Shin splints are medically known as ‘medial tibial stress syndrome’. Many runners suffer from from shin splints. The term refers to a condition which causes pain and discomfort on the inner border of the shin bone.
The lower leg is composed of two bones – the tibia (shin bone) and the smaller fibula. Muscles attaching to the inside of the tibia run down behind the inside of the ankle and under the arch of the foot. These muscles may be subjected to repeated excessive stress and they may tug at their attachment on to the shin bone. This repetitive micro-trauma produces microscopic tears of the muscle and/or minute injuries to the bone resulting in inflammation, soar tissue and pain.
In the initial stages of shin splints, pain is experienced at the beginning of the run, disappears during and returns after the run. As the injury becomes more severe, the discomfort may last longer into the run and eventually persist into daily activities. A word of warning – pain on the inside of the shin may occasionally be due to a stress fracture. In this case, there will be more a localised painful lump on the bone itself. The pain comes sooner, is more severe and lasts longer, until it eventually becomes continuous. The treatment for this is quite different to shin splints.
All these factors are made worse by the repetitive high impact experienced by the feet during running. It is interesting to note that with each stride, the runners leg absorbs 2-3 times their body weight.
Causes of shin splints
1. Flat Feet
Medically termed over pronation. Flattening of the arch over-stretches the muscles described, because these muscles support the arch, they become stressed if they are tight. These muscles can also be strained by having to work extra hard to keep the arch of the foot up.
Flat feet may be due to:
- Genetics. A great deal of people are born with a tendency to flat feet.
- Inadequate arch support in running shoes, allowing the foot to roll in or flatten.
- Hard running surfaces provide less “give’ and support for the arch. They also increase the shock absorbed by the legs.
2. Certain training factors
- A rapid increase in training pace or distance, results in the overuse of shin muscles.
- Running frequently on slopes (road cambers) or hills can cause the foot to roll in resulting in flattening of the arch.
3. Tight calves
4. Weak muscles that support the arch
Prevention
- Correct footwear, orthotic devices (if flat footed)
- Run on softer surfaces wherever possible
- Avoid rapid changes in distance, speed and running surfaces
- Avoid frequent running on slopes
Treatment
- Rest – allow time for healing and reduction of inflammation
- Icing – reduces the inflammation and pain
- Massage – deep tissue massage helps break down scar tissue and frees up tight muscles.
- Anti-inflammatory treatment – ultra-sound and/or medication
- Biomechanical correction of over pronation via orthotic devices and/or appropriate running shoes
- Specific strengthening of muscles that support the arch
- Stretching – regular stretching of calf muscles. NB: Prolonged stretches 30 seconds – no bouncing)
Calf stretching
1. Feet pointing forwards
- Back Straight
- Lunge forward with knee bent
- Heel remains on ground
2. Same position as above Knee Is Straight