Along with the anticipation, endorphins and improved health that come with beginning to run, starting a new training program or ramping up miles, there can be some aches and pains. Usually these are reminders that your body is adjusting to your new fitness levels. However, a dull aching pain at the front of the lower leg could mean you have an overuse injury called shin splints (aka medial tibial stress syndrome). Long thought to stem from stress where connective tissues attach to the shinbone, recent studies show shin splints are more of a bone injury. The injury is two to three times more common in women, possibly because women generally have a lower bone density than men. Roughly 3 million people a year are affected by shin splints.
Symptoms
Pain is generally felt along the edge of the tibia in the lower portion of the leg. The discomfort may be dull and throbbing to sharp and intense. It can hurt during and after exercise and may also result in some swelling. The lower leg may be sore to the touch at the site of the injured area.
A stress fraction in the tibia, tendinitis and chronic exertional compartment syndrome may also cause pain in the same general area as shin splints. If conventional treatments for shin splints do not help, your doctor may check for these conditions.
Causes
Shin splints are generally attributed to the stresses caused by higher impact activities like running and dancing. They are common in those runners who are increasing the intensity and amount of their running without allowing their bodies to adapt to the heavier load.
Recent studies indicate the trauma happens from the slight bend that happens in a stress-loaded bone. Easing into a training routine allows the bone to strengthen for the rigors of a high-impact sport such as running, and lessens the chance of shin splints. Repeated and sudden starts and stops on hard surfaces, muscle imbalances, tight calves, flat or inflexible arches, overpronation and worn-out shoes also contribute to achy shins.
Treatment
As overuse injuries go, shin splints are one of the easier ones to heal. That may not mean much when you’re in the midst of the pain, but there’s hope!
Rest, Ice, Compression, Elevation
Take a break from running until the pain dissipates. Ice the injured area for 10–20 minutes three to four times a day. Wear a compression sleeve or sock to stimulate blood flow through the shin. Compression and elevation (when you can) will help to reduce inflammation. Maintain fitness with low-impact activities, such as swimming, biking or using an elliptical trainer.
Visit your physical therapist
In addition to recommending strengthening, mobility and stretching exercises to aid with recovery, a physical therapist may perform sports massage to improve blood flow to the injured area.
Go shopping
If shin splints are a recurring theme, consider investing in orthotics or more supportive shoes to help correct overpronation and aid in proper foot alignment.
Tape it
Taping may take some of the stress off the injured area, especially as you’re in the acute phase and as you return to running. Here’s how to apply physio tape for shin splints.
Go slow
When returning to running, do so at a lower intensity and volume than before your shin pain.
Visit a doctor
If pain persists or worsens, be sure to visit a medical professional.
Prevention
Shin splints aren’t a permanent problem. Follow these tips to keep legs healthy and injury-free.
Warm up, stretch and strengthen
Every run should begin with a few minutes of walking and dynamic stretching and end with a few minutes of recovery stretching and rolling out post-run. Foot and ankle strengthening exercises are also essential for developing and maintaining good balance, flexibility and stability. They may not be your favorite activities, but even a few minutes of daily mobility and stability work will make a noticeable difference in overall functionality. (Here are a few stretch and strengthening exercises to get you started.)
But start slow
At least when it comes to workout loads. Too many miles too soon can add to medial tibial stress. Ramp up the frequency, length and speed of runs gradually to allow the body to adjust. Cross-training with activities like swimming will help you maintain overall fitness in a low-impact way to give your legs a break.
Wear the right shoes
While you certainly can go for a run in hiking boots or gym shoes, you may be setting yourself up for injury. Visit a specialty run store to ensure you have the proper fit, plus size and style of shoe.
Consider going barefoot
Once or twice a week, finish your run in a grassy area. Removing your shoes for a brief walk or run on the grass feels good, plus it gives your feet the opportunity to move naturally and get stronger. Remember to build up gradually.
More info
Watch this explanatory video from noted Boulder, Colo., physical therapist and running coach Douglas Wisoff:
