Shin Splints: What They Are & How To Get Rid of Them

For this week’s training issues topic, I’m going to cover an oldie but goodie that still gets folks from time to time – shin splints.

The technical term for these is Medial Tibial Stress Syndrome.

Medial describes the area: inside. Tibia is the shin bone. And stress is what’s causing the pain.

When the muscles and tendons in the lower leg get inflamed, they pull on the attachments of tendons and bone tissue at the inside (medial) and sometimes posterior (back) of the tibial bone.  Each time you plant your foot with force – it could be when running or even something like dancing – those muscles aren’t able to absorb the shock as they should, resulting in pain. For those with flat feet, the ability to absorb impact is even more compromised, resulting in rather acute pain.

Why do we get shin splints?

The main reason is from jumping right back into an activity too aggressively. Perhaps you took time off over the winter or needed to recover from an unrelated injury.

When you resume training after a prolonged break, you often need to get re-acquainted a bit with your gait and foot strike. Try to recall how you typically feel when running as well as your usual tendencies.

Are you a heal striker? Do you feel like you’re shortening your stride? Or lengthening it, perhaps?

Do you just feel heavy or lacking your old rhythm?  Maybe you’ve picked up a few pounds since you last trained? (Hey, it happens to all of us!)

Any one or all of these can impact your gait, stride, and overall running rhythm.

I know it seems a bit ridiculous to say you need to really think about how you are running or even walking but it isn’t always as easy as just putting one foot in front of the other. There are so many things that have to happen to make our legs move in a forward motion.

Hips have to be aligned correctly so each gluteus is able to move equally, helping the leg to extend.

The hip flexors have to be strong enough to pull the femur (thigh) up to flex and help bend at the knee.

Then our lower leg muscles need to understand how the foot should plant to give us the propulsion required for the activity we are asking it to do. If just one muscle isn’t doing its job, things can go south.

Shin Splints usually occur with a heal striker, or a heavy foot plant. If your gate is off, you will usually have a harder hit during leg turnover. This jarring impact causes the lower leg muscle to take the majority of the shock without dispersing it to the other muscles that help. The shock and all the force will be taken at the lower leg, causing pain and damage at the tibial area of the leg.
What can you do to fix shin splints?

1) I rarely tell clients to stop exercising, but in this case easing up on the running (or other activity) for a few days is best.  You can still do other non-impact activities.

2) Roll or massage the tibial muscles, using a hand roller, rolling pin or even a tennis ball.  Then add in some easy stretching to the calf and outside of the lower leg.

3) Alternating ice/moist heat sessions is a great way to alleviate inflammation in the area.  I recommend 5 alternating rounds of moist heat (think hand towel wrung out with hot water) and an ice pack. Always start and end with heat, switching immediately to the opposite temperature every 5-7 minutes.

4) When you are feeling like things have calmed down, start back with an easy jog and evaluate your running. Avoid running on uneven surfaces. Make sure you can start out flat and on softer ground, like a track or grass. Avoid hills and don’t step into gutters.

5) Mix things up by switching the direction you normally run. Find body weight exercises to help you get stronger.

Once you have no pain, you can resume running consistently as you should no longer be plagued by them. If things continue to be uncomfortable, you may need help addressing scar tissue or adhesions in the muscle before you can recover 100%.

Reach out to me and let’s get you back to running, dancing or your favorite sport!

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Yagi S, Muneta T, Sekiya I.
Incidence and risk factors for medial tibial stress syndrome and tibial stress fracture in high school runners.
Knee Surg Sports Traumatol Arthrosc
. 2013;21(3):556–563. Article Summary in PubMed

Becker J, James S, Wayner R, Osternig L, Chou LS.
Biomechanical Factors Associated with Achilles Tendinopathy and Medial Tibial Stress Syndrome in Runners.
AM J Sports Med. 2017 Sep;45(11):2614-2621. doi: 10.1177/0363546517708193. Epub 2017 Jun 5

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