Shin splints – or medial tibial stress syndrome – is pain and tenderness along the front part of your lower leg. It’s something most of us have experienced at one time or another usually when we go from doing very little to too much exercise in a short amount of time. While it is, in and of itself, an injury, I prefer to look at it as a warning sign that something needs to change before a more serious injury occurs.

Too often, I hear people complain that they’ve got shin splints, yet they forge ahead, fueled by the “no pain-no gain” mentality, or pushed on by team mates or a coach. Some of them start walking or running because they need to lose weight and figured this would be a great way to start, and usually these folks are so gung-ho about it, that they end up doing way too much right out of the gate. In some cases, it’s not that they are new to running. Some start running again, because they used to run a long time ago, but haven’t done anything in years. They try to start out where they left off years before. And for some, it’s just part of the training. I see this a lot with school-age athletes coming off of a summer of inactivity or decreased activity, or starting fresh in a new sport.

In all cases - it’s too much of a good thing, and those annoying shin splints are a big, flashing red light!

For example, a little over two years ago, I jumped head-first into training for my first marathon, having previously never run more than one or two miles at a time, and sporadically, at best. My training overall went very well, and I am still surprised at how little “suffering” I experienced, compared to some of the horror stories I’d heard about – chronic shin splints, bloody blisters, black toe nails, muscle strains, back pain, knee pain, gastrointestinal distress during a run, and more! Shin splints were the worst of it for me, and only in the very beginning of my training, because I went from doing very little, to too much, too quickly.

Despite my drive to do more and run farther and longer, I scaled back the amount of time I spent running, gradually building it up, which allowed my body to properly adjust to the increasing stress. I also iced, stretched, and strength trained to complement the sport and help reduce my chances of incurring an injury. Through smart training and proper rest and recovery, I got through my entire training injury-free and finished that marathon in four hours and 28 minutes! The next day, I was up and about, business as usual, as if this marathon never happened, while some of my friends were “out of order” for over a week with pulled muscles, soreness, hip pain…

It may not be the same for everyone, and “shin splints” could actually be the beginning of something a lot worse – like stress fractures – if you choose to ignore it and work through it. They account for up to 18% of running-related injuries, more frequently affecting women than men. Many factors may result in shin splints, and most of them can be addressed and corrected.

Common Causes

• A rapid increase in training that doesn’t allow the body enough time to adjust to the added stress
• Posture and gait – the way we execute the act of walking or running. A person whose rear foot turns out when they run, and/or runs “knock-kneed” is going to create increased stress on the muscles of the lower leg.
• Flat feet or very pronounced arches
• Hard walking/running surface - Cement and pavement are not very forgiving.

Solutions

• Address muscular imbalances through strength training and flexibility throughout the entire kinetic chain, not just your lower leg.
• Get into the right pair of shoes for you. In other words, don’t go for looks or marketing. Go to a walking/running specialty store and have a professional put you into the right shoes.
• Vary the surfaces on which you walk or run.
• Restructure your training program to allow adequate rest and recovery.

Treatment

As you work to address those factors, you still have to nurse your shin splints. The following suggestions will help to alleviate the symptoms, but will not “cure” your problem. If you do not address the cause, you will continue to experience shin splints, and eventually suffer from more serious injuries.

• Rest
• Scaling back your training, eliminating hills and uneven surfaces.
• Taking over-the-counter anti-inflammatory drugs (NSAIDs).
• Ice
• Compression

For a more clinical overview, you can check out this short journal article in Clinics in Sports Medicine:

Wilder RP. Sethi S. Overuse injuries: tendinopathies, stress fractures, compartment syndrome, and shin splints. Clinics in Sports Medicine. 23 (2004) 55-81.

Last Modified : October 6th, 2008 Filed under : Move Navigate : Previous post / Next post