How To Avoid Shin Splints

Shin splints are a common injury that we see particularly in runners. Shin splints are used to describe pain along the inside or front edges of the shin. The most common muscles that cause shin splints are tibialis anterior and tibialis posterior.

What causes shin splints?

Shin splints are caused by overstraining the muscles where they attach to your shin. The muscles repeatedly pull on the tibia (shin bone), and this excessive loading can result in inflammation and muscle tenderness. The bone may undergo a mild stress reaction, or in more severe cases can develop into a stress fracture. A bone scan or MRI may be required to diagnose the stress fracture.

Shin splints are often associated with poor foot and leg biomechanics, or errors in training load.

Common training errors include

• Increasing your training too quickly
• Running on hard or angled surfaces (like the edge of the road), or uneven ground
• Insufficient rest between runs or workouts

Biomechanics

• Overpronation occurs when the foot rolls inwards too much, flattening the arch of the foot and causing the lower leg to rotate inwards. This increases the stress on the soft tissues of the lower leg.
• Oversupination is where the foot rolls outwards too much, resulting in high arches. If you have high arches you will need lots of supportive cushioning in your shoes.
• Poor flexibility at the ankle joint which can happen after an ankle sprain or fracture
• Tight calf and hamstring muscles
• Poor muscle control
• Weakness in the foot arch muscles

Inappropriate footwear can also predispose you to developing shin splints. Footwear that is old and have lost their support and cushioning can cause injury.

Symptoms of shin splints

So what do shin splints feel like? Shin splints involve dull, aching pain in the front of the lower leg. The pain may be located along either side of the shinbone or in the muscles, and the area may be painful to touch. Symptoms usually develop gradually over time.

Treatment of shin splints

In the initial stages where you are unable to walk or run without pain, you may need to rest from running. Ice can help to reduce swelling and numb the pain. Anti-inflammatory pain medication can be used to help settle the inflammation. Physiotherapy will involve massage to help relieve your pain and optimise scar tissue healing. We will also prescribe specific stretching and strengthening exercises to ensure optimum rehabilitation. If the cause of your shin splints is due to poor foot biomechanics, you may require a foot orthotic to prevent any future recurrences. Here at WPH Physio we are able to assess your foot and fit you with orthotics to correct your foot biomechanics. We will also guide you on returning to your sport or running, and advise you on how to slowly build up your training load. The exercises we prescribe you will be sport specific to ensure you are fully equipped for the demands of your sport or running program.

We will advise you as to whether you require complete rest and if so for how long, if you can do some interval training in the meantime and when it is safe to return to running. We will guide you in a tailored return to running including length of your run, pace, rest periods between runs and gradual increases in volume.

If shin splints are left untreated and you continue with overtraining, they can progress into tibial stress fractures. Therefore it is important to seek treatment early so that you can get back to doing what you love.

How to avoid shin splints

Training load

If you are new to running, you will need to ease into the frequency and duration that you run. Start with no more than 15-20min runs, three times per week. After a couple of weeks at that intensity, you can start to slowly build up by increasing your runs by 5mins each fortnight. For those who are regular runners, you also need to ensure you make gradual changes to your running load.

Footwear

Shoes need to be changed regularly to ensure the foot has adequate support and shock absorption while running. If you are a high volume runner, shoes need to be changed every 6 months. Medium volume runners will need to change their shoes every 8-9 months, while low volume runners should update their footwear yearly.

Orthotics

If you have poor foot biomechanics, foot orthotics are vital in preventing shin splints. If your feet tend to roll inwards (overpronate), you will need an orthotic to provide you with adequate arch support. If you have very high arches you will require lots of cushioning to provide enough support as the foot tends to be more rigid.

Stretching

Perform regular calf stretches before and after running to avoid developing muscle tightness and improve your flexibility.

If you are suffering from shin splints and would like some more information or advice, please give us a call on 9875 3760 or email us info@wphphysio.com.au. We would be more than happy to help!