People who use exercises which involve running, jumping or even aggressive walking as part of a workout routine are at risk of a common injury called shin splints. As trainers we hear the term used fairly regularly, in fact we often use it ourselves to describe pain located along the tibia (the large bone at the front of your lower leg). While many people do experience shin splints most people do not understand what causes the pain or how to treat the condition. Shin splints can put you out of action for weeks or months if aggressive enough, but never fear most cases of shin splints can be treated with rest, ice and a few self-care methods.
What Are Shin Splints?
The term shin splints is used to describe a variety of generalised pain that occurs on the bone of the lower leg, but it actually refers to Medial Tibial Stress Syndrome (MTSS). Medial Tibial Stress Syndrome is the result of repeated stress or force on the bones (tibia and fibula), muscles and tendons present in the lower leg area. The bones, muscles and tendons become fatigued and traumatised as they endure to keep the foot, ankle and lower leg stable during activity.
What Causes Shins Splints?
There are many causes of shins splints, however they all can be categorised into two main groups: Overload and Biomechanical Inefficiencies.
Shin splints due to Overload include:
- Exercising on hard surfaces
- Exercising on uneven ground
- Beginning an exercise program without adequate preparation or recovery
- Increasing the intensity or duration of exercise too quickly
- Exercising in worn out or ill-fitting shoes
- Excessive uphill or downhill running.
Overload can be described as the repeated impact force associated with the activity of running or jumping. Shin splints does not necessarily come from excessive weight bearing activity like running but the repeated shock that reverberates through the lower leg during landing or change of direction. When the muscles become fatigued their ability to absorb shock diminishes increasing the risk of shin splints.
The main biomechanical inefficiency attributing to shin splints is foot type. Those with flat feet or high arches are prone to developing shins splints more than a neutral foot type. Unfortunately rest and ice are not the only answer when it comes to biomechanical inefficiencies and here is why:
Overpronation (Flat Foot Type): During weight bearing activity the force of landing causes the arch of the foot to collapse. Repeated force can result in the muscle starting to detach from the tibia causing pain the lower inside of the leg. For a foot that over pronates it is important that you train in a shoe that maintains your stability. Look for shoes that has a rigid sole from toe to heel, this type of shoe will encourage “motion control” but keep in mind that some overpronators need to use orthotics to help minimise instability during activity.
Underpronation (High Arch type): The high arch means that the foot rolls out during landing and is therefore poor at absorbing shock. The jarring forces of landing are transferred up the leg, and long term this can produce hairline fractures. A foot that underpronates needs shock absorption so you must wear a shoe that it flexible with a soft midsole to take up landing forces.
Biomechanical Inefficiencies can also include:
- Poor running mechanics
- Tight, stiff muscles in the lower leg
- Running which an excessive forward lean
- Running with an excessive backwards lean
- Landing on the balls of your feet
- Running with your toes pointed outwards
How to Prevent Shin Splints?
As we have just seen, having an overpronating or underpronating foot type can increase your risk of developing shin splints so it is important to get the right advice on footwear. Good quality footwear can go a long way in preventing shin splints so get properly fitted by a competent footwear sales person (Athletes Foot provide well trained staff).
Thorough stretching and warming up before activity is crucial for injury prevention. Stiff and tight muscles can be easily pushed beyond their natural range of motion so by warming up you ensure that the body is supple and ready to perform. Inadequate preparation can and does result in injury.
Rest and ice can sometimes be all you need with general shin soreness. Make sure you give yourself 48 to 72 hours between runs or other weight bearing activity so to allow adequate recovery for the muscles and tendons in the lower leg. Applying ice to the bottom half of the lower leg for 10 minutes after activity can reduce any swelling and also encourage proper recovery.
Remember prevention is better than cure so I encourage you to look after yourself when you exercise to ensure that you do not have to take a break from training for a prolonged period of time.