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Shin Splints

By Alan Williams, PT, OTR/L, ATC, CSCS

Even though my kids are grown, I still love to share things with them – a laugh, a meal, a memory. I can’t think of anything better. But there are other things I wish we didn’t have to share. For example, my daughter and I share a propensity for developing shin splints.

“Shin splints” is a blanket term for pain in the front of the leg below the knee. Officially called medial tibial stress syndrome (named for the medial tibial muscles or shin muscles), shin splints are often a very personalized ailment; there are many different causes, symptoms, and treatments. What works for one person may not necessarily work for another. But with a little trial and error, most cases can be successfully treated. Just remember to be patient! Shin splints don’t go away overnight. In general, the longer you’ve had the condition, the longer it will take to fully recover.

To successfully treat shin splints, first identify the source. There are three main causes: flat feet, overused muscles, or chronic compartment syndrome. Each has a specific set of symptoms and treatment recommendations. However, remember to see your doctor right away if your shin splints are accompanied by sudden, severe pain, swelling, numbness, or abnormal feelings of heat in your legs or feet.

Flat feet affect the biomechanics of walking and running, and the medial tibial muscles become weak and overstretched as a result – causing pain, swelling, and tenderness in the shin area. This can also occur with other biomechanical abnormalities, such as overpronation (where the feet roll too far inward) or supination (where the feet roll too far outward). These issues greatly benefit from the use of orthotics (look for ones specific to your condition). Once your gait is corrected, the shin splints should stop occurring, but you can treat short term symptoms by resting, using ice packs, and elevating your shins to reduce swelling.

Shin splints from muscular overuse often occur in people who put too much sudden stress on their legs – such as being sedentary during the week and then hiking 20 miles on the weekend. The medial tibial muscles aren’t prepared to handle the abrupt activity. Treatment in this case involves managing the pain of shin splints while strengthening your muscles with regular exercise. Rest your shins as much as possible, apply ice packs for 20 minutes several times a day, and use over-the-counter pain medications (if approved by your doctor). Stretching the medial tibial muscles is greatly beneficial; however, they are notoriously difficult to stretch. Try this stretch (it works best without shoes) – sit in a chair with your feet flat on the floor. Slide your toes back under your heels so the top of your toes are now on the floor. Hold for 15-30 seconds and repeat as needed. Press into the floor if you need more stretch, but stretch only to the point of gentle tightness. If it hurts, you’ve gone too far.

Too tight calf muscles can also cause shin splints. If the calf muscles don’t extend as normal during activity, the medial tibial muscles must stretch farther to compensate, thus becoming injured. Treatment includes the above steps, as well as an aggressive stretching program for the calf muscles. See your physical therapist for guidelines on how to do this.

Chronic compartment syndrome (CCS) is the most serious form of shin splints. During exercise, swelling naturally occurs in the legs. In CCS, this swelling happens to the point that it actually inhibits blood flow and compresses nerves, causing pain, tingling, numbness, and weakness in the shins and feet. In the worst CCS cases, surgery is needed to prevent muscle death. If your shin splints worsen with prolonged exercise (rather than improve as the medial tibial muscles warm up and get looser), see your physical therapist.

Shin splints can be a frustrating part of having an active lifestyle, but with patience and a little TLC, they won’t hold you back for long.

Don’t let shin splints keep you down. Call 463-0022 today for your FREE Shin Pain Assessment!