Rose on the Roads - May 2001
Todd Rose on the Roads: Shin Splints
Who has heard of shin splints?...probably everyone. Ah.. but who
knows anything about them?...probably very few. I've never had shin
splints and don't know many people who have (it seems to be more common
among sprinters - track especially), so I didn't care. But prevention is
the best medicine.
The lower leg pain resulting from shin splints is caused by very
small tears in the leg muscles at their point of attachment to the shin.
There are two types:
- Anterior shin splints, which occur in the front portion of the
shin bone (tibia); and
- Posterior shin splints, which occur on the inside (medial) part of
the leg along the tibia.
Anterior shin splints are due to muscle imbalances, insufficient
shock absorption, or toe running. Excessive pronation contributes to both.
Symptoms -- The pain may begin as a dull aching
sensation after running. The aching may become more intense, even during
walking, if ignored. Tender areas are often felt as one or more small
bumps along either side of the shin bone.
Causes of Injury
- Tightness in the posterior muscles, which propel the body forward,
places additional strain on the muscles in the front part of the lower
leg, which work to lift the foot upward and also prepare the foot to
strike the running surface.
- Hard surface running, or worn/improper shoes increases the stress
on the anterior leg muscles. Softer surfaces and shoe cushioning
materials absorb more shock and less is transferred to the shins.
- The lower leg muscles suffer a tremendous amount of stress when a
runner lands only on the balls of the feet (toe running), without the
normal heel contact. This is often associated with track athletes or any
speed work (frequent 5K races).
- The muscles of the foot and leg overwork in an attempt to stabilize
the pronated foot and the repeated stress can cause the muscles to tear
where they attach to the tibia.
- Rapid increase of speed or distance.
Short Term Treatment
- Aspirin or ibuprofen, NEVER acetaminophen, to
reduce inflammation and relieve pain.
- Ice immediately after running, NEVER before.
- Reduce mileage and intensity for 7-10 days; NEVER
run through the pain.
- Avoid hills and hard running surfaces.
- A varus wedge to support the inside of the food and reduce the
amount of pronation.
- Gentle stretching of the posterior leg and thigh muscles.
Self-enforced treatment of shin splints, as with most overuse
injuries, is successful in most cases.
Long Term Treatment - Persistent problems may
warrant a visit to a sports-medicine specialist who may prescribe the
- Strengthening and flexibility programs to correct muscle imbalance.
These exercises should only be done in the absence of pain.
- Orthotic devices.
- Anti-inflammatory medications.
- Physical therapy involving ice massage, ultrasound, electrostimuli
and heat to reduce inflammation and pain.
Of course, the best means of prevention of serious athletic injuries
is to maintain good muscle strength and flexibility. I will cover
weight training for runners in a future article. Happy trails!