running.
2) Restore full motion:
a. A lot of patients with shin splints have tight calf muscles or even tight hip flexor muscles which change your stride.
i. Sequential short-term running will address these muscles. VID
ii. Stretching does not have to be part of your warm-up or cool-down. But it HAS to be part of your training program. LIN
3) Begin non-weightbearing exercises to restore strength without all the pressure on the joints
a. Exercises to strengthen the Anterior Tibialis muscle.
i. Begin with isometric exercises to reduce the stress on the muscle. VID
ii. Progress to tubing exercises for the same muscle. VID
b. You will not be at this level very long; we just need to increase your strength while minimizing stress on your ankle.
4) Begin body weight exercises with emphasis on control versus strength and power.
a. Apply the kinesiology tape to your shin before you start your weight-bearing exercises.
b. These are done slowly, with a short range of motion, and STOP BEFORE IT HURTS.
c. Wall-slides, sit-to-stand, static lunges, lateral step-ups, etc. LIN
Click here for video to know if you are ready to progress to more aggressive exercises.
5) Correct running mechanics.
a. Gradually return to your previous running. Start on relatively flat ground or even on a treadmill. The best part of returning to running with a treadmill is that you can actually hear your footsteps. Also, a lot of treadmills are in front of a mirror so you can see your hands move and your feet move. If your arms or legs swing weird, you may want to have a physical therapist complete an evaluation before you return to full running. Listen and ‘feel’ how you run. Is one leg hitting the ground harder than the other? Does one arm swing differently than the other? Until you can run without pain and with fairly symmetrical running mechanics, you are still at risk of reproducing your old injury or creating a whole new injury to another part of your body.
b. As soon as you can run without pain and without a limp you can return to your normal running routine.
6) Return to running speedwork and hills. After you have been able to run on flat ground for a week with your with your normal training and have not had any pain, you can begin to add speed and hill training to your program.
7) My favorite step, get back to full running! Have fun. Eventually you will bust something else and be back to the website to fix that.
8) If you follow the steps on the website for 2-6 weeks (depending on how badly you hurt yourself the first time and on how long you tried to ‘run through the pain’) and your problem does not resolve, then call our clinic for an appointment and we can do something Dr. Google cannot do. We can complete a hands-on evaluation, in-person evaluation to determine the cause of your pain.