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Shin Splints
Definition: Inflammation of the muscle attachments and
interosseous membranes to the tibia (shin bone) on the inside of the
front of the lower leg. Note: "shin splints" is a very widely used
phrase and can refer to several lower leg injuries. The focus of this
description is specifically on the inflammation described above.
Symptoms:
- Pain or tenderness along the inside of the shin, usually about
halfway down the shin. Pain and tenderness may extend to the knee
- Pain on palpation of the shin
- Pain is most severe at the start of a run, but may disappear
during a run, as the muscles loosen up. This is different to a
stress fracture, where there is pain during weight bearing
activities (walking, stair-climbing)
Causes:
- Inflexible calf muscles and tight Achilles tendons - place more
stress on to the muscle attachments
Overpronation (feet rotate too far inward on impact) excessive
running on hard surfaces, such as concrete pavements
- Incorrect or worn shoes
- Overtraining, or a rapid increase in training load or intensity
- Beginner runners are more susceptible to this problem for a
variety of reasons, but most commonly due to the fact that the leg
muscles have not been stressed in such a way before they started
running.
Treatment
Self-treatment:
- Stop running, especially in the case of severe pain, if pain is
mild, then reduce training load and intensity, and avoid downhill
running and running on cambered surfaces
- Take a course (5 - 7 days) of non-steroidal anti-inflammatory
drugs(ibuprofen/voltaren/cataflam/mobic)
Apply ice to the shin area - for 10 minutes every 2 hours, in order
to reduce the inflammation
- Self-massage, using arnica oil or an anti-inflammatory gel, to
the muscle only (along the inside of the shin)
- Stretching of the gastrocnemius and soleus muscles. Hold for 30
secs. Relax slowly. Repeat to opposite side. Repeat stretch 2 - 3
times per day.
Remember to stretch well before activity
- Return to running gradually—full recovery is usually between two
to four weeks
Medical treatment:
- Podiatrist for custom-made orthotics to control overpronation
- Physical therapy, if injury doesn't respond to self-treatment in
2 to 3 weeks
- If injury does not respond to physiotherapy treatment, a bone
scan, diagnostic ultrasound or X-ray may be necessary to check for a
stress fracture.
Alternative exercises:
swimming, pool running, cycling (in low gear) "spinning"
avoid any weight-bearing exercises
- Preventative measures:
Correct shoes, specifically motion-control shoes and orthotics to
correct over-pronation
- Orthotics or arch supports
- Stretching of the gastrocnemius and soleus muscles. Hold each
stretch for 30 seconds, relax slowly.
Repeat stretches 2 - 3 times per day. Remember to stretch well
before running.
- Strengthening of foot and calf muscles.) Place a weight around
the foot, and move your foot up and down from the ankle, with no
movement in the rest of the leg. Or use a partner to grasp the foot
and provide manual resistance.
- Band exercises. Anchor one end of an exercise band (e.g; inner
tubing of bicycle) to a heavy object, such as the leg of a couch.
Loop the other end around the foot. Move the foot up, down, and from
side to side against the band's resistance to exercise different
muscle groups.
All pages on this website © 2008
Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
The material provided on this web site is for informative purposes only.
If you need specific medical advice, please contact the office for an appointment.
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