Shin SplintI entered the   house after a long walk in the evening and saw my teenage son nursing his lower leg by applying ice.  He was suffering from severe pain on his leg. He burst out on seeing me and cried— “I got shin splints.”

I consoled him and tried to explain him what actually is shin splints.  He forgot his pain and sat near me and listened attentively.

So I started telling him as to What is shin splints?

Shin splits is a popular phrase used for any pain on the lower leg. It is a very common problem faced by runners sometime or the other.  But before jumping to the diagnosis I suggest you must know what exactly is shin splints?

In some cases of shin splints there is inflammation of the connective tissue (fascia)which covers and connects the muscles of the lower leg to tibia.

Now you need to understand the anatomy of the lower leg. The “shins” are a group of muscles and bones that form the front, lower part of your leg.  See, your shin bone is actually known as the tibia bone which is the bigger bone on the lower leg. The other bone is the fibula. These two bones plus the femur bone have several muscles and tissues attached to them at different points and connect them to the foot going across the ankle joint. These many structures connected to each other which tends to become painful on running.

In serious cases of shin splints the connective tissue remains under stress and actually separates itself from the tibia. This condition is very painful and also takes time to heal.

Symptoms of shin splints

How will someone know that there is shin splints. What are the symptoms of shin splints?

The main symptom of shin splint is that there is a sharp or dull pain in one or both legs. It is usually experienced on the front of the shin. A severe pain is felt on pressing on the shin and it increases on exercise.

In mild cases there is tenderness in the lower leg. There is some swelling on the lower edge of the tibia.

In severe cases there is pain while walking as well.

Causes of shin splints

There are two main causes of shin splints:

  1. The first is too much impact to the lower legs, which is primarily created by heel striking. The constant hitting of the ground with your heels will irritate the connective tissue of the tibia. It will then become inflamed and the problem will increase if not corrected in time.

Impact on the lower legs can also occur by using old worn out shoes while running., striking the heel heavily, running on unstable surfaces like ice or snow, and running on a street with a sloping side

  1. The second main cause is overuse of the lower legs while running. Overuse injuries primarily happen when you push off with your toes to propel yourself forward.

Other causes can be

  • Shin splints are usually an exercise problem. Shin splints occur when there is overloading on the leg muscles, tendons or shin.
  • Excessive training or too much activity causes shin splints. Runners, dancers and gymnasts often suffer from this problem because there is a high impact and constant exercise of the lower legs.
  • Shin splits can also be caused by common activities like running up the hills by new runners, increasing the training time.
  • People with flat foot are also prone to shin splits.
  • Shoes that do not fit well also remain the cause of shin splits.
  • Postural problem is another cause, which means that your running posture is not correct and it is causing pressure on the shin
  • Muscle imbalance in the leg is also a reason which is usually a genetic issue that cannot be completely solved.

How to Prevent Shin Splints?

There are certain exercises which are found to be helpful in preventing shin splints. These are some exercises that are designed for strengthening the calves and abductors., These can be any   calf raising and hip abductor strengthening exercises. Some of them are –

  • Clams – Keep the pelvis perpendicular to the floor Make clams movement by moving your knees up and down. Repeat it 20 times
  • Donkey kicks —Go on four on the ground while keeping your abdomen tight and your back flat. Keeping kicking upwards with each leg 15 times without shaking from your position
  • Hip thrusts—Lie flat on your back and keep the top of the body in straight-line. Thrust the lower body upwards with each foot. Repeat 25 times.
  • Eccentric Calf raises—Step down slowly from a step and raise yourself back into the tip toe position with the other leg. Repeat the process 25 times.
  • Pick your foot alternately while standing in one place. In this movement no lower leg muscle is involved. The movement takes place from the knees. The same movement if practiced can be done while walking and eventually while running.

Common sense and also research proves that muscles become more elastic after being warmed up. Hence it is essential to do shin splint stretching should take place as part of a good warm-up. Here are a few splint stretches

  • Stand at arm’s length from a wall. keep your knees and feet straight and with your hands on the wall, lean forward as much as possible.
  • Sit on the floor with your left ankle on the right knee and give pressure on the foot with your hands. Now turn the foot up and in by using the muscles of the leg.
  • Attach some weight (a bucketful of stones or sand) on the foot and sit on the chair or table. Move your legs up and down without bending the knees.
  • Stand with your feet falling flat on the ground. Bend your knees without moving the heels from the ground.

Chi Running technique is the method of running in which the lower legs are used less. It is used only for momentary support between strides. It prevents the overuse of the lower leg.  This method is the best alternate and permanent treatment for shin splits.

The simple activities given below   help in building strength in your lower legs. Start them slowly and with short duration. Give a break if there is any sort of discomfort experienced in the lower legs.

  • Walk down and then back up steep hills slowly.
  • Walk on your toes for about 15 minutes daily.
  • Walk on your heels for another 15 minutes.
  • Walk with your feet turned inward and outward alternately for 10 minutes.
  • Gather up a flat towel on the ground using your toes only.
  • Pick up marbles from the ground by using your toes.

Besides exercises and activities here are a few tips to prevent worsening of shin splints.

  • As we just learnt that overuse of the lower leg is the main cause of shin splints. You must listen to your body and give rest as soon as something hurts the legs.
  • Intense pounding of the heels also lead to shin splits and so athletic insoles can be used to reduce the impact of high impact on the lower leg muscles. These insoles are readily available in shoe stores, sports stores and also in some drug stores.
  • Avoid running on concrete surfaces. Exercises must be done on crushed gravel or grass or on running tracks only.
  • Change your activity after a shin splint. A runner can change his activity to swimming, on the spot cycling or any other activity which will not hurt the lower legs.
  • Running up hills must be surely avoided as it is sure to increase the pain of the shin splint.

Treatment of Shin Splints

You must understand that there is no magic cure for this problem. It may take several weeks to heal and sometimes even months.

Now as you are suffering from pain let me give you some tips and advice on how to take care of your problem.  Start this famous R.I.C.E.R. process which involves –REST, ICE, COMPRESSION, ELEVATION   and REFERRAL within 48 hours of the injury.  It is the best emergency and fast cure for any muscle injury in the body.

Rest

Give rest to your legs and prevent overworking of the muscles and provide time for them to heal. Exertion at this time can worsen the condition. Reduce the movement of the lower legs as far as possible.

Ice

Apply ice on the shin three times a day to reduce inflammation. The best method is to rub an ice cube on the shin for 10 minutes. A frozen bag of peas or corns can also be used for this purpose.

Compression

  • Wrap an elastic bandage on the shin or wear a neoprene sleeve on the lower leg which may support the tissues and provide comfort.
  • You can take two tablets of aspirin or ibuprofen to reduce the pain and swelling of the shin splint.

Elevation

Keep your legs elevated by raising the leg above the heart level as far as possible. This will help in reducing the swelling and bleeding.

Referral

In case the pain is severe and you cannot walk at all and the first four steps give no relief you should consult a doctor.

Most often shin splits are not serious. But if after a few weeks of rest and pain killers the pain does not subside, the pain and swelling on the leg and the shin is becoming red and gives a hot feeling on touching it is increasing day by day, it is essential to see the doctor.  An x-ray may be taken to diagnose that there is no other problem.

Precaution — No Heat!

Avoid massage on the foot and do not apply any heat by heat pads, heat lamps, creams and spas for the first 24- 72 hours. Another thing to remember is to avoid alcohol as they tend to increase the swelling and bleeding of the injury.

Conclusion – Now you know most of the facts of shin splints –its symptoms, causes and treating and preventing methods, I feel you are satisfied will not worry for your problem and take care of it on your own. I am sure you can be good guide to your friends also now.

Always remember the R.I.C.E.R PROCESS of treating muscle pain. And also continue with a few shin stretching exercises regularly.