Get Rid of Shin Splints

Known medically as medial tibial stress syndrome, "shin splints" refers to pain from overusing or repetitively straining the muscles that run next to the shinbone (tibia) of the lower leg. Sometimes the condition also involves inflammation of the tibial periosteum (the thin sheath of tissue that wraps around the tibia). Shin splints are relatively common in runners, hikers, dancers and military recruits. Most cases of shin splints resolve on their own or can be treated with self-care measures, but sometimes therapy from a healthcare professional is required.

Steps

Changing Your Activities

1. Change your running routine. Shin splints are often caused by either running (or walking) too much uphill, on uneven terrain or on particularly hard surfaces such as asphalt or concrete. As such, try altering your course and changing the type of surface you run or walk on — switch to grass, sand or a rubberized athletic track, for examples. Alternatively, cut down on your mileage and the number of times your workout per week.
   • Over-pronation (the rolling in of ankles) and flat feet are risk factors for getting shin splints.
2. Change your shoes. Poorly fitting or excessively heavy shoes can also contribute to the development of shin splints. As such, wear stable, lightweight footwear that suits your sport or activity. Aim for no more than a 1/2 inch heel. If you're a serious runner, replace your shoes about every 350 to 500 miles or 3 months, whichever comes first.
   • Remember to always tie your shoes tightly, because loose shoes or flip-flops puts more strain on your foot and lower leg muscles.
   • Get fitted for your shoes by a shoe salesperson late in the day because that's when your feet are at their largest, usually due to swelling and slight compression of your arches.
3. Switch to different exercises temporarily. If changing your routine and footwear doesn't make a positive impact on your shin pain, then consider switching to an entirely different activity that may be more "friendly" to your shin muscles, such as swimming, cycling or rowing. Then after the shin splints resolve (perhaps in a matter of days or a few weeks), slowly reintroduce running, walking or dancing back into your routine.
   • Swimming burns more calories than walking or jogging because most swimming strokes require the use of all your body's muscles.
   • Lifting relatively heavy weights with your upper body is a good alternative, and it also burns more calories than cardiovascular exercise.
4. Lose some weight, especially if you're obese. Weight loss may help prevent shin splints as there's less pressure put on the bones and muscles of the lower leg. For most women, consuming less than 2,000 calories daily will lead to some weight loss every week even if you're only a light exerciser. Most men will lose weight at under 2,200 calories daily.
   • Switch to lean meats and fish, whole grains, fresh produce and lots of water for the best weight loss results.
   • Many overweight people have flat feet and tend to over-pronate their ankles, which are risk factors for developing shin splints.
5. Stop exercising and rest. Sometimes the best course of action for inflamed shin splints is to stop exercising your legs altogether. Because shin splints are often caused by overuse, common medical recommendations involve resting the legs for up to several weeks, but don't give up all physical activity and become a couch potato either.
   • Focus on the lower impact exercises mentioned above until the shin pain disappears, then slowly reintroduce weight-bearing activities such as walking, hiking, and then jogging.

Trying Home Remedies

1. Apply ice to your shin splints. Along with resting, icing your shin splints is a commonly recommended and effective therapy. Apply ice packs to the affected shin for 15 minutes at a time, at least four times per day for several weeks. The inflamed tissues of the shin are very superficial, so ice does not need to be applied for longer than 15 minutes at a time.
   • To protect your skin from frostbite, wrap the ice packs in a thin towel.
2. Stretch your shin muscles. Gently stretch your Achilles tendon (near your heel) and your calves if you have medial shin pain by wrapping a towel around your toes and then trying to slowly extend your leg while holding on to each end of the towel. Alternatively, gently stretch the anterior shin muscles (tibialis anterior) if your pain is centered in front of the shin bone by kneeling on a carpeted floor with your feet together and toes pointed back, then slowly sitting back onto your calves until you feel tension in the muscles of your shin. Hold each type of stretch for 20 seconds, relax and repeat 5x daily.
   • In a sitting position with your affected leg in the air, try tracing the letters of the alphabet with your toes. This is a good exercise that stretches all muscles of the lower leg.
3. Take an Epsom salt bath. Soaking your feet and lower legs in a warm Epsom salt bath can significantly reduce pain and swelling. The magnesium in the salt is thought to help the muscles relax. If swelling is a particular problem for you, then follow the warm salt bath with an ice bath until your feet feel numb (about 15 minutes or so).
   • Always dry your feet thoroughly before you get up and walk away from your foot bath in order to prevent slip and falls.

Seeking Specialized Help

1. Get a leg massage. Get a massage therapist to give you a foot, calf, and anterior shin massage. Massage reduces muscle tension and inflammation, helps break down scar tissue and promotes better blood flow. Have the therapist start rubbing from the feet and work towards the knee so the venous blood is helped back up towards the heart. The therapist may also perform trigger point therapy, which is sustained pressure to the sorest spots within the muscle.
2. Seek out physiotherapy. A physical therapist can show you specific stretches and strengthening exercises for your lower legs, and if need be, treat your sore muscles with electrotherapy such as therapeutic ultrasound, electronic muscle stimulation or microcurrent. Taping shin splints with medical-grade tape can help relieve symptoms by providing support for the muscles of the lower leg and also by reducing traction forces. Chiropractors are also trained to diagnose and treat musculoskeletal injuries of the limbs and they can re-align the joints / bones of the lower leg if need be.
   • Kinesio tape is a form of taping that has been clinically proven to decrease swelling and increase the range of motion.
   • Orthotics (custom-made shoe inserts) can also help with shin splints by supporting the arch of the foot and promoting better biomechanics when running or walking — they can be made by podiatrists or some chiropractors.
   • Wearing an elastic compression bandage during exercising may also prevent additional swelling in the shin.
3. Get an evaluation done at a reputable running store. High end running stores often employ people who are qualified to assess your gait, examine your legs and feet and check the wear patterns on your shoes. These people are not doctors, but they are usually experienced runners who can give you sound advice, which may reduce your risk of getting shin splints or help rid you of chronic shin splints.
   • You may be asked to jog over a force plate that's hooked up to a computer, or get videoed while you're running as part of the assessment.
4. Try acupuncture. Acupuncture involves sticking very thin needles into specific energy points within the skin in efforts to reduce pain and inflammation. Acupuncture for shin splints can be effective, especially if it's done when the symptoms first occur. Based on the principles of traditional Chinese medicine, acupuncture works by releasing a variety of substances including endorphins and serotonin, which act to reduce pain.
   • In a 2002 study, acupuncture treatment (twice weekly for three weeks) was found to outperform sports medicine (physiotherapy) and the use of anti-inflammatories for the treatment of shin splints.

Determining The Cause

1. Schedule an appointment with your doctor. If you develop shin pain that won't go away after a few days, and none of the usual treatments work, then schedule an appointment with your family physician. Your doctor will examine your legs and ask questions about your family history, diet and lifestyle, and maybe even send you for a blood test (to check blood glucose levels among many other possible causes of lower leg issues, calcium imbalance, potassium deficiency, vitamin D deficiency, etc., and rule out the possibility of diabetes). However, your family doctor is not a musculoskeletal or circulatory specialist, so you may need a referral to another doctor with more specialized training.
   • Other types of healthcare professionals who could help diagnose and treat shin splints include osteopaths, chiropractors, physical therapists and massage therapists.
   • Your family doctor may recommend anti-inflammatories such as ibuprofen, naproxen or aspirin to help you deal with the pain and inflammation of shin splints.
2. See a specialist about your legs. Shin splints are not considered a serious medical problem (although they can be quite painful and hinder walking), but there are some serious conditions that can mimic shin splints such as stress (hairline) fractures of the tibia, venous insufficiency (leaky vein valves of the lower leg), diabetic neuropathy, bone cancer, chronic compartment syndrome (swelling of the lower leg muscles) or popliteal artery entrapment. As such, a medical specialist may be needed to properly diagnose your condition, such as vascular surgeon or an orthopedist (musculoskeletal specialist).
   • Vascular ultrasound is a painless procedure that allows a doctor to assess the function of the veins and arteries of your lower leg.
   • X-rays or bone scans of the lower legs can be used to rule out more serious medical conditions such as bone cancer or fractures.
3. Get an accurate diagnosis and understand the cause. Make sure you get the doctor to clearly explain the diagnosis, especially the cause (if possible), and provide you with various treatment options for your condition. Obviously, conditions such as diabetes, cancer, or venous insufficiency have much different treatment protocols than a benign musculoskeletal injury such as shin splints. In most cases, changing your exercise routine or shoes and resting for a few weeks will be sufficient.
   • Shin splint pain is often worse in the morning after intense exercise from the night before.
   • The pain of shin splints is often deep and achy, and located laterally in the mid-section of the tibialis anterior muscle. Typically, one leg is involved and it's usually the most dominant one.

Tips

• Put athletic tape on your shin where it hurts.
• If you shin splints from running or jogging, try calf raises before going and exercising your legs. It helps to stretch the muscle in your calves and reduce pain during exercise.
• When your shin splints heal and you return to running, do not increase your mileage by more than 10% per week.
• If jogging caused your shin splints, then consider using two pairs of good shoes and alternate wearing them to vary the stresses on your legs.
• If you jog on roads with an obvious camber (tilt), then run out and back on the same side of the road. Likewise, when running on an athletic track, switch directions.
• If it is winter, don't soak your shins in warm/hot water. Take an ice bath with Epson salt in it instead.

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Sources and Citations

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• Determine Shoe Width
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• Treat a Sore Toe
• Get Rid of Foot Odor
• Treat Crepitus in the Knee
• Know if Your Toe Is Broken

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