For lots of runners persistent shin pain, or “shin splints” as it’s known, is a frustrating, but common, concern.
Shin splints symptoms
Symptoms typically occur in one leg (usually the dominant) and cause pain along the medial (inside) shin bone (tibia). Pain may be quite generalised and fluctuate during (and after) activity. Usually the shin is tender to touch along its length, and there might be swelling and palpable lumps also.
How do shin splints occur?
Despite so many athletes, casual runners, and all of us in between, being affected by shin splints there’s still not an agreed pathology or definitive cause.
- Small tears occurring in the muscle attachment to the tibia (“medial tibial stress syndrome”)
- Inflammation of the outer sheath of the bone (periosteum)
- Muscle inflammation
Many sports doctors and therapists believe shin splints is a combination of the above.
Why do shin splints occur?
What is agreed upon though, is that this aggravating condition is an overuse injury, almost always caused by “too much, too soon”. In other words, a result of not building up mileage gradually enough, or a too sudden change in routine (think running surface/terrain/gradient as well as distance).
Biomechanics often play a part, with over-pronation and muscle imbalance/weakness being likely contributors. Take into account also, the excess stress placed on one leg due to cambered roads or running a route in one direction only.
What can I do to “fix” shin splints?
Unfortunately, the first course of treatment is to stop running completely (for a time), or at least decrease running – depending on the duration and extent of the pain.
Consider diversifying with cross-training during this period – swimming and biking are excellent options that won’t overload the affected muscles.
Ice and anti-inflammatories are useful for decreasing inflammation and pain – initially ice for 20-30 minutes every few hours for the first few days.
Stretch the area by kneeling on a mat with the tops of your feet flat on the floor and your buttocks over your heels. Hold for 20-30 seconds. Also stretch the Achilles and calf.
See a physiotherapist to assess your biomechanics. Any muscle imbalance at the ankle/knee/hip can cause changes in loading to the lower leg, and need to be remedied so you can resume running without pain.
A physio can also assist with taping support, that can be worn throughout the day to relieve pain.
Patience is key to recovering from shin splints. With the right treatment it can take three to six weeks to come right, but if adequate rest and rehab isn’t provided it can take as long as six months.
How do I return to running?
When the injured leg is recovered, non-tender to touch, and as flexible and strong as the other, gradually return to running.
Increase mileage slowly – no more than 10 % weekly, and avoid hills and excessively hard surfaces until managing regular runs without symptoms.
Make sure your shoes are suited to your running/activity type and that they are not too worn as this will affect how much support they’re giving you. Orthotics might be worthwhile investigating if over pronation is a problem.
Some runners advocate alternating two pairs of running shoes to vary the stresses on the legs – this may also be worth a try!
See your doctor if symptoms are not improving, to rule out other potential causes of the pain – such as stress fracture or compartment syndrome.