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Shin Splints: Too Much, Too Soon

Physical Therapy

By: Kate Zanoni, LPTA

Doing too much too soon can be a recipe for shin splints! So what are they and how can you prevent them? Shin splints, also known as medial tibial stress syndrome, MTSS, are an overuse injury caused by repetitive stress to the lower legs. It’s common for runners to get them especially when they don’t gradually increase their mileage. Remember feeling pain in your shins right your first few practices at the start of a sports season? It’s painful! Running too much too soon can cause undue stress to the inside of the shin, leading to pain below the knee that radiates down the shin. You might feel this pain just on the inside of the shin or on the outside of the front of the shin. Either way, if you don’t treat it, shin splints can lead to hairline and stress fractures, an incomplete crack in the tibia, which must be treated immediately to prevent further damage to the bone and micro tearing in the surrounding muscles and connective tissues.

Runners aren’t the only ones affected. Shin splints also often occur in dancers, tennis players, basketball players, soccer players and other athletes. You can get them is you suddenly change your workout regimen, such as switching surfaces from pavement to clay to grass to turf, differing intensities on the dance floor, court or field, or running on uneven surfaces such as up/down hills on trails or hard surfaces. When an unconditioned athlete starts to train too hard or if an experienced athlete changes his/her training intensity or type of surface, the shin bone (tibia), muscles and tissues in the area can become overloaded, leading to inflammation and pain.

Shin splints usually occur from an imbalance between the calf muscles (gastrocnemius and soleus) and the muscles in the front of your leg (anterior tibialis), although additional muscles in the lower leg may also be affected. These muscles play a large role in your gait pattern and each function to flex (dorsiflex) and extend (plantarflex) your ankle while walking, running and jumping. Shin splints often affect beginners who have not adjusted to the additional stress of running or those who are not stretching enough.

Other factors that can contribute to shin splints:

-Inadequate and infrequent stretching

-Lack of arch support

-Worn out shoes

-Excessive stress placed on one leg over the other from running in the same direction on a track or on pitched roads

Although shin splints can occur on both legs, it’s more common for the dominant leg to be affected over the other due to overuse and associated compensation, leading to inflammation of the muscles in the front of the leg (anterior tibialis).

How to Treat Shin Splints

Rest! It’s crucial to stop running or participating in the activity that caused the injury to allow the inflammation to resolve. Depending on the severity and duration of the pain, it may take several weeks of rest to decrease the inflammation in the area. Ice your affected shin for 10-15 minutes 3-4 times per day to reduce the acute inflammation and ease the pain.

Once the initial inflammation has subsided, you can begin a stretching and strengthening program of the affected muscle groups to prevent reinjury by increasing tissue extensibility of tightened muscles and balancing out any muscle strength disparities that contributed to the problem.

To stretch your largest calf muscle (gastrocnemius), begin in a staggered stance position with one foot in front of the other. Keeping your back heel down, lunge forward by slightly bending your front knee. You should feel a stretch in the back of your calf in the back leg. Hold for 20-30 seconds and repeat 3 times for 2-3 times per day.

To stretch your smaller calf muscle (soleus), begin in a staggered stance position with one foot in front of the other. Lunge forward by slightly bending your front knee. Slightly bend your back knee as well to isolate the soleus muscle, but keep your heel on the ground to maximize the stretch. Hold for 20-30 seconds and repeat 3 times for 2-3 times per day.

To stretch the front part of your shin, begin in a slightly staggered stance with one foot slightly in front of the other. With your back foot, point your toes toward the floor and slightly inward, then gently press your foot into the floor until your feel a stretch in the front of your shin. Hold the stretch for 20-30 seconds and repeat 3 times for 2-3 times per day.

When you return to your sport, remember to reintroduce your activity incrementally to avoid doing too much too soon. When returning to running, increase your mileage no more than 10 percent per week to allow your muscles and joints to adjust to the increased stress.

For a specific stretching and strengthening program, please call Loudoun Sports Therapy Center at 703-450-4300 to setup an evaluation with one of our therapists. We will customize a program based on your specific needs and goals for returning to your favorite sport or activity.