Prevent Shin Splints

Shin splints, or medial tibial stress syndrome, is often a debilitating condition that involves pain and inflammation in the inner muscles and/or bone of the lower leg.[1] Shin splints are typically caused by overuse of the lower leg muscles from too much running, hiking, jumping or dancing. Because shin splints are essentially a type of repetitive strain, they can often be prevented by some common sense and simple home remedies. However, if you're a serious athlete, then consider getting some advice and/or preventative treatment from a healthcare professional.

Steps

Using Home Remedies for Prevention

  1. Change your routine or take a break from it. If you feel shin pain coming on frequently due to your jogging, dancing or workout routine, then consider altering it somehow by doing fewer repetitions, using lower weights or changing your running circuit.[2] For example, refrain from running up hills or on hard surfaces, or stop doing leg presses at the gym for a while and see how your symptoms respond — consult with a personal trainer if need be. If your leg problem is work related, then talk to your boss about switching to a more sedentary activity for a few days and allowing your lower leg muscles to rest and recuperate.
    • Recognizing a musculoskeletal injury in its early phase and allowing it time to heal by resting is the best way to prevent acute injuries from progressing or becoming chronic (long term).
    • Occupations that increase the risk of shin splints include forest rangers, field engineers, firemen, military recruits, certain referees (such as soccer or basketball), roofers and some types of construction jobs.
  2. Change your shoes or boots. Shoes and boots that don't provide arch support and/or ones that are relatively heavy are a risk factor for developing shin splints.[3] Poor arch support allows your feet to over-pronate (collapse inwards), which puts stress on your tibia and knee. If they make your feet too heavy, then they can strain the tibialis anterior muscle, which is responsible for lifting your foot when you walk or run. As such, look for well fitting, lightweight shoes and boots with good arch support and flexible soles if you want to prevent shin splints.
    • Avoid "negative heel" shoes or sandals that orientate the foot such that the heel sits lower than the forefoot — they put too much strain on the shin muscles. Instead, pick shoes and boots that are elevated in the heel by about 1/4 or 1/2 inch.
    • If you're a serious runner, replace your shoes every 350–500 miles or after three months, whichever comes first.
  3. Try stretching your shin muscles. Stretching the affected area of your lower leg might stop the pain or discomfort from progressing, especially if you address the problem during its initial stages.[2] Use slow, steady movements and remember to breathe deeply during your stretches. For the anterior tibialis muscle, the key is plantar flexing the foot, which means pointing your toes and contracting the arch of your foot. Try the fencing stance, with your affected leg outstretched behind you and your toenails touching the floor. Put pressure down on the top of your foot and feel the stretch in the front of your shin.
    • In general, hold stretches for about 30 seconds and repeat five to 10 times daily until the shin pain fades away.
    • Stretching directly after the application of moist heat might help because your shin muscles will be more pliable.
  4. Use a supportive bandage. If you feel some tightness or discomfort developing in your shin during exercise, then in addition to scaling back your intensity, consider wrapping the area below your knee with a supportive Tensor or Ace bandage or even a neoprene sleeve. Elastic bandages and neoprene sleeves provide support and warmth to the shin muscles, and may help bind the tendons up against the tibia to prevent stress and strain.[2]
    • Keep wrapping your lower leg until the tenderness disappears, which usually takes three to six weeks.
    • Tensor or Ace bandages and neoprene sleeves are inexpensive and widely available in drugstores.
  5. Apply ice or frozen gel packs. The application of cold therapy is an effective treatment for essentially all strain-type injuries, including shin splints, because it reduces inflammation and dulls pain.[4] If your shin muscles flare-up after physical activity, then apply ice to the most tender area for about 15–20 minutes every two to three hours until the pain and swelling subside. Compressing the ice against your shin with a bandage or elastic support is even more efficient for controlling inflammation.
    • Always wrap ice cubes or frozen gel packs in a thin towel to prevent frostbite on your skin.
    • If you don't have ice cubes or gel packs, then use a frozen bag of peas or corn from the freezer.
  6. Take an Epsom salt bath. Soaking your legs in a warm Epsom salt bath can significantly reduce the achy pain and swelling associated with mild-to-moderate muscle strain.[5] The magnesium component in the Epsom salt helps the muscles relax and pull inflammation out of the tissues.
    • Alternatively, you can apply moist heat to your shin if you're unable to soak your legs — microwaved herbal bags work well and are sometimes infused with essential oils that have relaxing properties.
    • If inflammation is a particular problem in your lower leg and it doesn't abate with a salt bath, then follow up with cold therapy until your shin gets numb (15-20 minutes).

Seeking Professional Help

  1. Get a lower leg massage. A strain occurs when muscle fibers are stretched beyond their tensile limits and subsequently tear, which leads to pain, swelling and some guarding (muscle spasm in attempts to prevent further damage). A deep tissue massage for your lower leg muscles (focusing on the tibialis anterior) might be helpful for preventing a strain because it reduces tension and promotes relaxation.[6] Furthermore, if you have a mild strain, a massage can be helpful for getting rid of mild inflammation. Start with a 30-minute massage, focusing on your shin muscles and calves. Allow the masseuse to go as deep as you can take it without wincing.
    • Drink lots of purified water after any massage in order to flush out inflammatory by-products from your body. Failure to do so might trigger a mild headache or malaise.
    • As an alternative to a professional massage, consider using a handheld vibrating massager on the soft tissues of your lower leg. Some research indicates that vibrations help to relax and strengthen musculature while stimulating nerves to reduce pain.[7]
  2. Try ultrasound therapy. Therapeutic ultrasound is a therapy used by some doctors, chiropractors and physiotherapists that reduces inflammation in soft tissues and stimulates healing.[8] Ultrasound machines emit sound frequencies through special crystals (although you can't hear it) that positively impact injured cells and tissues within the body. As a preventative treatment, ultrasound may be able to stop the progression of shin splints if you start to feel some mild tenderness in your lower legs.
    • Treatments are painless and usually last five to 15 minutes, depending if your leg condition involves significant inflammation or not.
    • Although a single treatment is sometimes sufficient for mild strains, more than likely it will take three to five treatments to notice significant results.
  3. Schedule a consult at a running store. To better understand what shoes may be best for you, get an evaluation done at a reputable running store. High-end running stores sometimes employ people who are qualified to assess your running gait, examine your arches and check the wear patterns of your old running shoes. They typically aren't doctors or physiotherapists, but they are usually experienced runners or fitness experts who can give you sound advice, which may help prevent shin splints and other conditions of the legs and feet.
    • You'll get help with selecting the best running shoe based on your foot type (flexible pronator vs. rigid supinator).[9]
    • You may have to run or walk over a computerized force plate as part of your gait assessment.
  4. Have some custom orthotics made. Another preventative strategy for shin splints is getting some custom made orthotics for your shoes and/or boots. Orthotics are semi-rigid sole inserts that help support the arch of your foot and promote better biomechanics while standing, walking and running.[10] By providing cushioning and some shock absorption while you run, walk and jump, orthotics can help reduce the risk of developing shin splints.
    • Medical workers who build and sell orthotics include podiatrists, as well as some physicians, chiropractors, and physical therapists.
    • You'll likely need to remove the factory insoles from your running shoes in order to fit the orthotics in.

Diagnosing Shin Splints

  1. Understand the cause. Shin splints are not considered a serious type of injury, although they can generate lots of pain and hinder the ability to run, or even walk. The main cause is too much strain on the leg muscles below the knee, particularly the tibialis anterior, which is responsible for lifting your foot while walking and running. Sometimes shin splints also involve inflammation of the tibial periosteum, the thin sheath of tissue that wraps around the tibia or shin bone.[1] In rare cases, shin splints may also involve stress (hairline) fractures of the tibia or blood circulation problems in the lower leg.
    • Risk factors for shin splints include intensive running and hiking (especially on hills), inadequate footwear, flat feet, and poor biomechanics or technique.
    • Military recruits, professional dancers and athletes such as soccer and basketball players have higher incidence of shin splints.
  2. Know the symptoms. The most common symptoms of shin splints include: tenderness, soreness or pain along the inner part of your lower leg, mild inflammation in the same area, and difficulty lifting your toes off the ground (known as dorsiflexion).[11] Pain is often noted during the initial part of a workout or activity, then lessens once the muscles are warmed up, then often reappears near the end of the session after the inflammation accumulates.[12] The pain is often described as dull and annoying initially, but with continuing trauma it can become excruciating for some.
    • Shin splints often feel worse in the morning because the soft tissues (muscles and tendons) tighten overnight.[2] Shin splints also flare-up when you forcibly try to lift your foot up (dorsiflex) against resistance.
    • The location and type of the pain is often enough for a correct diagnosis of shin splints, so x-rays, an MRI or diagnostic ultrasound are rarely needed for confirmation.
  3. Realize the complications. Allowing shin splints to develop and then become chronic not only creates pain and disability in your lower legs that's difficult to heal and get rid of, but other joints "higher up the chain" get negatively affected.[2] Not being able to lift your foot properly with walking, running or jumping causes other areas above (such as your knee, hip and low back) to overcompensate, which increases the risk of strain or sprain injuries in those locations. As such, preventing shin splints from getting bad with common sense, home remedies, and professional guidance is a smart strategy.
    • It's important to differentiate (by a qualified doctor, ideally) between other lower leg issues that have overlapping symptoms with shin splints, such as bone fractures, muscle compartment syndrome, popliteal artery entrapment, venous insufficiency and nerve entrapment.
    • Because females have a higher incidence of diminished bone density and osteoporosis, they are more likely to develop severe shin splints and stress fractures of the tibia.[13]



Tips

  • Avoid running up hills and over hard surfaces, such as concrete or asphalt, in order to help prevent shin splints.
  • Once shin splints become acute and flare-up, it can take up to six months before they are fully healed.
  • Cross-train with sports that are less stressful on your shins, such as swimming, cycling or rebounding on a trampoline.
  • If you often jog on roads with a significant camber (tilt), then jog out and back on the same side of the road.
  • When you are jogging start slow then medium then go a little fast.

Warning

  • This article is no substitute for the professional recommendations of a doctor, podiatrist, or physical therapist.

Related Articles

Sources and Citations

  1. ↑ 1.0 1.1 http://orthoinfo.aaos.org/topic.cfm?topic=a00407
  2. ↑ 2.0 2.1 2.2 2.3 2.4 http://www.runnersworld.com/tag/shin-splints
  3. ↑ http://www.mayoclinic.org/diseases-conditions/shin-splints/basics/prevention/con-20023428
  4. ↑ http://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4483
  5. ↑ http://www.saltworks.us/salt_info/epsom-uses-benefits.asp
  6. ↑ http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/massage/art-20045743
  7. ↑ http://www.vibration-training-advice.com/consumer-guide-and-safety-program/articles-71---80/vibration-therapy-and-dvt
  8. ↑ http://www.physiotherapy-treatment.com/shin-splints-treatment.html
  9. ↑ http://www.medicinenet.com/shin_splints/page2.htm
  10. ↑ http://www.footvitals.com/health/orthotics.html
  11. ↑ http://www.mayoclinic.org/diseases-conditions/shin-splints/basics/symptoms/con-20023428
  12. ↑ http://www.medicinenet.com/shin_splints/article.htm
  13. ↑ http://www.ncbi.nlm.nih.gov/pubmed/11570734

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