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Shinsplints

The most common symptoms are calf-muscle soreness with discomfort along the border of the shinbone. These symptoms will usually disappear by reducing the training load for a few weeks You may over or under pronate or supinate when you run. Most runners pronate. You may be wearing incorrect shoes.

Some Suggestions for Treatment for Shin Splints

Have your footwear checked, your shoes could be worn out or incorrect for your feet. Consider changing your running shoes to a more shock-absorbent pair, run on softer surfaces and seek professional advice. Avoid hills and extremely hard surfaces until the situation improves. Run on different terrain, preferably grass. It'll absorb the shock.

You need to strengthen the weaker muscles (shins) and stretch the stronger muscles (calves). To strengthen the shins, run up stairs. Yes, this seems to contradict 'avoid hills'. But steps are built differently than hills. Stand on stairs with your heels out over the edge. Lower your heels as far as they will go and hold for 15 seconds. Slowly raise yourself up on your toes. Repeat as many times as you want.

Alternate running on different sides of the road all of the time. Running on the same slope for long periods of time can cause adverse effects to the ankles and shins. Make sure that you are always facing the traffic. If you are running on a track, alternate your direction of travel.

The term 'shin splints' has been replaced by the terms: medial tibial stress syndrome, compartment syndrome and stress fracture. This is because pain in the shin area may be related to three different causes.
The term 'shin splint' has been medically used, in the past, to cover most problems occurring in the lower leg.
These included both bone and soft tissue problems.
Athletes (runners) have used the term shin splint to refer to pain occurring in either the anterior or the medial portion of the leg.


Medial Shin Splints

This is now referred to as medial tibial stress syndrome (MTSS). Pain is located at the medial aspect of the leg, adjacent to the medial tibia.
Tenderness can be found just behind the most medial portion of the tibia, in the mass of soft tissue and at the bone. Sore, inflamed structures include the medial muscles and tendons.

A bone scan may show a stress fracture. With medial shin splints, the tenderness extends along a vertical distance of the tibia.
If a stress fracture is present, tenderness extends horizontally across the front of the tibia.


What needs to be done?

The most cases the blame can be placed on overtraining, reduce the training. Evaluate your running program to determine if you have made any training errors.
Pronation is a main contributor. When the foot pronates the medial structures of the leg are stretched and put under stress.

Running on a slanted surface, such as the side of a road, or on a track can place the upper leg in a position to develop this problem.
Decrease training immediately.
Do not run if pain occurs during or following your run.
Try non-weight bearing exercise such as: swimming, biking, and deep water running to maintain your fitness.
Running on soft surfaces is not always the best solution as the foot is more likely to pronate more on very soft terrain. Certainly the avoidance of concrete is wise.
Posterior stretching exercises can help, but what is needed is pronation control. Pronation, which is a major contributing factor may be controlled with shoes or orthotics.
Icing after running may provide some relief, but it will not cure the situation. It is important to seek professional medical attention.


Anterior Compartment Syndrome

It is caused by the muscles swelling within a closed compartment with the result being an increase in pressure in the compartment. It is vital to seek evaluation and treatment, if this is suspected.
The blood supply can be put at risk and muscle injury and pain may occur. The symptoms include: strange nerve sensations, leg pain, and muscle weakness. Surgical decompression of the compartment may be required.


Anterior Shin Splints

This is a medical term that has pretty much disappeared.
Symptoms that occur in the anterior lateral tibial region, are assumed to be either stress fractures or a form of compartment syndrome.

Runner's At Risk for Anterior Shin Splints

The usual runners at risk for anterior shin splints are beginning runners. 
Runners who have not acclimatized to the stresses of running. 
Runners with a poor choice of shoes and running surfaces (i.e. concrete). 
Runners overtraining. 
Runners doing too much downhill running will make the situation worse on the anterior
muscles. 
Runners training with repetitive impact on hard surfaces. 
Runners with excessive pronation.

Solutions

The key factors are: 
Work on decreasing the imbalance between the posterior and anterior muscles.
Avoid running on concrete or other hard surfaces 
Check for Overtraining 
Decrease training immediately. 
Do not run if pain occurs during or following your run. 
Review your stretching.  The posterior muscles should be gently stretched along with the
stretching of the calf muscles and the hamstrings. 
Shoes with too many miles on them should be replaced. 
Check for proper shoes (cushioning).
Shock absorption should be a factor in selecting shoes in a runner suffering with anterior
shin splints. 
Downhill running can aggravate this problem and should be avoided. 
Too long a stride can also delay healing. 
After exercise icing can lessen symptoms.

© Women in Motion -September 1.2000

Women in Motion 2000

Page Updated September 1.2000.