If you’ve ever put a lot of mileage on your legs, you might know what it’s like to feel shin splints. The aching lower-leg pain, officially called media tibial stress syndrome, is caused by overuse and repetitive, high-impact activities.
Shin splints are typically felt along the inner edge of the shin bone and are often described as a dull or throbbing pain. Pain from shin splints is usually widespread along the shin, as opposed to pain from a stress fracture, which tends to be pinpoint tenderness at a single location on the shin bone.
When you experience shin splints, you shouldn’t tough it out. Pushing through the pain can make your recovery longer and lead to a stress fracture. The pain usually sets in when you begin physical activity and ends after a period of rest. Swelling or bruising can occur in the affected area, and pain can be worse when you’re standing on your toes or rolling your ankles inward.
If you keep working out with shin splints, you may notice pain starts earlier in your activity and with less intensity.
The pain we feel from shin splints is an inflammation of the muscles, tendons and bone tissues surrounding our shins. Military trainees, runners, dancers, football players and soccer players are all particularly susceptible, but shin splints affect people doing many other activities.
Among the causes and aggravations of shin splints are:
• High-impact exercises like running or jumping
• Weak bones, possibly caused by vitamin D shortage, osteoporosis or an eating disorder
• Steep or hard running surfaces
• Flat feet or other foot problems
• Incorrect form, such as pronation, the tendency to roll your ankles inward while running
• Shoes that lack support
Rest is critical to treat shin splints. Recovery typically takes at least two weeks and can require four or more weeks of downtime. When pain subsides, you should gradually return to activity, and you can ease in with low-impact activities like swimming, biking or water running.
During recovery, apply ice to the sore shin for 15 to 20 minutes, three to six times a day. Always put a barrier, like a towel, between the ice and your skin.
If you need something to alleviate pain, over-the-counter pain relievers can help. Acetaminophen(Tylenol®) and ibuprofen (Motrin®) are among the options available at retail stores.
Shin splints can result from a vitamin D deficiency.
Adding vitamin D3 supplements to your daily routine can help with prevention. Stretching the calves, shins and lower-leg muscles can aid healing and relieve pain. And shoe inserts or custom-made orthotics can reduce injury, especially if you have flat feet.
After two to four weeks of rest, you should return to activity by gauging your pain. You can increase activity gradually, but if pain returns, you should cease activity and seek care to avoid further injury.
If at-home care isn’t providing relief, your doctor may recommend physical therapy or an X-ray or MRI to rule out stress fracture or other injury.
With the proper rest and support, you’ll recovery from shin splints and return to regular activity. But prevention is better than treatment, so take these steps to prevent shin splints:
• Warm up completely before exercise
• Stretch after exercise, especially the lower legs
• Strengthen the lower legs and core muscles
• Gradually increase running intensity and frequency
• Cross train with lower-impact exercises like swimming, biking, rowing or using an elliptical machine
• Replace running shoes every 300 to 500 miles
• Use shoe inserts
As usual, if things are headed in the wrong direction, or aren’t getting better with rest, your healthcare advisor and perhaps a sports medicine specialist is a great resource to engage.
Dr. Alfred Casale, a cardiothoracic surgeon, is chief medical officer for surgical services for Geisinger and chair of the Geisinger Heart and Vascular Institute. Readers may write to him via ae@timesleader.com.
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