What Are Shin Splints?
Shin splint pain is a diagnosis for ‘overuse’ injuries to the front of lower leg, as a result of poor conditioning. The technical term for shin splints is, medial tibial stress syndrome (MTSS). Pain presents itself after a series of intense workouts, characterized by a dull ache on the inside, lower portion of your shin at the beginning of a workout. The discomfort may disappear once you have warmed up, so the problem tends to be ignored.
If the condition is left untreated, the re occurring pain persists for longer portions of your workout. In time, pain advances throughout your training sessions as well as your cool-downs, and also present during regular daily activities. If you palpate the area near the back, inside edge of the lower part of your tibia (the large shin bone in the lower leg), you can identify tenderness without any noticeable swelling, and the pain seems to revolve around the soft tissues (muscles, tendons and connective tissue) near to, but not on the tibia itself.
Internal Compartment Syndrome
The first type of injury occurs due to increased pressure in the front of the leg, otherwise know as ‘internal compartment syndrome’. Tight or overworked calf muscles tug on the attachments of the border along the shinbone, causing damage and pain. The bodies natural defense system attempts to stop the pain, by laying down scar tissue. This action cause more pain and tightening.
External Compartment Syndrome
The second type of injury, known as ‘external compartment syndrome’ occurs due to unstable dorsiflexors (leg muscles). Typically, the ankle dorsiflexors, the muscle that draw the top surface of the foot towards the shin and also restricts the foot pulling away (plantarflexion) from the shin too vigorously, are dysfunctional. The runner with this type of injury often makes a ‘slapping’ sound, as the foot strikes the ground. The problem is caused by, a rapid increase in the size of the calf muscles, resulting in an increase of pressure on nerves and blood vessels, creating pain.
If there is pain on the tibia, this may be due to another condition, known as a stress fracture. Caused by excessive weight bearing in either running, sprinting or jumping. Some common causes are inappropriate footwear, poor biomechanics, incorrect running technique, muscle tightness, and muscle fatigue.
Shin Splint Pain Treatment
There are three elements to the rehabilitation process; reducing pain and inflammation, identifying possible causes and restoring muscles back to optimal condition with a gradual return to full fitness. Treatment resolution may take anywhere from 3 weeks to 12 weeks.
The acronym PRICE represents protection, rest, ice, compression and elevation. Apply a cold compress wrap around the affected part for 10 minutes every hour during the first 24 to 48 hours reducing frequency to 3 or 4 times a day as symptoms improve. Do not apply ice directly to the skin as it may burn. Wrap some ice in a small towel or cloth. Alternatively there are a variety of commercial cold packs available, form sport shops, pharmacists and super markets.
Rest is often ignored, but continuous training on an injury, even mores so with severe shin splints. You can maintain an exercise routine by switching to swimming, cycling, cross trainer, rowing machines, step machines and other ergonomic equipment.
As most people have to be on their feet during the day it may not be possible to rest completely. Kinesiology or traditional zinc taping can instantly relieve symptoms in most patients. The application of tape supports the muscles of the lower leg by pulling them towards the shin bone reducing traction forces at the most painful part and allowing the soft tissues (muscle, tendon etc.) to rest.
A doctor may prescribe anti-inflammatory medication e.g. ibuprofen to help reduce pain and inflammation. However I would advocate massage, IASTM, and gentle active stretching.
Returning to full fitness
A gradually return to running, can begin after 2 weeks of pain fee walking is achieved. Apply tape or a neoprene sleeve to the shin to support it for the first few exercise sessions. At the end of each training session apply ice to the shin for about ten minutes.
Ensure you stretch properly before each training session and after. Hold stretches for about 30 seconds and repeat 5 times. Use massage regularly as this will help prevent the muscles tightening up, hardening and putting strain back onto the lower leg again.
Each training session should start with a short walk followed by a stretch.
Day 1: walk 5 minutes jog 2 minutes repeat 4 times
Day 2: rest, swim or cycle.
Day 3: walk 5 minutes jog 3 minutes repeat 3 times
Day 4: rest, swim or cycle.
Day 5: walk 5 minutes jog 4 minutes repeat 4 times
Day 6: rest, swim or cycle.
Day 7: walk 5 minutes jog 6 minutes repeat 4 times