Shin Splints

Treatment

The immediate treatment for shin splints is rest. Running and other strenuous lower limb activities, like football and other sports which include flexing the muscle, should be avoided until the pain subsides and is no longer elicited by activity. Furthermore, the lower legs may be taped to stabilize and take some load off the periosteum. Finally, using good shoes is important.

In many cases one is able to continue training with a mild case of shin splints. Time off from running may be required in severe cases. In such cases rest and ice would be needed to decrease inflammation. For the milder, yet painful cases, in which running can be maintained, certain treatment methods must be followed through.

Anti-inflammatory medications such as I-B Propfin should be taken one hour before starting practice. Just before practice the affected area should be heated up. The use of hot towels, heat pack or whirlpool for 15-20 minutes should do the trick. This will help loosen up the area as well as providing comfort but will not solve the problem. Discovering the cause is the first step in treating an injury.

The changing of shoe may be necessary as well. Stretching prior to running will be beneficial. Training on soft surfaces will help alleviate excessive pounding. Precaution should be made to running on uneven surfaces which could result in increased foot motion, a matter you are trying to correct. Once the workout is completed and after a good cool down, ice the affected area as soon as possible for 20 minutes. Plastic cups filled with water and placed in the freezer as well as baggies of ice work well. Normally, continued running, even if it is reduced, will help get rid of shin splints as running will help strengthen leg muscles. A friction massage using the thumbs may prove to be beneficial. Firmly rub the affected area from the bottom of the leg upward.

Acute treatment

The immediate treatment for shin splints is rest. Running and other strenuous lower limb activities, like football and other sports which include flexing the muscle, should be avoided until the pain subsides and is no longer elicited by activity. In conjunction with rest, anti-inflammatory treatments such as icing and drugs such as NSAIDs (in particular, NSAID gel) may be suggested by a doctor or athletic trainer. Over-the-counter pain relievers can also be taken, though there is some controversy over their effectiveness. Furthermore, the lower legs may be taped to stabilize and take some load off the periosteum. Finally, using good shoes (ideally compensating for individual foot differences) is important. The shin can be trained for greater static and dynamic flexibility through adaptation, which will diminish the contracting reflex, and allow the muscles to handle the rapid stretch. The key to this is to stretch the shins regularly. However, static stretching might not be enough. To adapt a muscle to rapid, eccentric contraction, it has to acquire greater dynamic flexibility as well. One way to work on the dynamic flexibility of the anterior shin is to subject it to exaggerated stress, in a controlled way, such as walking on the heels. If the muscle is regularly subject to an even greater dynamic, eccentric contraction than during the intended exercise, it will become more capable of handling the ordinary amount of stress. Experienced long-distance runners practice controlled downhill running as a part of training, which places greater eccentric loads on the quadriceps as well as on the shins. A physical therapist, athletic trainer, or doctor should be consulted before engaging in this type of training.

Nutrition

Although typically proper nutrition is associated with other types of injuries (stress fractures particularly), shin splints can be greatly improved with a few simple dietary changes. One thing that will help to build strong and durable shins is proper intake of calcium. Another is a diet high in protein, to assist in building and repairing muscle.

Long-term treatment

The long-term remedy for muscle-related pain in the shin is a change in the running style to eliminate the overstriding and heavy heel strike.

Sprinting is performed on the toes, as is some middle-distance running. In most middle to long-distance running, striking with the heel, rolling through the foot and pushing off the ball is the most efficient. Competitive runners vary in styles, but as distance increases, more runners tend towards striking with the heel or mid-foot as the natural gait of the body - most marathoners can be seen to strike with the heel.^[3] Striking solely with the forefoot over distance focuses stress on the calves and underuses the hamstrings. Moreover in preventing shin-splints, heel-striking offers the best shock absorption and natural form, reducing impact stress on the calf and shin muscles.^[4]